5th canadian obesity summit€¦ · as well as over 25 hours of cpd accredited programming to help...

1 | 5th Canadian Obesity Summit | #COS17

5th CanadianObesity Summit

FAIRMONT BANFF SPRINGSBANFF, ALBERTA

APRIL 26–28, 2017Pre-conference workshops April 25

con-obesitysummit.ca#COS17

REPORT CARD ON ACCESS TOOBESITY TREATMENT FOR ADULTS IN CANADA 2017Obesity is a chronic disease that impacts the lives of millions of Canadians. But, how well are we doing at treating obesity in Canada? The Canadian Obesity Network has now examined access to publicly provided medical care for adults with obesity, including interventions covered by private health benefit plans.

Full report, methodology and additional findings are available at: www.obesitynetwork.ca/reportcard

Table of Contents

Message from the Minister of Health ...................................................................................................................... 4

Message from the CON Board of Director, Science Chair & Accreditation Statement ........................................... 5

CON-RCO Board of Directors & CON Public Engagement Committee ................................................................. 6

CON-RCO Science Committee / Organizing Committee & Abstract Reviewers .................................................... 7

Venue / Hotel Floorplans ......................................................................................................................................... 9

Awards & Grants .................................................................................................................................................... 11

Exhibition ............................................................................................................................................................... 12

Conference App .................................................................................................................................................... 13

Social Events ......................................................................................................................................................... 14

Group Exercise Opportunities ............................................................................................................................... 15

General Information .............................................................................................................................................. 16

Schedule at A Glance ............................................................................................................................................ 19

Satellite Meetings .................................................................................................................................................. 23

Workshops ............................................................................................................................................................. 24

Lunch Symposium ................................................................................................................................................. 30

Mini-Review Session Details .................................................................................................................................. 32

Pecha Kucha Session Details ................................................................................................................................. 53

Concurrent Oral Session Details ............................................................................................................................ 56

Poster Presentations .............................................................................................................................................. 63

Abstract Details ..................................................................................................................................................... 66

Thank you to our Sponsors! ................................................................................................................................. 111


Message from CON Science Chair & Scientific Director

A message from Dr. Gordon A. Zello, Chair, Canadian Obesity Network Science Committee & Dr. Arya M. Sharma, Scientific Director, Canadian Obesity Network

Welcome to the Canadian Obesity Network’s 5th national interdisciplinary conference on obesity prevention, management and treatment.

Representing over 15,000 health professionals, researchers, policy makers, and other obesity stakeholders, as well as 15,000 public support-ers, CON-RCO’s mission is to improve the lives of Canadian affected by obesity through the advancement of anti-discrimination, prevention, and treatment efforts.

The 5th Canadian Obesity Summit will once again welcome Canada’s best researchers and health professionals from across disciplines for three days of plenary talks, Pecha Kucha sessions, original research and workshops, as well as over 25 hours of CPD accredited programming to help you support people living with obesity.

In our continued efforts to improve access to respectful, compassionate and evidence-based obesity prevention and treatment in Canada, CON-RCO will also present the first Report Card on Access to Obesity Treatment for Adults in Canada. The report card shows that there are significant inequities in ac-cess to obesity care in Canada and we have much more work ahead of us.

On behalf of the CON-RCO Scientific Committee it is our pleasure to welcome you to this exciting event.

Gordon A. Zello, PhDChair, Science Committee,Canadian Obesity NetworkProfessor, Nutrition and DieteticsCollege of Pharmacy and NutritionUniversity of Saskatchewan

Arya M. Sharma, MD/PhD, FRCPCScientific Director, Canadian Obesity NetworkProfessor, Faculty of Medicine,Chair holder for Obesity Research and ManagementUniversity of Alberta

AccreditationThe Canadian Obesity Summit is accredited!

By attending this program, you are eligible for 4.0 SCOPE points. SCOPE is an internationally-acclaimed obesity education program that helps health profes-sionals understand obesity and how to treat, management and prevent it. You can find more information about SCOPE at www.worldobesity.org/scope.

This program is also Continuing Professional Development (CPD) certified This learning activity has reached the required Continuing Professional Devel-opment standards and benchmarks. The learning value has been scrutinised to ensure integrity and quality. The CPD Certification Service provides recognised independent CPD accreditation compatible with global CPD requirements.


CON-RCO Board of Directors

CON Public Engagement Committee

Kelly Isfan Chair, Board of DirectorsPresident, CEO and Privacy Officer, Norfolk General Hospital & West Haldimand General Hospital Simcoe, ON

Arya M. Sharma, MD/PhD, FRCPCScientific Director, Professor, Faculty of Medicine Chair holder Obesity Research & Management, University of Alberta, Edmonton, AB

Feria Bacchus, MHScVice President, Sales & Marketing NRC Picker Canada Toronto, ON

Mary-Ellen Harper, PhDProfessor, Mitochrondrial Bioenergetics Laboratory, Department of Biochemistry, Faculty of Medicine, University of Ottawa,Ottawa, ON

Bemal MehtaVice President, Energy Intelligence June Warren-Nickle, Energy GroupCalgary, AB

Eva Pila, PhD CandidateCo-Chair CON-SNP National Executive University of Toronto, Toronto, ON

Chandra RamasamyVice President, Operations of Graycon Group, a division of Ricoh Canada Inc., Calgary, AB

David SutherlandCore Consulting Capacity CoordinatorFort Albany First NationsFort Albany, ON

Gordon Zello, PhD, MScProfessor, Nutrition Assistant Dean, Division of Nutrition & Dietetics University of Saskatchewan, Saskatoon, SK

Marty Enokson Chair, Edmonton, AB

Ian Patton Vice-Chair, Toronto, ON

Adrianna O’Regan Edmonton, AB

Jodi Krah Science Committee Representative, Fonthill, ON

Ryan DrummondEdmonton, AB

Kelly Moen Victoria, BC

Alex Schwarzer Edmonton, AB

Katherine TaylorHamilton, ON

Lisa SchafferVancouver, BC

Brenndon GoodmanToronto, ON


Dr. Geeta Achyuthan, Regina, SK

Ms. Allison Barnett, Dunnville, ON

Ms. Alexandra Cooke, Montreal, QC

Dr. Laurent Biertho, Quebec, QC

Ms. Alexa Ferdinands, Edmonton, AB

Ms. Melissa Fernandez, Laval, QC

Ms. Maylene Fong, Vancouver, BC

Dr. Mary Forhan, Edmonton, AB

Dr. Lise Gauvin, Montreal, QC

Dr. Hasan Hutchinson, Toronto, ON

Dr. Ian Janssen, Kingston, ON

Ms. Thiru Kanagasabai, Montreal, QC

Ms. Jodi Krah, Toronto, ON

Dr. David Lau, Calgary, AB

Ms. Allana LeBlanc, Ottawa, ON

Ms. Rebecca Liu, London, ON

Dr. David Macklin, Toronto, ON

Dr. Priya Manjoo, Vancouver, BC

Ms. Jennifer McConnell-Nzunga, Victoria, BC

Dr. Jonathan McGavock, Winnipeg, MB

Ms. Maxine Myre, Edmonton, AB

Ms. Eva Pila, Toronto, ON

Ms. Amanda Raffoul, Waterloo, ON

Dr. Robert Ross, Kingston, ON

Ms. Aaryn Secker, Niagara Falls, ON

Dr. Arya Sharma, Edmonton, AB

Ms. Corrie Vincent, Ottawa, ON

Dr. Shahebina Walji, Calgary, AB

Dr. Gordon Zello, Saskatoon, SK

Dr. Geeta Achyuthan, Regina, SK

Dr. Kristi Adamo, Ottawa, ON

Dr. Angela Alberga, Montreal, QC

Dr. Chris Ardern, Toronto, ON

Dr. Stephanie Atkinson, Hamilton, ON

Ms. Allison Barnett, Toronto, ON

Dr. Laurent Biertho, Quebec, QC

Dr. Daniel Birch, Edmonton, AB

Dr. Normand Boulé, Edmonton, AB

Dr. Denise Campbell-Scherer, Edmonton, AB

Dr. Tony Chett, Hamilton, ON

Dr. William Colmers, Edmonton, AB

Ms. Alexandra Cooke, Montreal, QC

Dr. Alain Dagher, Montreal, QC

Dr. Eric Doucet, Ottawa, ON

Ms. Alexa Ferdinands, Edmonton, AB

Ms. Melissa Fernandez, Laval, QC

Ms. Maylene Fong, Vancouver, BC

Dr. Mary Forhan, Edmonton, AB

Dr. Michel Gagner, Montreal, QC

Dr. Lise Gauvin, Montreal, QC

Mr. Steven Glazer, Toronto, ON

Dr. Andrea Haqq, Edmonton, AB

Ms. Dawn Hatanaka, Mississauga, ON

Dr. Hasan Hutchinson, Ottawa, ON

Ms. Sarah Hutchison, Victoria, BC

Dr. Pascal Imbeault, Ottawa, ON

Dr. Ian Janssen, Kingston, ON

Ms. Susan Jelinski, Calgary, AB

Dr. Shahzeer Karmali, Edmonton, AB

Dr. Thirumagal Kanagasabai, Montreal, QC

Ms. Maryam Kebbe, Edmonton, AB

Dr. Sara Kirk, Halifax, NS

Ms. Jodi Krah, Fonthill, ON

Dr. Jennifer Kuk, Toronto, ON

Dr. Marie-France Langlois, Sherbrooke, QC

Dr. David Lau, Calgary, AB

Ms. Allana Leblanc, Ottawa, ON

Dr. Jian (Jason) Liu, St. Catharines, ON

Mr. Michael Lyon, Vancouver, BC

Mr. David Macklin, Toronto, ON

Ms. Priya Manjoo, Victoria, BC

Ms. Jennifer McConnell-Nzunga, Victoria, BC

Dr. Jonathan McGavock, Winnipeg, MN

Dr. Kathrine Morrison, Hamilton, ON

Ms. Maxine Myre, Edmonton, AB

Dr. Helena Piccinini-Vallis, Halifax, NS

Ms. Eva Pila, Toronto, ON

Dr. Carla Prado, Edmonton, AB

Dr. Denis Prud’homme, Ottawa, ON

Ms. Amanda Raffoul, Waterloo, ON

Dr. Sandeep Raha, Hamilton, ON

Ms. Ximena Ramos Salas, Edmonton, AB

Dr. Laurene Rehman, Halifax, NS

Dr. Denis Richard, Quebec, QC

Dr. Robert Ross, Kingston, ON

Ms. Aaryn Secker, St. Catherines, ON

Dr. Arya Sharma, Edmonton, AB

Dr. Sanjeev Sockalingam, Toronto, ON

Dr. Guang Sun, St. John’s, NL

Dr. Laurie Twells, St. John’s, NL

Dr. Corrie Vincent, Toronto, ON

Dr. Gordon Zello, Saskatoon, SK

CON-RCO Science Committee / Organizing Committee

Abstract Reviewers

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Revised and approved by


Conference Secretariat

MCI Group Canada Inc.

200 – 1444 Alberni Street

Vancouver, BC V6G 2Z4

CANADA

Tel.: +1.604.688.9655

Fax: +1.604.685.3521

Email: [email protected]

http://www.con-obesitysummit.ca/

Disclaimer

All reasonable endeavors will be made to hold the 5th Canadian Obesity Summit and to present the printed program as scheduled

under circumstances which assure the comfort and safety of the Conference Participants. However, the Canadian Obesity Network and

its branches, and their respective directors, officers, employees, representatives or agents, shall not be liable in any manner whatever to

any person as a result of the cancellation of the Conference or any of the arrangements, programs or events connected therewith; nor

shall any of the foregoing entities or persons be liable in any manner whatever for any loss, injury, damage or inconvenience which may

be suffered by any person while travelling to or from, or during such person’s presence in, Canada in connection with the Conference.

Participants are advised to consider procuring their own insurance against any such occurrences.

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First Floor

Second Floor

Nester’sFoodstore

RetailRetail

Retail

Retail

Data Group

Theatre

TheatreLobby

Bowling Centre

Kitchen Preparation Area

Van Horne Ballroom

Van Horne Foyer

N.R.Crump

President’sHallFoyer

Ground-Level Entranceto Conference Centre

Courtyard

BaronShaughnessy

Sir EdwardBeatty

D.C.Coleman

President’s Hall

ABC

Garden Terrace

Alberta Room

To Garden Terrace

Conservatory

RiverviewLounge

CascadeBallroom

NewBrunswick

Room

OvalRoom

Staircase toMeeting Rooms

Down to Mt. Stephen Hall

and Banff Springs Shops

Open to Mt. Stephen Hall below

StrathconaRoom

AngusRoom

GrapesWine Bar

Rundle Lounge

Lacombe Room

Empress Room

PalliserRoom

IvorPetrakRoomElevators

Spanish Walk

Foyer

Alhambra Room

Curio Foyer

Up to M

ezzanine 2

Grand Staircasedown to Lobby Level


Upper Bow Valley Terrace

Garden Terrace

Bow Valley GrillThe Banffshire Club

CourtyardMt. Stephen HallHeritage Hall

Rundle Hall

OakRoom

Norquay RoomGuest Rooms 150s

Elevators WilliamWallaceRoom

McKenzie Room

ChamplainRoom

FrontenacRoom

Venue / Hotel Floorplans

Mezzanine II Mezzanine I


First Floor

Second Floor

Nester’sFoodstore

RetailRetail

Retail

Retail

Data Group

Theatre

TheatreLobby

Bowling Centre

Kitchen Preparation Area

Van Horne Ballroom

Van Horne Foyer

N.R.Crump

President’sHallFoyer

Ground-Level Entranceto Conference Centre

Courtyard

BaronShaughnessy

Sir EdwardBeatty

D.C.Coleman

President’s Hall

ABC

Garden Terrace

Alberta Room

To Garden Terrace

Conservatory

RiverviewLounge

CascadeBallroom

NewBrunswick

Room

OvalRoom

Staircase toMeeting Rooms

Down to Mt. Stephen Hall

and Banff Springs Shops

Open to Mt. Stephen Hall below

StrathconaRoom

AngusRoom

GrapesWine Bar

Rundle Lounge

Lacombe Room

Empress Room

PalliserRoom

IvorPetrakRoomElevators

Spanish Walk

Foyer

Alhambra Room

Curio Foyer

Up to M

ezzanine 2



Upper Bow Valley Terrace

Garden Terrace

Bow Valley GrillThe Banffshire Club

CourtyardMt. Stephen HallHeritage Hall

Rundle Hall

OakRoom

Norquay RoomGuest Rooms 150s

Elevators WilliamWallaceRoom

McKenzie Room

ChamplainRoom

FrontenacRoom

Conference CentreFollow us on Social Media!

#COS17

www.youtube.com/user/ canadianobesity

Canadian Obesity Network-Réseau canadien en obésité (CON-RCO)

Venue / Hotel Floorplans


CON-RCO Distinguished Lecturer Award The CON-RCO Distinguished Lecturer Award will be presented in recognition of outstanding contributions to the obesity research community in Canada. The recipient will be announced at the opening ceremonies of the Canadian Obesity Summit, and will deliver a keynote address.

TOPS New Investigator Research Award This award recognizes an individual for a singular achievement or their career contributions to research in the field of obesity. This award is made possible through an annual grant from the Take Off Pounds Sensibly (TOPS). The award recipient will receive a plaque, a $2,500 prize, and a travel grant to attend the Canadian Obesity Summit. The award will be presented during the closing ceremonies at which the recipient will be invited to present the TOPS New Investigator Research Award Lecture. Award recipients must be able to attend the Canadian Obesity Summit.

CON-SNP Rising Star This award recognizes an individual who has promoted the work of CON-SNP through individual work, Chapter initiatives, mentoring SNPs, speaking at CON or CON-SNP events, helping CON-SNP chapters or other similar activities.

CON-SNP Champion Award This award recognizes an active CON-SNP chapter (or individual who belongs to a CON-SNP chapter) who has promoted the work of CON-SNP.

CON-SNP Faculty Supervisor Award This award aims to reward and recognize a faculty member who has demonstrated excellence in their teaching, research and service to the University, community and their trainees (students, clinical or post-doctoral fellows). This award also recognizes a faculty member who has excelled in nurturing trainee research development in his/her discipline, who has demonstrated outstanding teaching abilities and who exhibits a passion and enthusiasm for teaching and learning.

Student Poster and Oral Awards The best student poster and oral presentations will be awarded cash prizes at the Canadian Obesity Summit. The decision will be made by a board of referees and the awards will be presented at the closing ceremonies on Friday April 28th.

Awards & Grants


The serious solution for weight management.

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EXHIBITION(Riverview Lounge, Cascade Room / Main Hotel Level M2)

DATE TIME

Tuesday, April 25 06:30 – 20:30 (Welcome Reception)

Exhibit Area Hours Wednesday, April 26 09:30 – 16:30

Thursday, April 27 09:30 – 16:30

Friday, April 28 09:30 – 16:30

EXHIBIT COMPANy/ORGANIZATION BOOTH # EXHIBIT COMPANy/ORGANIZATION BOOTH #

VitalAire 1 SECA 11

Ideal Protein/ Laboratoires COP, Inc. 2 Obesinov 12

Valeant Canada 3 Alberta Health Services SN-OBN 13

Natural Factors – PGX 4 Healthy Together 14

Dairy Farmer of Canada 5 Respiratory Homecare Solutions 15

Nestle – Health Science 6 Take Off Pounds Sensibly – TOPS 16

Novo Nordisk 7/8 Celebrate Vitamins 17

Inbody Canada 9 American Board of Obesity Medicine 18

Weight Watchers Canada 10 Canadian Obesity Network 19/20

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Scan to download

Available for

5th Canadian Obesity Summit

Stay engaged and download the o�cial COS 2017 Summit App to your iOS or Android mobile phone or tablet!

Instantly access

√ Latest program updates√ Speaker bio’s√ Schedule and exhibitor info√ Venue map and more

Download the Summit App TODAY!


Social Events

Welcome Networking Reception

Tuesday, April 25th

18:30 – 20:30

Riverview Lounge and Foyer

The Canadian Obesity Summit Commit-tee invites all delegates to the COS 2017 Welcome Reception. Join us for a great opportunity to meet colleagues, network and visit the exhibitors.

Summit Social – Bowling Alley

Tuesday, April 25th

20:30

Fairmount

(optional social event organized by CON-SNP National Executive) Participants attending the networking reception are encouraged to come keep the networking going and participate in some friendly bowl-ing. Come meet your hosts, the CON-SNP National Executive, in the Fairmont Bowling Alley (optional food and drink available).

Summit Reception with PEC Members

Wednesday, April 26th

17:30 – 18:30

Conservatory

End the day with an opportunity for informal networking with members of the Public Engagement Committee. Open to all conference delegates.

Summit Social – Wild Bill’s

Wednesday, April 26th

20:30

Wild Bill’s Legendary Saloon, Town

Centre Bldg, 201 Banff Ave | 2nd Floor

(optional social event organized by CON SNP National Executive) Meet in the Fair-mont lobby at 8pm to walk together to the Wild Bill’s Legendary Saloon, a lively venue offering live entertainment, spacious dance floor and bars; a perfect evening spot to mingle with friends and have fun!

Summit Reception with SNP Leadership

Thursday, April 27th

17:30 – 18:30

Conservatory

Take a break from scientific sessions to par-ticipate in an interactive networking meet-ing. Meet the CON National Student and New Professional Executive Committee and discover what our university chapters have been up to this year. You will have the opportunity to connect with researchers, professionals and students from all over the country. Come to decompress, socialize and make new contacts at our “speed-net-working” event. Don’t forget your business cards! This event is open to all conference delegates.

Summit Social – Rose & Crown

Thursday, April 27th

20:30

Rose & Crown, 202 Banff Ave

(optional dinner & social event organized by CON-SNP National Executive) Meet in the Fairmont lobby at 8pm to walk togeth-er to the Rose & Crown, a laid-back hang-out offering cocktails, brews & pub grub, with a rooftop patio & nightly live bands.

Summit Closing Ceremonies & Awards

Friday, April 28th

17:30 – 18:30

Conservatory

Find out who is this year’s TOPS New Investigator Award winner. All award winners will be announced and prizes will be delivered.

Summit Social – Hoodoo Lounge

Friday, April 28th

20:30

Hoodoo Lounge, 137 Banff Avenue

(optional social event organized by CON-SNP National Executive) Meet in the Fairmont lobby at 8pm to walk together to downtown Banff to eat then meet for dancing at the Hoodoo Lounge. Mention the “Canadian Obesity Summit” for “no line, no cover” before 10:30 pm.


Group Exercise OpportunitiesNo previous experience or special equipment required. Offer on a first come, first served basis.

Pre-conference:MONDAy RuN CLuB – hosted by lululemon: Every Monday at 7:00 pm, anyone and everyone is welcome to join! Meet at the lululemon store (121 Banff Ave, Banff, AB) for 7pm and run around the town of Banff. The distance is totally personal and people are able to take it at their own pace without feeling stressed or completely out of their comfort zone.

During the conference:

WEDNESDAy, APRIl 26, 2017

06:30 – 07:30 WALKING GROuP & RuNNING GROuP – hosted by CON-SNP: Whether you are an avid runner/walker or just hoping to get some cardio in to start your day please join us in the Fairmont hotel lobby dressed for the weather for a route approximately 60 min in length.

MINDFuLNESS WORKSHOP AND yOGA WITH TRISH HuSTON – hosted by lululemon: Meet in the NR Crump Room dressed to exercise. Trish is a registered yoga and meditation teacher. She is curious about how we can continue to be conscious and aware amidst the distractions we constantly face. Trish can share best practices about how to focus on the end goal while not burning out on a daily basis. For more information on Trish, visit her website at www.trishhuston.com

THuRSDAy, APRIl 27, 2017

06:30 – 07:30 WALKING GROuP & RuNNING GROuP – hosted by CON-SNP: Whether you are an avid runner/walker or just hoping to get some cardio in to start your day please join us in the Fairmont hotel lobby dressed for the weather for a route approximately 60 min in length.

06:30 – 07:30 HATHA yOGA – hosted by Gillian Mandich: Meet in NR Crump room dressed to exercise. What a great way to start the day - wake up and join Gillian for an invigorating morning Hatha yoga practice! Sunrise yoga is designed for everyone – from beginners to ad-vanced – and will develop stamina, strength, and balance though its focus on developing proper alignment, breathing techniques, and body awareness. This class will get your blood flowing, improve focus and alertness, as well as energize your mind and body!

18:45 – 19:45 BOXFIT CLASS WITH JAKE WATSON – hosted by lululemon: Meet in the NR Crump Room dressed to exercise. Jake is a strength coach, certified exercise physiologist and accredited Kinesiologist. Jake will lead a introductory style class to boxing.

FRIDAy, APRIl 28, 2017

07:00 – 08:00 HHIIT/ABS – hosted by Rebecca Liu: Meet in NR Crump and spend 30 minutes working on your agility, strength, and cardio endur-ance with a HIIT sports-inspired workout. Whether you are a beginner or a pro, this class is for everyone. Follow-up with 30 minutes of strengthening your core. Improve your technique with body weight exercises like crunches, and hovers; finish off with some hip, butt, and lower back exercises.

13:00 – 14:00 THERAPuTIC yOGA WITH KAIT AND KATIE – hosted by lululemon: Meet in the NR Crump Room dressed to exercise.Katie and Katie are both 200 hour certified Yoga instructors. Gaining their certificates in Goa, India and in Banff, Alberta, Kait and Katie will lead a therapeutic yoga class focusing on targeting the connective tissues and muscles in the body to help you on the path to a healthier lifestyle. Come learn movements you can take at your own pace and take home with you!

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07:00 - 08:00

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General Information

Conference Dates and Venue

April 26–28, 2017

Fairmont Banff Springs Hotel

405 Spray Avenue

Banff, Alberta

T1L 1J4

Tel.: +1. 403.762.2211

Toll Free: +1.800.257.7544

http://www.fairmont.com/banff-springs/

Access/Security

Names badges will be provided to all attendees, sponsors and exhibitors and will be available for pick up at the 5th Canadian Obesity

Summit Registration Desk, in the Curio Foyer. Please wear your badge at all times as it is your admission to all conference sessions, the ex-

hibit area, and non-ticketed social events. There is a $60 CAD reprint fee for any lost or misplaced name badge.

Conference Language

The official language of the 5th Canadian Obesity Summit is English. All sessions will be conducted in English.

Exhibit Area Hours:

The Exhibits are located in the Riverview Lounge and will be open at the following times:

Wednesday, April 26: 9:30 – 16:30

Thursday, April 27: 9:30 – 16:30

Friday, April 28: 9:30 – 16:30

Lost Property

Please report any lost or unattended items immediately to the Registration Desk located in the Curio Foyer. Should you lose anything while

at the conference, please enquire at the Registration Desk where any recovered lost property will be held. At the end of the conference, all

unclaimed lost and found items will be given to the Fairmont Banff Springs Hotel.

Parking

The hotel’s parking is located beside the Convention Center. It is a three-level roofed parkade with 415 parking spaces:

Self-parking: $25 CAD/night, with unlimited access

Valet service is also available: $39 CAD/night, with unlimited access

Electric Vehicles - complimentary

Fairmont Banff Springs along with Sun Country Highway Ltd, a manufacturer of electric vehicle charging stations has installed Banff’s

first electric vehicle charging station, in the hotel’s parkade. Fairmont Banff Springs is pleased to offer complimentary self parking and

complimentary charging for all electric vehicles of our guests.

Photographer

An official photographer will be present during the conference. By registering for the 5th Canadian Obesity Summit, you agree to have your

picture taken. Photography may be used for marketing purposes for future conference events.


Health Breaks & Lunch

Tuesday, April 25

10:00 – 10:30 AM Health Break Conservatory

12:00 – 13:00 Lunch Conservatory

14:30 – 15:00 PM Health Break Conservatory

Wednesday, April 26

09:30 – 10:00 AM Health Break Riverview Lounge

11:30 – 13:30 Lunch Symposium – Novo Nordisk Van Horne A&B

11:30 –14:00 Lunch Riverview Lounge

16:00 – 16:30 PM Health Break Riverview Lounge

Thursday, April 27


11:30 – 13:00 Lunch Symposium – Almased Van Horne A&B

11:30 –13:00 Lunch Symposium – Valeant Van Horne C

11:30 – 14:00 Lunch Riverview Lounge


Friday, April 28


11:30 – 13:30 Lunch Symposium – PGX Van Horne A&B

11:30 – 13:30 Lunch Symposium – Dairy Farmers Van Horne C

11:30 – 14:00 Lunch Riverview Lounge


Registration Desk

The Registration Desk is located in the Curio Foyer and will be open during the following times:

Monday, April 24 .................07:30 – 18:00

Tuesday, April 25 .................07:30 – 21:00

Wednesday, April 26 ...........07:30 – 18:00

Thursday, April 27 ................07:30 – 18:00

Friday, April 28 .....................07:30 – 18:00

Registration Desk Phone number: 403 760 6074

Smoking Policy

The Fairmont Banff Springs Hotel is a non-smoking venue. Attendees must refrain from smoking or using electronic smoking devices (includ-

ing electronic vapors) in all Session Rooms and Ballrooms. Smoking is also prohibited within customer service areas of food and/or liquor

establishments (indoor or open patios).

WIFI

Complimentary wireless internet is included in the conference areas.

Network Name: Fairmont Meeting

Password: COS2017


Conference Secretariat

MCI Group Canada Inc.

200 – 1444 Alberni Street

Vancouver, BC V6G 2Z4

CANADA

Tel.: +1.604.688.9655

Fax: +1.604.685.3521

Email: [email protected]

http://www.con-obesitysummit.ca/

Disclaimer

All reasonable endeavors will be made to hold the 5th Canadian Obesity Summit and to present the printed program as scheduled

under circumstances which assure the comfort and safety of the Conference Participants. However, the Canadian Obesity Network and

its branches, and their respective directors, officers, employees, representatives or agents, shall not be liable in any manner whatever to

any person as a result of the cancellation of the Conference or any of the arrangements, programs or events connected therewith; nor

shall any of the foregoing entities or persons be liable in any manner whatever for any loss, injury, damage or inconvenience which may

be suffered by any person while travelling to or from, or during such person’s presence in, Canada in connection with the Conference.

Participants are advised to consider procuring their own insurance against any such occurrences.

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Closed meeting (by invitation only):PEC Strategic Planning Meeting (Day 2)Frontenac

Pre-Conference Event:Dietitian Learning Retreat (Day 2)Van Horne C

WS.02:The Alberta Pediatric Obesity Strategy: From Inception to IntegrationIvor Petrak

WS.05: Culture and history as determinants of eating behaviours: how does our ancestry affect our relationship with food?Ivor Petrak

WS.04: Considering the com-bined impacts of sleep, sedentary behaviour and insufficient phys-ical activity on obesity and healthMt. Stephens Hall

WS.03: Clinical Updates in Bariatric Surgery: What Every Clinician Needs to Know from Referral to Post-Surgery Follow-upAlberta/New Brunswick

WS.01:Nordic Walking: An Ideal Physical Activity for Prevention & Treatment of ObesityAlhambra

WS.06:Rehabiltating and Assisting Obese Patients with Medical Devices – All About Body Types and Bariatric AidsAlhambra

Closed meeting (by invitation only):CON-SNP National Executive MeetingFrontenac

Putting LIFE into LIFE-style ManagementVan Horne C

WS.07:Nothing about me, without me! Patient-centered Weight Bias Research!Ivor Petrak

CON-SNP Career Panel: I’ve Got My Degree; Now What?Ivor Petrak

WS.04: Considering the com-bined impacts of sleep, sedentary behaviour and insufficient phys-ical activity on obesity and healthMt. Stephens Hall


WS.08:Better Together: Co-Design and Imple-mentation of the Kidfit Junior Program with Children, Families and Community PartnersAlhambra

WS.09:Designing a Successful Community Based Approach to Pre-venting Childhood ObesityBariatric AidsAlhambra

Schedule-at-a-Glance

MONDAy, APRIl 24, 2017

TuESDAy, APRIl 25, 2017

Closed meeting (by invitation only):PEC Strategic Planning MeetingFrontenac

Closed meeting (by invitation only): Food Addiction in Obesity – Ethical and Policy Implications CIHR RetreatIvor Petrak

Pre-Conference Event:Dietitian Learning Retreat (Day 1)Van Horne C

Satellite Meeting (off-site):Developing International Part-nerships for Improving Obesity Prevention & Management Training in Primary CareBanff Centre

Registration Desk OpensCurio Foyer

LunchConservatory

Networking & Health BreakConservatory

Networking & Health BreakConservatory

08:00–17:00

08:30–10:00

13:00–14:30

10:30–12:00

10:00–10:30

07:30–19:00

12:00–13:00

17:00–18:30

18:30–20:30

Opening CeremonyAlberta/New Brunswick

Welcome ReceptionRiverview Lounge/ Cascade Ballroom

14:00–14:30

15:00–16:30

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WS.04: Considering the com-bined impacts of sleep, sedentary behaviour and insufficient physical activity on obesity and healthMt. Stephens Hall



Weight of Living: Personal Perspective

Mini-Review 1:Reshaping Canada’s Food Policies for HealthAlberta/New Brunswick


Mini-Review 2:My Patient has Lost Weight Now What?Mt. Stephens Hall

Concurrent Presentations 1:Weight Bias, Stigma, and Body ImageAlberta/New Brunswick

Concurrent Presentations 2:Clinical Management AdultsIvor Petrak

Concurrent Presentations 3:Pregnancy & Maternal/ Fetal HealthMt. Stephens Hall

WS.10:Mindful Eating for ObesityAlhambra

Mini-Review 5:Weight bias: Moving beyond awareness to creating change!Alberta/New Brunswick

Mini-Review 6: Bariatric Surgery IMt. Stephens Hall

Networking & Health BreakRiverview Lounge / Cascade Ballroom Exhibition & Poster

ViewingRiverview Lounge / Cascade BallroomMini-Review 3:

Government Frameworks for Obesity Prevention & ManagementAlberta/New Brunswick

Mini-Review 4: Pediatric ObesityMt. Stephens Hall

Pecha Kucha Presentations 1Alberta/New Brunswick

Pecha Kucha Presentations 2Mt. Stephens Hall

Lunch Symposia: The Growing Weight of Obesity: An update on psychological and pharmacological managementVan Horne A&B

Lunch & Exhibits Riverview Lounge / Cascade Ballroom

Summit Reception with PEC MembersConservatory

Dinner & Explore Banff on own

Summit Social – Please see page 14

Networking & Health BreakRiverview Lounge / Cascade Ballroom




08:15–09:30

14:00–16:00

16:30–17:30

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Mini-Review 7:Living with ObesityAlberta/New Brunswick


Mini-Review 8:Pregnancy & Maternal HealthMt. Stephens Hall



Networking & Health Break Riverview Lounge / Cascade Ballroom

Summit Reception with SNP Leadership Conservatory



Exhibition & Poster ViewingRiverview Lounge / Cascade BallroomMini-Review 9:

Family Based Pediatric CareAlberta/New Brunswick

Mini-Review 10: Managing Obesity as a Chronic DiseaseMt. Stephens Hall



Lunch Symposia: Strategies for Personalized Weight Management Van Horne A&B

Lunch Symposia: Initiating Behavioural Change in Obesity: The Right Patient, the Right Motivation, and the Right SolutionsVan Horne C

Concurrent Presentations 4:NutritionAlberta/New Brunswick

Concurrent Presentations 5:Metabolism: Preclinical Insights Alhambra

Concurrent Presentations 6:Bariatric Surgery IMt. Stephens Hall

WS.11:Complexity & Obesity 2.0Ivor Petrak

Mini-Review 11:Nutrition Beyond FoodAlberta/New Brunswick

Mini-Review 12: Microbiome/CIHR Mt. Stephens Hall




08:15–09:30

09:30–10:00

11:30–14:00

16:00–16:30

17:30–18:30

18:30

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Mini-Review 13:Population Health - SurveillanceAlberta/New Brunswick


Mini-Review 14:Energy Metabolism & Body Composition Mt. Stephens Hall

Networking & Health BreakRiverview Lounge / Alhambra Exhibition & Poster

ViewingRiverview Lounge / Cascade BallroomMini-Review 15:

Physical Activity Benefits Beyond Weight LossAlberta/New Brunswick

Mini-Review 16: Bariatric Surgery IIMt. Stephens Hall




Workshop: Canadian Obesity Network Local ChaptersMt. Stephens Hall


Summit Closing Ceremony & Awards (Reception to follow)Alberta/ New Brunswick/ Conservatory



Concurrent Presentations 7:Public HealthAlberta/New Brunswick

Concurrent Presentations 8:Children & Adolescents Ivor Petrak

Concurrent Presentations 9: Physical ActivityMt. Stephens Hall

WS.12:Transforming Primary Care Practice to Improve Obesity Prevention and Management Alhambra

Lunch Symposia: Pharmacological, Dietary and Behavioural Strategies for Appetite Reduction and the Promotion of Satiety. Weight Management Outcomes in a High Volume Provincially Funded ProgramVan Horne AB

Lunch Symposia: Promoting Healthy Living: Moving Beyond Weight and Putting The Person First! Van Horne C




08:15–09:30

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Satellite Meetings

SuNDAy, APRIl 23, 2017 – TuESDAy, APRIl 25, 2017

Public Engagement Committee Strategic Planning Meeting (By invitation only)Annual strategic planning meeting for the Canadian Obesity Network’s Public Engagement Committee.

MONDAy, APRIl 24, 2017

Food Addiction in Obesity – Ethical and Policy Implications CIHR Retreat (By invitation only)

A CIHR-funded planning and knowledge initiative to develop provincial, national, and international collaborations to form a food addiction research network for policy development, knowledge translation and exchange. This retreat will bring together diverse research partners and knowledge users to examine the individual, societal, and policy impact of the emerging food addiction concept on obesity treatment in Canada.

Developing International Partnerships for Improving Obesity Prevention & Management Training in Primary Care Off-site meeting being held at the Banff Centre (By invitation only)

The inaugural coalition meeting to improve obesity prevention and management training in primary care.

SATuRDAy, APRIl 28, 2017

Annual General Meeting, Canadian Obesity Network, Board of Directors and Science Committee

Clinical Practice Guidelines Working Group Meeting (By invitation only)


Workshops-at-a-Glance


WS.01 Nordic Walking: An Ideal Physical Activity for Prevention & Treatment 08:30 – 10:00 Alhambra of Obesity

WS.02 The Alberta Pediatric Obesity Strategy: From Inception to Integration 08:30 – 10:00 Ivor Petrak

WS.03 Clinical updates in Bariatric Surgery: What Every Clinician Needs to Know 08:30 – 16:30 Alberta/ New Brunswick from Referral to Post-Surgery Follow-up

WS.04 Considering the Combined Impacts of Sleep, Sedentary Behaviour and 08:30 – 16:30 Mt. Stephens Hall Insufficient Physical Activity on Obesity and Health

WS.05 Culture and History as Determinants of Eating Behaviours: How does our 10:30 – 12:00 Ivor Petrak ancestry affect our relationship with food?

WS.06 Rehabilitating and Assisting Patients Who Have Obesity with Medical 10:30 – 12:00 Alhambra Devices: All About Body Types and Bariatric Aids

WS.07 Nothing About Me, Without Me! People-Centered Weight Bias Research 13:00 – 14:30 Ivor Petrak

WS.08 Better Together: Co-Design and Implementation of the Kidfit Junior 13:00 – 14:30 Alhambra Program with Children, Families and Community Partners Putting LIFE Into Lifestyle Management 13:00 – 16:30 Van Horne C CON-SNP Career Panel: I’ve Got My Degree; Now What? 15:00 – 16:30 Ivor Petrak

WS.09 Designing a Successful Community-Based Approach to Preventing 15:00 – 16:30 Alhambra Childhood Obesity


WS.10 Mindful Eating for Obesity 14:00 – 17:30 Alhambra


WS.11 Complexity and Obesity 2.0 14:00 – 16:00 Ivor Petrak


Canadian Obesity Network Local Chapters 12:00 – 13:00 Mt. Stephens Hall

WS.12 Transforming Primary Care Practice to Improve Obesity Prevention 14:00 – 16:00 Alhambra and Management


WS.01 Nordic Walking: An Ideal Physical Activity for Prevention & Treatment of Obesity08:30 – 10:00Workshop Presenters: Mandy Johnson, Urban Poling Inc., Vancouver, BCWorkshop Description: This workshop will be 45 minutes of pre-sentation and discussion followed by 45 minutes of outdoor activity. Walking is the favourite physical activity of Canadians, with a pleth-ora of physical and mental health benefits. Walking is often referred to as a “wonder drug” more potent than medications for treating a variety of lifestyle conditions. Nordic walking could be viewed as the “extra-strength” dose as it turbo-charges walking by engaging virtually all the muscles of the upper body in addition to the lower body. On average, Nordic walking increases the caloric expenditure of walking by 20% without any perceived increase in exertion. After reviewing current research that supports these claims and discuss-ing the psycho-social benefits of Nordic walking, participants will be outfitted with walking poles and taken outside to experience the unique Canadian variation of Nordic walking technique that is growing in popularity across the country with people of all ages and abilities. The activity session will include learning correct Nordic walking technique and going on a short walk (intensity: easy) with the opportunity to reinforce the learning while experiencing the joy of outdoor activity in the spectacular environment in the vicinity of the Banff Springs Hotel. Participants are required to have sturdy outdoor walking shoes and recommended to wear a few layers of clothing that can be removed as people warm up.Learning Objectives:• TolearncorrectNordictechniques.• ToreviewcurrentresearchonbenefitsofNordicwalking.

WS.02 The Alberta Pediatric Obesity Strategy: From Inception to Integration08:30 – 10:00Workshop Presenters: Rena LaFrance, Alison Connors, Alberta Health Services, Edmonton, ABWorkshop Description: Obesity is a complex chronic disease that af-fects individuals across the lifespan. The Alberta Health Services (AHS) Obesity Initiative aims to reduce the burden of obesity in the province and spans the age and care continuums. The pediatric component of the Initiative focuses on children ages 2–17 years and includes a multi-pronged model of care. Pediatric obesity services include MEND (Mind, Exercise, Nutrition…Do It!), Primary Care services, Outpatient Dietitian Counselling, and Pediatric Centres for Weight and Health (specialty care). Best treatment option is determined in partnership between the child/family and primary care provider with consideration given to family preference, stage of change, root causes and comor-bidities of overweight/obesity. The development and implementation of the model demonstrates the results of collaborative efforts between the five AHS zones; Primary Health Care, Nutrition Services; Popu-lation, Public and Indigenous Health; physicians, community based agencies and many other stakeholders. While there have been numer-ous successes under the Pediatric Obesity Strategy, the need for scale and spread of the existing model is needed. In an effort to reach additional families, the initiative now seeks to partner with sectors

external to health care including provincial and municipal govern-ments, education, indigenous communities and other private and public stakeholders. To address the social determinants of health and unique local needs of families, a special focus will be placed on ensur-ing access to vulnerable populations. Highlights of the obesity initia-tive to date (including challenges and opportunities), current state and next steps for model integration and optimization will be discussed.Learning Objectives:•TodiscusstheAlberthealthserviceobesityinitiative.•Todiscussthedevelopmentandimplementationofthemulti-

pronged of care.•Tounderstandthemultiplefactorsinvolveinrollingouta

pediatric obesity strategy

WS.03 Clinical updates in Bariatric Surgery: What Every Clinician Needs to Know from Referral to Post-Surgery Follow-up08:30 – 16:30Workshop Presenters: David Urbach1, Karyn Mackenzie1, Patti Kasta-nias1, Wynne Lundblad2, Alexis M. Fertig2, Susan Wnuk1, Stephanie Cassin3, Raed Hawa1, Chau Du1, Rebecca Kirsh1, Jennifer Brown4, Sanjeev Sockalingam1

1 University Health Network, Toronto, ON2 University of Pittsburgh, Pittsburgh, PA3 Ryerson University, Toronto, ON4The Ottawa Hospital Bariatric Centre of Excellence, Ottawa, ON Workshop Description: Bariatric surgery is recognized as an effec-tive and durable treatment for severe obesity; however, bariatric and primary care teams require awareness and skills to manage the myriad of pre- and post-operative concerns. Pre-surgery concerns consist of bariatric surgery readiness assessment, surgical risks and psychosocial stability. Further, patients require additional assessment and inter-vention after surgery, including early recognition of bariatric surgery complications and evidence-informed psychosocial interventions to maintain weight loss and health benefits long-term. This full-day workshop will provide participants with an integrated interprofes-sional approach to bariatric surgery assessment and aftercare. Each presentation will answer a critical bariatric surgery question pertaining to pre-surgery and post-surgery care. The morning presentations will review the evidence for bariatric surgery, surgical risks, pre-operative nutritional risks, psychiatric risks and pharmacological concerns. The afternoon sessions will respond to common clinical questions pertain-ing to early post-surgery complications, common vitamin deficiencies, new onset psychiatric disorders, and the evidence for behavioural and psychosocial interventions to support weight loss. Case discussions will illustrate approaches to these common clinical challenges. The presenters will summarize new guidelines and share their published protocols and resources with participants.Learning Objectives:•Describetherolethatclinicianshaveinpre-andpost-bariatric surgery care.•Identifynewtoolsandevidenceforassessingandsupporting bariatric surgery patients throughout the bariatric surgery process.•Applymedical,nutritionandpsychosocialprotocolsand interventions that improve patient outcomes after bariatric surgery.

Workshops Details




WS.04 Considering the Combined Impacts of Sleep, Sedentary Behaviour and Insufficient Physical Activity on Obesity and Health08:30 – 16:30Workshop Presenters: Allana LeBlanc, University of Ottawa Heart Institute; Chris Ardern, York University; Jean-Philippe Chaput, CHEO Research Institute CHEO Research Institute; Sarah Neil-Sztramko, McMaster University; Thirumagal Thirumagal Kanagasabai, McGill University; McGill University; Jonathan McGavock, University of Manitoba; Bolette Rafn, University of British Columbia; John Spence, University of Alberta.Workshop Description: Session 1: Where We Stand – Current State of the Literature Among the modifiable factors that increase the risk of obesity are insufficient sleep, sedentary behaviour and physical inactivity. Until re-cently, these lifestyle factors were largely researched in isolation, and without consideration for their interactive effect. It is now apparent that sedentary time and purposeful activity, as well as sleep quality and duration, may be important in overall health. Session 2: Information for ResearchersObtaining accurate estimates of physical activity, sedentary behaviour and sleep is important for both epidemiologic and applied obesity research. A wide variety of self-report and objective measurement tools exist; each capture different types of information, were de-signed for and validated in different populations, and thus are ap-propriate in different situations. This session will provide an overview of the most common tools, and the strengths, limitations and most appropriate use of each. Participants will have the opportunity to use these tools, and see real-time data scoring and analysis to gain a more thorough understanding of how these tools can be used. Session 3: Information for PractitionersThe purpose of this session is to provide solutions for the rising proportion of children and youth who are sitting more and sleeping and moving less. By reversing this trend, children and youth will be at a decreased risk for a range of non-communicable diseases. We will pull from lessons learned around the world and provide insights on areas where Canada is challenged and where we are succeeding. We will also give an overview of what a healthy day looks like, and how health care providers can help parents, teachers, and caregivers promote these habits among the children they work with. This ses-sion will provide a comprehensive look at healthy active living among children and youth and provide participants with tools to disseminate this information in practice. Session 4: Where We are Going – Future Directions (Master Class) This will be a Master Class panel discussion with experts from the day, along with some special guests, answering your questions and engaging in friendly debate on the practical implications of emerging technology. Learning Objectives:• To understated the current state of literature for sleep sedentary behavior and physical inactivity. • Togainknowledgeonhowtousetoolforrealtimedatascoring and analysis. • Toexplorevarioustoolsuseforhealthyactivelivingamong children in use.

• Toenhanceparticipantsfamiliaritywithpracticalimplicationsof emerging technology

WS.05 Culture and History as Determinants of Eating Be-haviours: How Does Our Ancestry Affect Our Relationship with Food? 10:30 – 12:00Workshop Presenters: Wendy Shah and Colleen Cannon, Craving Change™Workshop Description: As experts in the psychology of eating, registered dietitian Wendy Shah and clinical psychologist Dr. Colleen Cannon help people understand “why” they eat the way they do. A critical step towards fostering this understanding is by increasing both the client and the clinician’s awareness of the client’s personal influ-ences on their eating behaviours. This includes how culture and his-tory may have had an impact on their thoughts, assumptions, values, and expectations. Canada is known for its multicultural composition. As health care providers, prompting clients to reflect on and discuss their culture and history can be a fascinating and fruitful way to help them begin to understand their relationship with food. Learning Objectives: •Todiscusstheremarkablesimilaritiesandvariationsinclients’ descriptions of how culture, heritage, and history play a role in food choices and eating behaviours. •Tofocusontheexperienceofworkingdirectlywithindigenous community members who have a distinctly unique history and face challenging circumstances that can influence their relationship with food. •Aninteractiveworkshopinwhichattendeeswillbeencouragedto share their clinical and personal experiences.

WS.06 Rehabilitating and Assisting Patients Who Have Obesity with Medical Devices: All About Body Types and Bariatric Aids10:30 – 12:00Workshop Presenter: Malene Alexandrowiz, XXL Rehab, Kastrup, DenmarkWorkshop Description:One of several requirements to set up the right rehabilitation approach is to understand how different body shapes move and behave. Based on XXL-Rehab guidelines, simulation suits, experi-ence and existing knowledge, this workshop will provide guidelines and advice on how to handle bariatric patients in a respectable way in different situations. We will consider the principles of rehabilita-tion connected to different body types and movements, which are critical to know before choosing programs or designing solutions to improve, maintain and preserve functional independence.Learning Objectives: • Togaininsightstobarriersinthebuiltandsocialenvironmentfor persons living with obesity. • Toapplytheconceptsofideationanddesignrelevancetotheir area of practice.• Togainexperiencesonhowtohandlebariatricspatientsin respectful way in various situation.

Workshops



WS.07 Nothing About Me, Without Me! People-Centered Weight Bias Research13:00 – 14:30 PMWorkshop Presenters: Jodi Krah, PEC Members, Ian Patton, York University, Mary Forhan, University of AlbertaModerators: Sara Kirk, Angela Alberga, Ximena Ramos SalasWorkshop Description: Weight bias and stigma are deeply ingrained in healthcare settings and lead to many inequities for people living with obesity. Weight bias exists in various forms in the healthcare system, including receiving inappropriate comments about weight, being treated disrespectfully because of weight and using inaccessible equipment and facilities that do not accommo-date body diversity. Reduced time spent with patients and patient avoidance of the healthcare system strongly affect the quality of care of patients living with obesity. Weight bias and stigma are also prevalent in the education sector, which affects health and educa-tional outcomes for people with obesity. It can increase vulnerability to anxiety, stress, depression, suicidal thoughts and behaviors, avoidance of physical activity and disordered eating habits. The workshop will bring together the Canadian Obesity Network’s Public Engagement Committee (CON-PEC) in collaboration with the pan-Canadian EveryBODY Matters Collaborative team of re-searchers studying weight bias and people-centered research and practice. The workshop will begin with a panel of speakers from CON-PEC sharing their experience with weight bias and research. The EveryBODY Matters Collaborative will provide examples of patient-engaged and person-centered research from the field of weight bias in health care and education. Participants will then engage in an interactive discussion to identify useful practices and existing mechanisms that can be used to develop meaningful peo-ple-centered research in the area of weight bias reduction. Learning Objectives:•Tohearthevoicesofpeopleaffectedbyweightbiasandtheir vision for people-centered research;•Acquirepracticalskillstoengagepeoplewithobesityin research and practice and to reduce weight bias in healthcare and education settings.

WS.08 Better Together: Co-Design and Implementation of the Kidfit Junior Program13:00 – 14:30Workshop Presenters: Dianne M. Fierheller1, 2, Ian S. Zenlea1, 3, Brenda Callaghan4, Lisa Metzger1, Alexandra Wills1

1. Trillium Health Partners, Mississauga, ON, 2. McMaster University, Hamilton, ON, 3. University ofToronto, Toronto, ON, 4. City of Mississauga, Mississauga, ONWorkshop Description: Developing sustainable and effective programs is required in the treatment of obesity with young children in Canada. Participation in structured weight manage-ment programs is often challenged by systemic barriers such as accessibility, transportation and childcare. Given the barriers to treatment, innovative and collaborative models of care are needed between hospital-based clinics and community agencies that will support and engage children and their family members throughout the treatment process and following transition from the program. This workshop will highlight the co-design and implementation

process of the KidFit Junior Program, an innovative partnership between patients and families, Trillium Health Partners (THP) and The City of Mississauga. The program is for children in grade 5 and under living with obesity and their families. In the first year of development, KidFit embedded focus groups into the first phase of the program. Several key themes were identified in the child and caregiver feedback: the importance of program implementation occurring within the community to promote accessibility, regular physical activity, food preparation skills, and the importance of including all family members in the program. KidFit and the City of Mississauga staff designed phase 1 and phase 2 of the program to include educational sessions for caregivers, while simultaneously offering physical literacy programming run by Parks and Recreation Staff to young patients and their siblings. Through interactive dis-cussion, brainstorming and hands-on group activities participants of the workshop will learn about this innovative program, and how to build family and community engagement practices into program design and implementation.Learning Objectives:• UnderstandhowtheKidFitJuniorProgramcreatedmulti-sector partnerships to deliver obesity treatment for young Canadian children. • Buildfamilyandcommunityengagementpracticesintoyour program design and implementation to ensure sustainability and effectiveness.

Putting LIFE Into Lifestyle Management13:00 – 16:30Workshop Presenters: Michael Vallis1, David Macklin2, Krista Leck-Merner3, Dayna Lee-Baggley3,1. Dalhousie University and Nova Scotia Health Authority, Halifax, NS, 2. University of Toronto, Toronto, ON, 3. Nova Scotia Health Authority – Central Zone, Halifax, NSWorkshop Description: This session presents a model of care that addresses the processes required for lifestyle change (i.e., internal-ly motivated behaviours that a person puts effort into protecting/maintaining). Five core drivers of behaviour are addressed:Obesity bias. This component addresses self-image/self-esteem vis a vis weight and shape. Promoting positive, accepting views of oneself and dealing with bias from others is the goal of this intervention.Expectations. This component addresses weight loss expectations, with the goal to align patient goals with known biology of weight loss.Doing. This component addresses the meaningful/achievable behaviours that a person is ready to change using motivational communication interventions. The goal is to develop a realistic behavioural plan that can be taken on in a nonjudgmental, empowering manner.Wanting. This component addresses one’s relationship with food; cravings, pleasure, emotional eating and the functional role of food. The goal is to improve the emotional functioning in light of the neurobiology regarding the drive to eat.Thinking. This component addresses the cognitive aspects of eat-ing. Cognitive behavioural interventions highly specific to eating situations and behaviours are enumerated.

Workshops


Workshops

Learning Objectives:• Toaddresstheprocessrequireforlifestylechange.• Todemonstratetheuseofthismodelinindividualcarewithin primary care service by a physician. • Togainunderstandingoftheuseofthismodelinagroupof obesity management clinic by a dietitian/psychologist team. CON-SNP Career Panel: I’ve Got My Degree; Now What?15:00 – 16:30Workshop Moderators: Thirumagal Kanagasbai, Jennifer McConnell, CON-SNP National ExecutivesWorkshop Panelists:Academia: Jennifer Kuk, Associate Professor at York UniversityIndustry: Nora Madian, Senior Manager, Stakeholder & Corporate Relations at Novo NordiskGovernment: Hasan Hutchinson, Director General of the Office of Nutrition Policy and Promotion within the Health Products and Food Branch of Health CanadaClinical: Sean Wharton, Medical Director of the Wharton Medical Clinic in Burlington, OntarioNGO: Manuel Arango, Director, Health Policy. Heart and Stroke Foundation of Canada – Heart and Stroke FoundationWorkshop Description:Do you have questions about your career options but don’t know who to ask? We have a panel of experts from academia, industry, government, non-profit, and the clinical sectors to answer your questions. Come prepared with your questions for this event, and get answers from our career panel experts.Learning Objectives: • Togainknowledgeonvariouscareeroptions.

WS.09 Designing a Successful Community-Based Ap-proach to Preventing Childhood Obesity15:00 – 16:30Workshop Presenters: Dennis Edell1, Shazhan Amed2

1. Epode International Network, Toronto, ON, 2. BC Children’s Hospital, University of British Columbia, Vancouver, BCWorkshop Description:EPODE (Ensemble Prévenons l’Obésité Des Enfants) is a large-scale, centrally coordinated, capacity building approach for communities to implement effective and sustainable strategies to prevent child-hood obesity. The EPODE experience suggests that successful child-hood obesity prevention requires an integrated community-wide approach in which both individual and environmental determinants are targeted in all settings where children live, learn, and play.Collective Impact defines the collaborative nature of this approach and calls for multiple organizations or entities from different sectors to adopt a common agenda, shared measurement and alignment of effort. This workshop is designed for those seeking to implement in their community, a customizable, workable and proven solution for reducing the prevalence of obese and overweight children. Workshop participants will learn: The core principles of successful community-based childhood obesity prevention programs; How to design a program relevant to their setting and public health goals for childhood obesity prevention and health equity; How to Identify

key opportunities and overcome barriers to implementation. The format for this workshop will be interactive. Participants will consider and discuss in the context of their specific situations strategies such as program evaluation, social marketing, acquiring political support, sustainability via PPP, and program organization. Workshop leaders Edell and Amed have been involved in program design, training and implementation of community based childhood obesity prevention programs in Canada.Learning Objectives: • Tounderstandthecoreprincipalofsuccessfulcommunity-based childhood obesity prevention programs.• Tounderstandhowtodesignaprogramrelevanttotheirsetting and public health goals for childhood obesity prevention and health equity.• Toidentifythekeyopportunitiesandovercomebarriersto implementation.


WS.10 Mindful Eating for Obesity14:00 – 16:00Workshop Presenters: Susan M. Wnuk1,2, Chau Du1,3, Wei Wang1

1. University Health Network, Toronto, ON, 2. University of Toronto, Department of Psychiatry, Toronto, ON, 3. City University of London, Department of Psychology, London, United KingdomWorkshop Description: Long-term weight loss maintenance is the goal for bariatric patients and clinicians as it is associated with medical, psychological, and quality of life benefits. Weight regain after weight loss interventions including surgery is concerning, es-pecially when it is associated with problematic psychological and behavioural factors such as emotional eating and loss of control over eating. When these factors are present, both clinicians and patients can lose confidence in the patient’s ability to achieve and maintain a healthy weight. Mindfulness approaches have been used successfully with a variety of presenting problems includ-ing chronic pain, depression, anxiety, and more recently binge eating and emotional eating. Importantly, mindfulness practices have also been shown to improve gastrointestinal (GI) symptoms. Given how closely the gut and brain interact, emotional and psychosocial factors can trigger symptoms in the gut. Therefore, mindfulness can address symptoms in both systems. This work-shop will introduce the principles of mindfulness as it relates to eating, including case conceptualization, mindful eating prac-tices, brain-gut health, and other relevant mindfulness exercises for eating problems. The emphasis will be on integrating skills to cope and understand triggers that can lead to overeating,emotional eating, and loss of control, rather than on restricting.Learning Objectives:•Describethetheoreticalprinciplesofmindfuleating.•Understandhowmindfuleatingcancontributetoahealthier brain-gut connection.•Learnhowtoincorporatemindfuleatingtechniquesintodailylife, and facilitate 1–2 mindful eating exercises with patients/clients.

THuRSDAy, APRIl 27, 2017TuESDAy, APRIl 25, 2017


Workshops

WS.11 Complexity and Obesity 2.014:00 – 16:00Workshop Presenters: Diane Finegood, Professor, Simon Fraser University (Moderator); Harry Rutter, London School of Hygiene and Tropical Medicine; Robyn Tamblyn, CIHR Institute of Health Services and Policy Research; Sonia Wutzke, The Australian Prevention Partnership Centre, Hasan Hutchison, Health Canada.Workshop Description: There’s been a lot of discussion and a growing acceptance of the value of complex systems thinking to help address obesity and other wicked public health challenges. But it seems little has changed for public health research which is still focused on individuals and on the elements of the system that gives rise to obesity. The focus remains at the individual level because this is where a reductionist approach can be applied. Some funders have turned their attention to funding programs for natural experiments, as well as “evocative” and “systems” grant-making methods. Academics are responding to these pro-grams but we are far from seeing an impact on the public health literature or being able to give decision-makers the evidence they need to support a systems approach. So, what do we need to do to change this state of affairs? We need to start by asking differ-ent questions and then developing the methodology that allows us to answer them. If we want decision-makers to apply solutions appropriate to complex problems, we need to provide them the evidence base to support it.Learning Objectives:• Buildconsensustoadvancenewmodelsofpublichealthaction.• Identifytheresearchrequiredtoprovideasupportingevidencebase.

WS.12 Transforming Primary Care Practice to Improve Obesity Prevention and Management14:00 – 16:00Workshop Presenters: Denise L. Campbell-Scherer1,2, Elizabeth Sturgiss3, Thea Luig4,Katrina Anderson3, Arya M. Sharma2,4 1. Department of Family Medicine, University of Alberta, Edmon-ton, AB, 2. Alberta Diabetes Institute, University of Alberta, Edmonton, AB, 3. Academic Unit of General Practice, Australian National University, Canberra, ACT, Australia, 4. Department of Medicine, Division of Endocrinology, University of Alberta, Edmonton, ABWorkshop Description: Obesity is an issue across all healthcare systems in the developed world. Connecting ideas and findings from different international settings give the opportunity to learn about frameworks that might work. This practical workshop will allow participants to explore the management of obesity using examples from two different primary healthcare settings, Canada and Australia. The workshop will highlight research findings on how to support patients and interdisciplinary primary care teams to improve obesity prevention and management. Participants will be introduced to primary care resources: the 5As for Obesity Management™, the 5As Team Tools, and the CHANGE Program. Interactive components will allow participants to share their own experience, programs and resources with the group.Learning Objectives:• Comparetheprimaryhealthcaresettingininternational contexts with a focus on support for obesity management.• Introductiontopracticaltoolsandresourcestosupportprovider and team training, and patient intervention to improve• obesitypreventionandmanagement.• Learnnewskillstobeusedinaconsultationsettingfrom around the world.• Focusonhowtospreadskillsandconfidenceinyourlocal primary healthcare community.

Canadian Obesity Network Local Chapters11:30 – 12:30 PMChair: Arya M SharmaPresenters: Michael Vallis (YHM), Sue Pedersen/Shahebina Walji (YYC), Sean Wharton/Sandra Elia/Priti Chawla (YYZ), JP Chaput (YOW), David Harris/Veronica Kacinik (YVR)If you are part of a local CON chapter or want to find out more about starting one this is your chance. Each established chapter will present what their chapter has done and what they learned. Find out more about local chapters and how CON can support your chapter as we grow. Learning Objectives:• Describethebarriersandlimitsfacedbylocalchapters• ApplylearningsfromestablishedCONlocalchapters

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lunch Symposium

Lunch: 11:30 – 12:00, Symposium: 12:00 – 13:30Speakers: Arya Sharma, David Lau, Michael Vallis, David Macklin, Sean WhartonThe body of evidence around obesity is rapidly growing, as is our knowledge of its impact on patients. This fast pace underscores the need for the healthcare community to remain dedicated to continued learning on obesity and approaches to its manage-ment. During this program, participants will follow an expert pan-el through an exploration of the neurobiology of obesity, and the importance of behavioural and pharmacologic interventions in managing this chronic disease. Taking a step further, participants will review how these concepts can be integrated into clinical practice to improve patient care.

Learning Objectives:• Recallthemultifactorialetiologyofobesityandthebenefits of its management.• Describecurrentapproachestoobesitymanagement,witha focus on behavioural modifications and pharmacotherapy.• Assessthebenefitsandlimitationsofapproachestoobesity management and strategies for their incorporation into clinical practice.(This program was supported in part by an educational grant from Novo Nordisk)

The Growing Weight of Obesity: An update on Psychological and Pharmacological Management

Initiating Behavioural Change in Obesity: The Right Patient, the Right Motivation, and the Right Solutions11:30 – 13:00Chair: David Lau1

Presenters: Daniel Gagnon2, Sean Wharton3

1. University of Calgary 2. Université de Montréal 3. University of TorontoHow do you know if the patient living with obesity is ready forchange? Stay up to date on the rapidly evolving landscape ofobesity pharmacotherapy and gain new tools to address obesity,engage patients to change and set up a framework for long-termsuccess.(This program was supported in part by an educational grant fromValeant)Learning Objectives:•Determinethepersonlivingwithobesitymotivationand readiness to change•Engagepatientsbyaskingappropriatequestionstoidentify personal barriers to change•Counselpatientsontheroleofbiologicalandgeneticfactors that contribute to obesity and weight regain•Discussanti-obesitymedicationsandhelpchoosetheproper agent as adjunct to the treatment plan

Strategies for Personalized Weight Management11:30 –13:00Co-Chairs: Aloys Berg and Arya M. SharmaPresenters: Arya M. Sharma1,2, Carla Prado1, Jens Walter1

1. University of Alberta 2. Canadian Obesity NetworkA large number of studies have analyzed different strategiesaimed at inducing a negative energy balance and, consequently,body weight loss. This informative and interactive symposium,co-chaired by Drs. Aloys Berg and Arya Sharma, will review thevarious strategies that can be employed for personalized weightmanagement. Topics that will be covered include dietary treat-ments such as meal replacement strategies, personalized nutri-tion and the influence of gut microbiota. Limited space available.(This program was supported in part by an educational grant fromAlmased)Learning Objectives:•Describetheoptionsforpersonalizedlong-termweight management•Identifytheimpactsofpersonalizednutritiononmetabolic adaptation and body composition•Describethelinkbetweennutritionandobesityasitrelatesto gut microbiota




lunch Symposium

Pharmacological, Dietary and Behavioral Strategies for Appetite Reduction and the Promotion of Satiety: Weight Management Outcomes in a High Volume Provincially Funded Program11:30 – 12:30Presenter: Michael R Lyon, Medical Weight Management CentreJoin Dr. Michael Lyon for lunch and have your questions aboutweight management strategies answered. Dr. Lyon is a Diplomateof the American Board of Obesity Medicine and the MedicalDirector of a provincially funded weight management centre inBritish Columbia.(This program was supported in part by an educational grant from PGX)Learning Objectives:•Describethestrategiesforappetitereduction•Identifymethodstopromotesatiety

Promoting Healthy Living: Moving Beyond Weight and Putting the Person First!11:30 – 12:30Presenters: Jo-Anne Gilbert1 and Ximena Ramos Salas2

1. University of Montreal and Leader of the movement “Imparfait et en santé”; 2. School of Public Health, University of Alberta and Canadian Obesity Network.Health promotion messages and strategies have been criticized for promoting a simplistic narrative that contribute to weight bias in our society. Often the public health narrative about health pro-moting behaviours is centered on weight. However, weight is not a behaviour and healthy eating, sleep and physical activity have health benefits that are far beyond weight. The ‘healthy weight’ narrative has also lead to individuals being overly concerned about their weight and health. Evidence-based resources on the complex interactions between weight and health are need-ed to support Canadians who want to improve their health and wellbeing. But how do we talk about weight and healthy lifestyles without causing unintended consequences such as excessive preoccupation with weight? How do we provide evidence-based information about the complexity of weight and health in a way that is useful to Canadian adults? How do health promotion mes-sages align with the realities of people living with obesity? This exciting session will answer these questions and more.(This program was supported in part by an educational grant fromDairy Farmers of Canada)Learning Objectives:• Describethebarriersandlimitsfacedbyhealthprofessionals working in the weight management field• Applylearningsfromapeople-centeredandevidence- informed process to design an educational resource targeted to Canadian adults who are concerned about their weight and who want to improve their lifestyles



Mini-Review Session Details

WEDNESDAy, APRIl 26, 2017MiniReview1:ReshapingCanada’sFoodPoliciesforHealth08:15 – 09:30 (Co-Chairs: Neil Neary & Leia Minaker)Alberta/ New Brunswick

TheWeightofLiving:PersonalPerspectivesKelly Moen, PEC memberI am a former Bariatric Patient. I have a keen desire to introduce and advocate for a greater focus on mental and emotional well-being of the bariatric patients. The Current landscape of our medical industry lacks in its understanding and teaching regarding obesity treatments. We can no longer believe in the tale of “move more and eat less”. We need to treat today’s obese generations by focusing on our resources for new re-search and development of treatments and cures. We require a full bio-psychosocial approach when it comes to understanding and treating obesity. Together we can win, apart we will only flounder.

Our21stCenturyDietofConvenience:WhyWeNeedMarketingtoKids(M2Ks)andSugary Drink Policies Manuel Arango, MA, MHAManuel Arango is the Director of Health Policy & Advocacy, Canada, for the Heart and Stroke Foundation. Located in Ottawa, he oversees the Foundation’s policy & advocacy efforts. Manuel also acts as a media spokesperson for the Foundation on a variety of policy issues. Manuel has chaired various coalitions and a board of directors. He has a Masters in experimental psychology (Carleton University) and a Masters in health administration (University of Ottawa). Manuel’s policy/advocacy interests focus on cost-effective popula-tion-wide interventions that can make it easy for Canadians to be healthy as possible. He was formerly a legislative assistant on Parliament Hill. Since being at the Foundation he has served as Health Policy Analyst; Manager, Government Relations, and; Assistant Director Health Policy. Manuel is passionate about his wife and two hockey & soccer focused children, as well as about ensuring that governments create the healthiest environments possible, so that the healthy choice can always be the easy choice for all Canadians.Learning Objectives:•TolearnhowtheCanadiannutritionenvironmenthaschanged•Todevelopanunderstandingoftheneedforpopulationlevelobesityandchronicdiseaseinterventions, including marketing to kids restrictions and sugary drink interventions.•Tounderstandhowfruitjuiceasasugarydrinkimpactshealth

HealthyEatingStrategy:RespondingtoTheSenateReportinObesityHasan Hutchinson, PhD, NDHasan Hutchinson is the Director General of the Office of Nutrition Policy and Promotion within the Health Products and Food Branch of Health Canada. As the focal point for public health nutrition within the federal government, the office strives to promote the nutritional health and well-being of Canadians. The Office’s main functions include dietary guidance, food and nutrition surveillance, research and data analysis, health promotion and public health nutrition policy. Hasan is the co-chair of the Federal/Provincial/Territorial Group on Nutrition and of the multi-sectoral Network on Healthy Eating. He serves on a number of nutrition-related committees at the World Health Organization and Pan American Health Organization and has served on a number of health-related committees at the Organization for Economic Co-operation and Development and at the United Nations. He also served as Chair of Canada’s Sodium Working Group. Previous to his current role, Hasan was Associate Director of the Institute of Nutrition, Metabolism and Diabetes at the Canadian Institutes of Health Research (CIHR) and, before that, was Senior Advisor in International Affairs at Health Can-ada. Before working in the public service, Hasan was a faculty member in the Department of Neurology and Neurosurgery at McGill University. His formal education includes a PhD in Quantitative Genetics and an ND in Naturopathic Medicine.Learning Objectives:•Tosharefindingsfromthe2015evidencereviewfordietaryguidance•ProvideanupdateontherevisionofCanada’sFoodGuide•Provideanoverviewofstakeholderengagementactivities

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The New Canada Food Guide


WEDNESDAy, APRIl 26, 2017MiniReview1:ReshapingCanada’sFoodPoliciesforHealth08:15 – 09:30Alberta/ New Brunswick


TheProspectofSugarBeverageTaxationinCanadayann leBodo, MSc, PhDSince 2012, Yann Le Bodo is a project manager at the Evaluation Platform on Obesity Prevention (EPOP) set-up by Laval University (Université Laval) and the Quebec Heart and Lung Institute-Laval University (Université Laval). He is in charge of projects in the area of healthy eating and physical activity policies. He is also a Ph.D. student in community health at Laval University (Université Laval)’s Faculties of Medicine and Nursing. An important part of his research has focused on sugar-sweetened beverage taxation in Canada. Before joining the EPOP, Yann worked as a project manager in health education at community level in France (2007), and as European and international coordinator of the EPODE childhood obesity prevention network (2008–2011). He holds a Master in food innovation from Angers School of Agriculture (France, 2005) and a M.Sc. in diet-relat-ed social sciences from Toulouse II University (France, 2006). He is co-author of several peer-reviewed pub-lications, as well as co-editor and co-author of the books “Preventing childhood obesity: EPODE European Network recommendations” (Lavoisier 2011), “L’Expérience québécoise en promotion des saines habitudes de vie et en prévention de l’obésité: comment faire mieux?” (Presses de l’Université Laval 2016) and “Taxing soda for public health: a Canadian perspective” (Springer 2016).Learning Objectives:• Toprovideanoverviewoftheevidenceabouttherationaleandpotentialeffectsofsugar-sweetened beverage taxation for public health.• ToexposetheprospectsandchallengesofsuchapolicyinCanada,includingfeasibilityandacceptability considerations. • Thepresentationwillbepartlybasedonthepublicationofthebook:Taxingsodaforpublichealth. A Canadian perspective. Le Bodo, Y, Paquette, MC, De Wals, P. (2016). Springer. Available at: http://www.springer.com/gp/book/9783319336473. A 4-page summary of the book can be downloaded here: http://iucpq.qc.ca/fr/taxing-soda-for-public-health

TheWeightofLiving:PersonalPerspectivesAdrianna O’Regan, PEC memberA former bariatric surgery patient that has experienced first-hand the stigma that seems to face people living with obesity. She is an Educational Assistant in the Edmonton area and with that she has seen how obesity can affect children and adults alike. Adrianna is an eager participant of CON to help change the typical societal norm that seems to be showcased in regards to excess weight with individuals.

MiniReview2:MyPatientHasLostWeightNowWhat?08:15 – 09:30 (Co-Chairs: Yoni Freedhoff & Theodore Kyle)Mt. Stephens Hall



LifestyleInterventionMarie-France langlois, MD, FRCPC, CSPQDr Langlois trained in Endocrinology at Université de Sherbrooke (Quebec, Canada) and completed a research fellowship at Harvard University (USA, 1995-1997). She currently practices as an endocrinologist, Director of the Ambulatory Metabolic Unit, which includes diabetes, obesity and lipid disorders clinics, and Medical Manager of the chronic diseases trajectory at the CIUSSS de l’Estrie –CHUS in Sherbrooke. She is also Professor of Medicine and Physiology at Université de Sherbrooke. She received the Young investigator award of the Canadian Society of Endocrinology and Metabolism in 2007 and held a National-Scientist award of the Fonds de la recherche du Québec – Santé (FRQ-S). Her research interests include the regulation of adipogenesis, the treatment and prevention of obesity and diabetes, and health services research in the area of cardio-metabolic chronic disease prevention and management. She is author or co-author of more than 80 articles and 200 abstracts, is an appreciated speaker and regularly sits on per-review Committees. Learning Objectives:• Describelongtermchangesfavoringweightregainafterweightloss• Discusslifestyleinterventionstrategiesthatcanlimitweightregainafterweightloss

Meal Replacements Marie-Phillippe MorinDr. Marie-Philippe Morin completed her Doctorate in Medicine and her residency in General Internal Med-icine at Laval University. She is the recipient of the Governor General’s Academic medal of Canada. Dr. Marie-Philippe Morin works as a General Internal Medicine Specialist at the Quebec Heart and Lung Institute and is an Assistant Professor affiliated to Laval University. She is currently completing a one-year fellowship in bariatric medicine through the University of Ottawa under the supervision of Dr. Judy Shiau and Dr. Robert Dent at the Ottawa Hospital Bariatric Centre of Excellence and LEAF Weight Management Clinic. In 2016, she received grants from the Royal College of Physicians and Surgeons of Canada, the ASMIQ (Association des Spécialistes en Médecine Interne du Québec) and the Quebec Heart and Lung Institute foundation for the purpose of completing her studies in bariatric medicine. Her specialty interests are cardiovascular risk factor management associated with obesity and the management of medical/nutritional complications after bariatric surgery, particularly duodenal switch.Learning Objectives:• TounderstandwhatisaMealReplacement(MR)andtherationaleforusingMRs.• TounderstandthedifferencebetweenafullvsapartialMRstrategy.• ToreviewtheevidenceintheliteraturesupportingtheuseofMRforweightmaintenance.• ToevaluatethebenefitsofusingmedicationafterweightlosswithaMRstrategy

Surgery and Medication Sean Wharton, MD, PharmD, FRCP(C)Dr. Wharton has his doctorate in Pharmacy and Medicine. He is the medical director of the Wharton Medical Clinic, a community based internal medicine weight management and diabetes clinic. He is an adjunct profes-sor at McMaster University in Hamilton and York University in Toronto. He also works as an internist at Toronto East General Hospital, and the Hamilton Health Sciences. Dr. Wharton is a researcher, and is qualified as a diplomat of the American Board of Obesity Medicine. Dr. Wharton’s research focuses on bariatric medicine and type 2 diabetes. He is the lead author of the weight management section of the 2013 and 2018 Canadian Diabetes Guidelines, and co-chair of the 2018 Canadian Obesity Guidelines.Learning Objectives:•Tounderstandthesurgicalandmedicaloptionsavailable•Toreviewtheevidenceintheliteraturesupportingtheuseofsurgeryand/ormedicationforobesity management.•Toevaluatethelong-termoptionsafterweightloss

WEDNESDAy, APRIl 26, 2017MiniReview2:MyPatientHasLostWeightNowWhat?08:15 – 09:30 (Co-Chairs: Yoni Freedhoff & Theodore Kyle)Mt. Stephens Hall



DevelopmentsinEuropeanNutrition,PhysicalActivity,andObesityPoliciesJoão Breda, PhD MPH MBADr Breda works in the Division of Noncommunicable Diseases and Life-course at World Health Organization (WHO)/Europe. He provides support to the 53 Member States in the WHO European Region on the im-plementation of the European Charter on Counteracting Obesity and evaluates their progress. His team is responsible for the world’s largest and most comprehensive surveillance mechanism for childhood obesity. Before joining WHO he was the Portuguese focal point to WHO/Europe for nutrition and physical activity, and the High Level Group on Nutrition and Physical Activity and the European Platform on Diet, Nutrition and Physical Activity of the European Union (EU). Dr Breda was the first coordinator of the national platform against obesity under the Portuguese Ministry of Health. He worked as a public health nutritionist at the general health directorate in Ministry. He was the Head of the Nutrition Department at Atlantic University in Lisbon and lecturer and researcher at the Escola Superior Agrária de Coimbra (ESAC), the University of the Algarve and the School of Hospitality and Culinary Arts in Coimbra. He has published in scientific journals given presentations at national and international congresses, written several dozen papers and published 17 original books.Learning Objectives: •Toreviewthedevelopmentofnutrition,physicalactivity,obesitypolicyinWHO/Europememberstate.•TosituateobesitypolicyactionwithinWHO’sglobalactionplanforthepreventionofandcontrolof non-communicable diseases.

GovernmentResponse:SenateObesityReportorObesityPreventionPolicyinCanadaDavid K. lee Learning Objectives:•Toreviewthepresentsenaterecommendations•Understandthehealthminister’smandatecommitments•Toreviewthehealthyeatingstrategyincludinglabellingandclaims,nutritionqualitystandards,protecting vulnerable populations, and improving healthy eating information

Legal Implications of Classifying Obesity as A Chronic Disease Jacob Shelley, llB, llM, MTS Jacob is a doctoral candidate in the Doctor of Juridical Science program at the Faculty of Law, Universityof Toronto. His dissertation is exploring the use of product liability law in the prevention of obesity. Jacob has a Bachelor of Laws and Master of Laws, both from the University of Alberta, where he focused on public health law. Jacob’s primary research area concerns the proper use and scope of law in public health, particularly the use of law in the prevention of chronic diseases. He has presented on weight bias and discrimination, and has recently published a paper arguing for reframing how we approach the problem of obesity. Jacob is a Vanier Canada Graduate Scholar and Fellow with the CIHR Training Program in Health Law, Ethics & Policy.Learning Objectives:•ToexamineCanadiancaselawclassifyingobesityasachronicdisease•Contemplatewhetherobesityfallsunderthelegaldefinitionofdisability

WEDNESDAy, APRIl 26, 2017MiniReview3:GovernmentFrameworksforObesityPrevention&Management10:00 – 11:00 (Co-Chairs: Jennifer Brown & Shahebina Walji)Alberta / New Brunswick

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Healthy Eating Strategy: Responding to the Senate Report on Obesity



PositiveMentalHealthasaStartingPointfortheTreatmentofChildObesitylaurie Clark, PhD., C.Psych.Laurie Clark is a clinical psychologist and clinical investigator with the Centre for Healthy Active Living (CHAL) at the Children’s Hospital of Eastern Ontario, where she works with an interdisciplinary team to help children, youth and their families achieve their best health. Laurie is part of the Pediatric Research on Eating Disorders and Obesity (PREDO) unit at CHEO, the first collaboration of its kind in Canada, which is interested in preven-tion, policy, and research of joint risk factors associated with eating disorders and obesity. She also is a clinical professor with the School of Psychology at the University of Ottawa. Her research interests are in the areas of pediatric weight management, using communimetrics to co-ordinate care in weight management, and the interplay between emotional and physical health. Learning Objectives:• Tounderstandtheinterplaybetweenmentalandphysicalhealth• Tounderstandtheimpactofmentalhealthissuesonweightmanagement.• Toexplorewaystointegratementalhealthpromotionintoweightmanagementstrategies

TheAlbertaPediatricObesityStrategy Rena laFrance, MDDr. Rena LaFrance is lead physician of the Pediatric Centre for Weight and Health at the Misericordia Hospital in Edmonton, Alberta, Canada. She is also the Medical Director for Pediatric Chronic Disease ( province wide services) in the Primary Health Care Portfolio for Alberta Health Services. Dr. LaFrance received her first 3 degrees includ-ing two bachelors degrees in microbiology and medicine as well as her M.D at the University of Manitoba. She completed her 5 year residency in psychiatry where she spent time studying eating disorders, at the University of Alberta. She then obtained her FRCPC (Fellow of the Royal College of Physicians of Canada). She has been in clinical practice within pediatric bariatric medicine for 10 years. She hopes to prevent future disease in children and their family members by focusing on the biological, psychological and social determinants of weight. Her other related work includes treatment and support for pediatric patients at the Stollery Children’s Hospital in Edmonton Canada since 2006 where she sees children with a variety of conditions including, diabetes, cardiac transplant, cancer, migraine/pain and epilepsy. She is also academically affiliated with the University of Alberta as an assistant clinical professor, department of psychiatry and an adjunct assistant clinical professor, department of pediatrics.Learning Objectives:•Appreciatethechallengesandopportunitiesassociatedwithdevelopingandimplementingaprovincial pediatric obesity strategy. •Discusspartneringforsuccesswithstakeholdersexternaltothehealthcaresystem.•Engagingandsupportingvulnerablepopulations.

WEDNESDAy, APRIl 26, 2017MiniReview4:PediatricObesityCare10:00 – 11:00 (Co-Chairs: Jon McGavock & Stasia Hadjiyannakis)Mt. Stephens Hall



TheTeamtoAddressBariatricCareinCanadianChildren(TeamABC3):ProgresstoDateGeoff Ball, PhD, RDGeoff Ball received a BSc in Dietetics from the University of British Columbia (Vancouver, BC), completed a dietetic internship with Capital Health (Edmonton, AB), and obtained a PhD in Nutrition and Metabolism from the University of Alberta (Edmonton, AB). After completing post-doctoral training in Preventive Medicine at the University of Southern California (Los Angeles, CA), Geoff joined the Department of Pediatrics at the University of Alberta. He serves as the Founding Director of the Pediatric Centre for Weight and Health, a multi-disciplinary weight management clinic at the Stollery Children’s Hospital (Edmonton, AB). Geoff’s clinical and health services research includes several methodological approaches (e.g., clinical trials, qualitative inqui-ry, epidemiology, literature reviews) to achieve a primary aim – generate, translate, and apply new knowledge that can optimize obesity management and prevention for children, youth, and families. His research has been supported by the Canadian Institutes of Health Research, Public Health Agency of Canada, Alberta Innovates – Health Solutions, Alberta Centre for Child, Family and Community Research, Women and Children’s Health Research Institute, and Stollery Children’s Hospital Foundation. Learning Objectives:• AppreciatethemagnitudeandimpactofsevereobesityinCanadianchildrenandyouth• Describetherangeofongoingstudiestocharacterizeandmanagesevereobesityinchildrenandyouth

WeightBias:Whatcanwedoaboutit?Angela Alberga, PhDBorn and raised in Montreal, Dr. Alberga completed her BSc (Major Exercise Science, Minor Psychology) at Concordia University. She then completed her MSc and PhD in the School of Human Kinetics, specializing in exercise physiology at the University of Ottawa. She was awarded a Canadian Diabetes Association Doctoral Research Award for her research focused on improving the cardiometabolic health of children and adolescents with obesity through exercise. It is through these experiences that she learned how prevalent and harmful weight-based stigma is and has since been devoted to research, teaching and knowledge translation efforts to reduce weight discrimination in society. Dr. Alberga was awarded a Banting Canadian Institutes of Health Research (CIHR) Postdoctoral Fellowship by the Federal Government of Canada at the University of Calgary supporting her research on weight bias reduction in education, healthcare and public policy. She is currently an Assistant Professor in the Department of Exercise Science at Concordia University. Dr. Alberga’s research program focuses on better understanding how (i) societal, and (ii) school and other institutional factors, influ-ence weight-related issues including obesity, eating disorders, physical inactivity and weight bias.Learning Objectives:• TosharetheresultsofWeightBiasSummitsinCanadaaimedtomovebeyondawarenesstocreatechange• Todemonstrateresearchevidenceoneffectiveweightbiasreductionstrategiesinhealthcare• Torecommendpracticaltipsonhowtoreduceweightbiasinday-to-daypractices

WEDNESDAy, APRIl 26, 2017MiniReview4:PediatricObesityCare10:00 – 11:00Mt. Stephens Hall

MiniReview5:WeightBias:MovingBeyondAwarenesstoCreatingChange!16:30–17:30 (Co-Chairs: Mary Forhan & Renuca Modi)Alberta / New Brunswick



Addressing Weight Bias in Health Care: Inter-professional health educationSara Kirk, PhDDr. Sara Kirk is a Professor of Health Promotion at Dalhousie University with cross-appointments to the IWK Health Centre and Mount Saint Vincent University, Halifax. She is also the Scientific Director of the Healthy Populations Institute (HPI) at Dalhousie University, a Senate-approved, multi-faculty Institute dedicated to improving population health and promoting health equity by understanding and influencing the complex con-ditions that impact the health of communities. Dr. Kirk’s own program of research explores how we can create supportive environments for chronic disease prevention. Her research uses a ‘socio-ecological’ approach that considers how individual behaviour is influenced by other broader factors, such as income, education and societal norms. Her work has focused on addressing weight bias within the health system, using drama to highlight the challenges people experience when navigating a healthcare system that is not designed to effectively support chronic disease management.Learning Objectives:• Appreciatehowweightbiasaffectsphysicalandmentalhealthandwellbeing• Understandthewaysinwhichweightbiasmaybeperpetuatedwithinsocietyandculture• Identifypracticalstrategiestoreduceweightbiasinresearch,practice,andpolicy

AddressingWeightBiasinPublicHealth:ChangingthenarrativetoavoidunintendedconsequencesXimena Ramos Salas, MSc, PhD (c)Ximena Ramos Salas is a PhD candidate at the University of Alberta’s School of Public Health and the Man-aging Director of the Canadian Obesity Network. As a population health researcher, she is exploring the unintended consequences of obesity prevention policies for people with obesity. Her research goal is to spark solutions that will prevent the perpetuation of weight bias and obesity stigma and create more effective pop-ulation health approaches. Ximena is also an expert consultant with the World Health Organization Regional Office for Europe where she provides technical and strategic support for the Nutrition, Physical Activity and Obesity Program.Learning Objectives:• Toreviewkeyweightbiasconceptsandtheories• Toapplyconceptstopublichealthpracticeandpopulationhealthoutcomes• Todiscussstrategiesforchange

AnOverviewofBariatricSurgicalProceduresRichdeep Gill, MD, PhDDr. Richdeep Gill joined the Calgary Department of Surgery in August 2015 in the section of General Surgery. He was born and raised in Calgary before shifting to Edmonton, AB to pursue his M.D. a the University of Alberta. He completed his surgical residency & PhD in Edmonton before his Minimally Invasive & Bariatric Surgery Fellowship at the Royal Alexandria Hospital. He currently practices Minimally Invasive Upper Gastro-intestinal & Bariatric Surgery at the Peter Lougheed Hospital and South Health Campus in Calgary, AB. His clinical research interests are focused on Upper GI malignancies & Bariatric surgery outcomes.Learning Objectives:•Toreviewthemostcommonlyperformedbariatricprocedures,theirefficacy,andadverseeffects•Toprovideaperspectiveontheadvantagesanddisadvantagesofeachprocedure

MiniReview6:BariatricSurgeryI16:30 – 17:30 (Co-Chairs: Priya Manjoo & Marie-France Langlois)Mt. Stephens Hall

WEDNESDAy, APRIl 26, 2017MiniReview5:WeightBias:MovingBeyondAwarenesstoCreatingChange!16:30 – 17:30Alberta / New Brunswick



TheEvolutionofMentalHealthCareinBariatricSurgerySanjeev Sockalingam, MDDr. Sanjeev Sockalingam is an Associate Professor of Psychiatry at the University of Toronto and Deputy Psychiatrist-in-Chief at the University Health Network for the Toronto General and Princess Margaret Hospital sites. He is the Director of the Bariatric Surgery Psychosocial Program. He is also the co-lead for the Extension for Community Healthcare Outcomes (ECHO) Ontario Mental Health at the Centre for Addiction and Mental and Health and the University of Toronto, which is a provincial hub-and-spoke knowledge-sharing network model building mental health and addiction capacity in rural Ontario. Dr. Sockalingam is the Director of Con-tinuing Practice and Professional Development for the Department of Psychiatry at the University of Toronto. He is also the Director of Curriculum Renewal for the Medical Psychiatry Alliance, a $60-million dollar health systems and education initiative. Dr. Sockalingam has >100 peer-reviewed publications and is the co-editor of the book, “Psychiatric Care in Severe Obesity”, a comprehensive summary of an integrated approach to the assessment and managing psychosocial care in severe obesity. His clinical and research interests include un-derstanding psychiatric morbidity in medical and surgical patients and improving service delivery to improve physical and mental health outcomes. He has a primary research focus on psychosocial outcomes related to bariatric surgery.Learning Objectives:• Describetherolethatclinicianshaveinpre-andpost-bariatricsurgerycare.• Identifynewtoolsandevidenceforassessingandsupportingbariatricsurgerypatientsthroughoutthe bariatric surgery process.• Applymedical,nutritionandpsychosocialprotocolsandinterventionsthatimprovepatientoutcomesafter bariatric surgery

MedicalTourism–It’saHighStakesGambleDaniel W Birch, MSc MD FRCSC FACSDr Birch completed his surgical residency at McMaster University in Hamilton in 1998. He has completed a Fellowship in minimally invasive surgery at the Minimal Access Training Unit (MATTU) in Guildford Surrey, UK and at The University of Kentucky in Lexington, Kentucky. He was appointed assistant professor in the Depart-ment of Surgery, McMaster University in 1999, associate professor in the Department of Surgery, University of Alberta in 2004 and promoted to Professor of Surgery in 2011. He is medical director of CAMIS (The Centre for the Advancement of Minimally Invasive Surgery) at the Royal Alexandra Hospital. He completes advanced minimally invasive procedures for a wide variety of gastrointestinal disease including Bariatric Surgery and is an author on over 100 peer-reviewed publications. Learning Objectives:• ConsidertheroleoftheBariatricTeaminCanadawhenconsultedforcomplicationsrelatedtomedicaltourism• UnderstandtheprevalenceofmedicaltourismforBariatricSurgeryinAlberta• Recognizetheimpactandcoststothehealthcaresystemassociatedwithmedicaltourism

WEDNESDAy, APRIl 26, 2017MiniReview6:BariatricSurgeryI16:30 – 17:30Mt. Stephens Hall



TheWeightofLiving:PersonalPerspectivesRyan Drummond, PEC memberI joined CON after being inspired by its Chair Marty who helped me through my post op surgical complication journey. We have like ideals and I want to help the Public Engagement Committee and CON overall achieve all their goals. I have dealt with obesity all my life and so has my family. Both my wife and I have succeeded in losing a lot of weight post Bariatric Surgery and I want to fight and advocate for this treatment, as well as many others, become more readily available and available to the obese population all across Canada. I want to take this fight to make obesity considered a disease and not such a bias to people so that my children can live in a more informed and embracing world. I am married with 2 growing boys and love playing sports and watching movies. I am Civil Engineering Tech and work for the City of Edmonton.

HealthServicesResearchinBariatricCare:LivingWhileLosingMary Forhan, OT Reg (Alberta), PhDDr. Mary Forhan is an assistant professor, Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta. Dr. Forhan was the first occupational therapist in Canada to work in the area of obesity contributed to the development of the obesity and healthy occupation position statement for the Canadian Association of Occupational Therapists. Dr. Forhan is the lead of the Bariatric Care and Rehabilita-tion Research Group that aims to reduce the disability and promote quality health care for patients living with obesity. Her research focuses on addressing physical, social and environmental barriers to full participation in activities of daily living and life events for persons living with obesity. Dr. Forhan is also an active educator with a focus on inter-professional education to improve access to quality health care for patients with obesity. She is a founding member of the Canadian Obesity Network and continues to be active as a member of the CON-RCO Science Committee and an academic member of the CON-RCO Patient Engagement Committee.Learning Objectives:• Learnabouttheimpactofobesityonaccesstoqualitycareinhospitalsettings.• Learnaboutfactorsthatcontributetoqualitycareandoutcomesincludinglengthofstay,patient satisfaction and access to care• Learnaboutstrategiesthatpromotehealthrelatedqualityoflifeforpatientslivingwithobesity

BenefitsofObesityand(Un)intendedConsequencesofWeightLoss:ADevil’sAdvocatePositionJennifer Kuk, PhDDr. Jennifer Kuk is an Associate Professor in the School of Kinesiology and Health Science at York University. She has published over 100 scientific papers and chapters related to obesity, health and lifestyle behaviors.Currently, she is investigating the relationship between obesity and health through clinical human studies and epidemiological approaches. She is researching the metabolically normal obesity phenotype and factors that identify successful weight management in adult and youth.Learning Objectives:• Recognizethevariationsintheexpressionofhealthriskinthosewithobesity.• Appreciatethepotentiallynegativeoutcomesassociatedwithweightlossandfailedweightloss maintenance (weight cycling).• Understandthesub-populationswhereintherisksofweightlossmaypotentiallyoutweighthebenefits

THuRSDAy, APRIl 27, 2017MiniReview7:LivingwithObesity08:15 – 09:30 (Co-Chairs: Sara Kirk & Pascal Imbeault)Alberta / New Brunswick



LivingwithObesity:BeforeandAfterBariatricSurgerylaurie Twells, PhDDr. Laurie Twells is an Associate Professor with the School of Pharmacy and the Faculty of Medicine at Memo-rial University in Newfoundland and Labrador. Dr. Twells completed a Master’s of Science in Epidemiology and Health Policy at the London School of Hygiene and Tropical Medicine in the UK before completing her PhD in Clinical Epidemiology at Memorial University. Dr. Twells research focuses on: the prevention, management and treatment of adult obesity; infant nutrition and childhood obesity; obesity and its impact on health services utilization. Dr. Twells is the principle investigator of a Translational Program of Research on Bariatric Care that examines the experiences of bariatric surgery patients as they wait for, undergo and adjust to life after surgery, and assesses post-surgical clinical outcomes, health related quality of life and healthcare system use and costs.•Toexamineweightlossinseverelyobesepatientsaftersurgery.•Tounderstandchangesinhealth-relatedqualityoflife,asreportedbypatients,beforeandaftersurgery.•Todescribepatients’perceptionsof“health,well-beingandsuccess”followinginthefirstyearaftersurgery.

TheWeightofLiving:PersonalPerspectivesBrenndon Goodman, PEC memberBrenndon attends University and is looking forward to a career in politics or law. He has faced the challenges and difficulties of being overweight his entire life. He attended many unsuccessful weight loss programs until he found the Sick Kids Team Obesity Management Program. It was here that he discovered the support and helpful approach to weight loss. In 2012, he underwent bariatric surgery and has lost over 1/3 of his body weight thus far. Brenndon was featured on a CTV W5 program about his weight loss journey. Brenndon is very committed to helping young people understand and cope with the stigma and difficulties they face being overweight and to help curb the growing epidemic of childhood obesity in a modern world.

Prenatal Stress and Obesity: Results from the Stress in Pregnancy International ResearchAlliance(SPIRAL)Kelsey Needham Dancause, PhDI am a Biological Anthropologist interested in maternal and child health and the developmental origins of health and disease. I study maternal stress and health behaviors during pregnancy and their relationships with child development, particularly obesity and cardiometabolic outcomes. I am a member of the Stress in Pregnancy International Research Alliance (SPIRAL), whose members study prenatal stress and child behavioral, cognitive, motor, and physical development in three studies of prenatal stress due to natural disasters. I have also created two studies of chronic psychosocial stress and health behaviors during pregnancy, and their relationships with child development, in understudied populations. We analyze stress and health behaviors among socially disad-vantaged women in Montreal, and in Vanuatu, a lower-middle income country in the South Pacific (the “Healthy Mothers, Healthy Communities” study). Together, these studies help to clarify the role of prenatal stress in child development; highlight health behaviors that might interact with prenatal stress and exacerbate its effects; and might ultimately highlight areas for intervention to improve maternal and child health outcomes.Learning Objectives:•Tounderstandthedevelopmentaloriginsofhealthanddisease•Toappreciatethecomplexityofdesigninghumanstressstudies

THuRSDAy, APRIl 27, 2017MiniReview7:LivingwithObesity08:15 – 09:30 (Co-Chairs: Martin Binks & Sue Pedersen)Alberta / New Brunswick

MiniReview8:Pregnancy&MaternalHealth08:15 – 09:30 (Co-Chairs: Martin Binks & Sue Pedersen)Mt. Stephens Hall



ENRICH: Supporting Healthy Weights in Pregnancy and Postpartum Rhonda Bell, RD, PhDI lead a team of trainees (graduate and undergraduate students and post docs) and research staff in studies that examine the role of nutrition in promoting health and preventing and treating diabetes and its complications. My research program integrates applied and basic research. Much of my work is conducted within the paradigm of the Developmental Origins of Health and Disease, examining the role of nutritional intake during sensitive periods of development on health, specifically diabetes risk, in mothers and their offspring. In the applied setting, I am leading the ENRICH Program (a Collaborative Research and Innovation Opportunity funded by Alberta Innovates Health Solutions) aimed at improving maternal health during pregnancy and postpartum using innovative strategies that meet the needs of diverse groups of women across Alberta. The goals of this Program are to: 1) advance knowledge regarding food and nutrient intake and energy expenditure in pregnancy and postpartum; 2) understand perceptions and experiences of diverse groups of pregnant and postpartum women pertaining to diet, body weight and health; 3) identify needs, gaps and opportunities in health service delivery systems that may be harnessed to promote optimal dietary intake and appropriate weight management strategies; and 4) collaborate with knowledge users, to develop and evaluate strategies aimed at promoting optimal dietary intake and appropriate weight management. Learning Objectives:•ToprovideanupdateontheENRICHstudiesthatareaimedatimprovingmaternalhealthinpregnancyand postpartum by finding innovative ways to promote healthy weights and healthy eating•Toidentifyinnovativestrategiesthatmeettheneedsofdiversegroupsofwomenandcareproviders

Obesity Management in Women with Infertility Jean Patrice Baillargeon, MD, MScJean-Patrice Baillargeon, MD, MSc is board-certified in endocrinology and metabolism and professor of medicine at the Université de Sherbrooke. Dr Baillargeon primary areas of expertise include reproductive endocrinology, polycystic ovary syndrome, obesity, health system improvement and biostatistics/epidemiol-ogy. He completed a postdoctoral fellowship on the metabolic aspects of polycystic ovary syndrome (PCOS) under the supervision of Dr Nestler in 2003 and obtained a Master’s in Clinical research and Biostatistics from the Virginia Commonwealth University, Richmond VA. He is director of the Reproductive Endocrinology clinic of the Centre hospitalier universitaire de Sherbrooke (CHUS) and an active member of the Lifestyle Multidis-ciplinary Management Clinic of the CHUS. Dr Baillargeon obtained a CIHR Partnerships for Health System Improvement grant for the evaluation of clinical outcomes and costs of a transferable interdisciplinary lifestyle intervention in obese infertile women. This project is also funded by the Quebec Ministry of Health and the Research Center of Centre hospitalier universitaire de Sherbrooke, and puts together a national network of researchers and decision-makers interested in the implementation and evaluation of a lifestyle modification program integrated to fertility clinics. Dr Baillargeon received a Young Investigator Award from the Canadian Society of Endocrinology and Metabolism (CSEM) and is actually the President Elect of this Society. His has published >65 original peer-reviewed articles, 25 review articles and 6 book chapters.Learning Objectives:•Tounderstandthecausesofinfertilityandtheimpactofobesity•Toevaluatelifestylebenefitsandassessimpactsonfertility,pregnancyandneonataloutcomes


THuRSDAy, APRIl 27, 2017MiniReview8:Pregnancy&MaternalHealth08:15 – 09:30Mt. Stephens Hall



ParentingStress:AssociationswithChildhoodObesity,PhysicalActivity,andTvviewingKathryn Walton, MSc, RD PhD CandidateKathryn Walton is a PhD Candidate in the Department of Family Relations & Applied Nutrition at the Univer-sity of Guelph. Her research interests focus on factors in the general home environment that may increase risk of obesity among young children. Her Masters research focused on the association between parenting stress and obesity risk related behaviours among children including reducing physical activity and increased screen time. The focus of her PhD work has shifted to explore the influence of parent-child interactions during eating on children’s eating behaviours, dietary intake and weight status. This work has been largely informed by my work in the community as a Registered Dietitian.Learning Objectives:•Tounderstandwhatisparentingstress•Todeterminetheassociationbetweenparentingstressandchildweightoutcomes•Toevaluatetheimplicationsforpractice

TheSocialDeterminantsofPediatricObesity:TimetoLetGoofDietandExerciseJonathan McGavock, PhDJonathan McGavock is the Robert Wallace Cameron Chair in Evidence-based Child Health in the Department of Pediatrics and Child Health in Faculty of Medicine at the University of Manitoba. At the Manitoba Institute of Child Health, his research laboratory studies the role of physical activity associated with the prevention and management of type 2 diabetes in youth.Learning Objectives:•Tounderstandthesocialdeterminantsofpediatricobesity•Toidentifyinnovativestrategiestoimprovehealth

Looking Beyond Nutrition and Obesityleia Minaker, BSc, MSc, PhDLeia Minaker is an assistant professor in the School of Planning at the University of Waterloo and an Affiliated Scientist at the Propel Centre for Population Health Impact. She received a PhD in public health from the Uni-versity of Alberta in 2013, and currently holds a Canadian Cancer Society Research Institute Career Develop-ment Award in Cancer Prevention. She is interested public health nutrition, especially around retail food environment interventions (like healthy corner stores) and using urban planning practice to create healthy cities.Learning Objectives:• Participantswillidentifybenefitsofdifferentdietarypatternsbeyondnutritionandweightstatus• Participantswillcomparepublichealthfoodrecommendationstoidentifyinconsistencies• Participantswillrecognizedifferentcompellingfood-healthnarrativesthatcaninfluencedietaryintakeinthe population

THuRSDAy, APRIl 27, 2017MiniReview9:FamilyBasedPediatricCare10:00 – 11:00 (Co-Chairs: Jean-Philippe Chaput & Mark Tremblay)Alberta / New Brunswick



Obesity as a Chronic DiseaseArya M. Sharma, MD, PhDIn 2002, Arya M. Sharma was recruited from the Humboldt University, Berlin, Germany, to a Canada Research Chair (Tier1) in Cardiovascular Obesity and Management at McMaster University. In 2007 he accepted a position as Professor and Chair in Obesity Research and Management at the University of Alberta, where he is also the Medical Director of the Edmonton Regional Bariatric Program. In 2005, he spearheaded the launch of the Canadi-an Obesity Network, which, with well over 10,000 members, has remarkably transformed the landscape of obesity research and management in Canada. He is also Past-President of the Canadian Association of Bariatric Physicians and Surgeons. His research focuses on an evidence-based approach to managing obese patients and includes the development of the Edmonton Obesity Staging System. Dr. Sharma has authored or coauthored more than 300 publications and has lectured widely on the aetiology and management of hypertension, obesity, and related cardiometabolic disorders. Dr. Sharma is regularly featured as a medical expert in national and international TV and print media including the CBC, CTV, New York Times, and MSNBC. Dr. Sharma maintains a widely-read blog where he regularly posts his ideas and thoughts on obesity prevention and management: http://www.drsharma.ca.Learning Objectives:• Abletodiscussthehomeostaticmechanismsinvolvedinbodyweightregulation• Gaininsightintothemetabolicandweighteffectsofdifferentdietaryapproachestoweightmanagement• Understandtheroleofmealreplacementstrategiesinlong-termweightmanagement

ImprovingObesityPreventionandManagementinPrimaryCare:The5AsTeamProgramDenise Campbell-Scherer, MD, PhD, CCFP, FCFPDenise L. Campbell-Scherer is an Associate Professor in the Department of Family Medicine, University of Alberta, and a practicing family physician, researcher and teacher. She is co-Lead with Dr. Arya Sharma for the “Implemen-tation and validation of the 5As framework of obesity in primary care: the 5As Team (5AsT) project.” The goal of the study is to increase the quality and quantity of obesity management in primary care by using the 5AsT inter-vention to change provider behaviour. Dr. Campbell-Scherer’s research focuses on innovations to transform clinical practice and result in change of benefit to patients, providers and the healthcare system. She has been active in the BETTER, BETTER2, and BETTERWISE projects (www.better-program.ca) that are seeking to transform primary prevention and screening of multiple conditions in diverse regions of Canada. In addition, she is a Co-Investigator and part of the Steering Committee for the ACPLF Innovation Stream on CHANGE. Dr. Campbell-Scherer is also an Associate Editor for the journal Evidence-based medicine, BMJ publishing group (http://ebm.bmj.com).Learning Objectives:• Explorethepatientperspectiveontheroleofprimarycareinobesitymanagementandtheirexperienceof existing resources;• Exploresuccessfulstrategiesforimprovingtheconfidenceandcompetenceofinterdisciplinaryprimarycare providers and teams in obesity prevention and management;

THuRSDAy, APRIl 27, 2017MiniReview10:ManagingObesityasaChronicDisease10:00 – 11:00 (Co-Chairs: David Macklin & Andre Tchernof)Mt. Stephens Hall



TreatingtheBigPicture:DiabetesandObesitySue Pedersen, MD, FRCPCDr. Sue is a Specialist in Endocrinology & Metabolism, having completed her training at the University of Calgary in 2005. She is also a Diplomate of the American Board of Obesity Medicine. Over the last decade, she has worked at the University of Saskatchewan and the University of Copenhagen, Denmark, where she began her work in obesity research. Dr. Sue has a busy endocrinology practice at the C-ENDO Diabetes & Endocrinology Clinic in Calgary, with a focus on type 2 diabetes and obesity. She is a member of the Expert Committee for the 2018 Canadian Diabetes guidelines, and she is a principal investigator for several research studies in diabetes and obesity. She maintains a public information website about weight management and diabetes: www.drsue.ca. Learning Objectives:• Discussapproachtoaligngoalsofglycemiccontrolandweightmanagementinpatientslivingwithdiabetes• Discussbenefitsofweightmanagementinpeoplewithdiabetes• Reviewtreatmentoptionsforweightmanagementinthecontextofdiabetesi. Lifestyle managementii. Pharmacotherapyiii.Bariatric surgery

CanWeTrustDataonDietaryIntake?Sharon Kirkpatrick, PhDSharon Kirkpatrick is a registered dietitian and Assistant Professor at the School of Public Health and Health Systems at the University of Waterloo. Her work focuses mainly on methodologic issues associated with measuring what people eat and drink and strategies to mitigate measurement error in dietary assessment. She works with a number of cohort studies to identify feasible and robust approaches to the measurement of diet. Her work also encompasses technology to increase the feasibility of comprehensive capture of intake while reducing respondent burden. She was previously a nutritionist with the Risk Factor Monitoring and Methods Branch of the U.S. National Cancer Institute and received two National Institutes of Health Awards of Merit for her work related to dietary assessment. She holds a PhD in Nutritional Sciences and Master of Health Science in Community Nutrition from the University of Toronto. Dr. Kirkpatrick is currently funded by a Canadian Cancer Society Research Institute Capacity Development Award.Learning Objectives:• Reviewanddiscussrecentdebatesregardingthevalueofdietarydata• Describestrategiestomitigateerroranditseffectsonstudyfindings• Examinecircumstancesinwhichself-reportdietarydatamaynotbeappropriate• Exploreemergingdirectionsforadvancingdietaryassessment• Discoverresourcestosupportrobustdietaryassessmentinresearch

Can Policy Ameliorate Socioeconomic Inequities in Obesity and Obesity-Related Behaviours?Dana Olstad, PhD, RDDr. Dana Olstad is an Assistant Professor in the Department of Community Health Sciences at the University of Calgary. Her research program aims to inform development and implementation of policies, both inside and outside the health sector, to improve dietary behaviours, body weight, and health, particularly among disadvantaged groups. Learning Objectives:• Understandtheroleofuniversalpoliciesinreducingsocioeconomicinequitiesinobesityandobesity- related behaviours• Understandhowtargetedpoliciescanhelptoreduceobesityinsocioeconomicallydisadvantagedgroups

THuRSDAy, APRIl 27, 2017MiniReview10:ManagingObesityasaChronicDisease10:00 – 11:00Mt. Stephens Hall

MiniReview11:NutritionBeyondFood16:30 – 17:30 (Co-Chairs: Bohdan Luhovyy & Mary L’Abbe)Alberta / New Brunswick



FoodsThatImproveMetabolicParametersGordon Zello, PhDGordon Zello is a Professor of Nutrition in the College of Pharmacy and Nutrition and currently Head of the Division of Nutrition and Dietetics at the University of Saskatchewan He is also an Associate Member of the Col-lege of Kinesiology. He arrived in Saskatoon in 1992 after completing graduate studies determining the dietary amino acid and protein needs of young adults at the University of Toronto and The Hospital for Sick Children. Dr. Zello teaches courses in “Protein, Fat, Carbohydrate and Energy Metabolism”, “Nutritional Assessment” and “Research Methods” and has an active graduate and research program in both basic and applied nutrition. His fields of specialization are intermediary metabolism and nutritional assessment. His research interests include the measurement of body composition, energy expenditure, and nutrient requirements in both healthy and clinical populations, as well as studying the integration and regulation of metabolism in differing nutritional states. Dr. Zello is a member of the University’s Obesity Research Group and the Saskatchewan Natural Products Network. He has published over 70 scientific articles and review papers, and has given over 90 conference presentations.Learning Objectives:•Toidentifyfoodsthatimprovemetabolichealth•Highlightandidentifywheretheevidenceisstrong

TheRoleoftheGutMicrobiomeinObesity:OpportunitiesforNutritionalInterventionsJens Walter, PhDJens Walter is an Associate Professor and Campus Alberta Innovation Program Chair for Nutrition, Microbes,and Gastrointestinal Health at the University of Alberta. After receiving his doctoral degree from the Universityof Hohenheim in Germany, he performed postdoctoral research into genetic and metagenomic approaches tostudy gut microbial ecology at the University of Otago in New Zealand. His main research interests are the inves-tigation of ecological and evolutionary processes that shape host–microbial symbioses in the vertebrate gut, andspecifically the effect of diet on composition and function of the gut microbiome in the context of health.Learning Objectives:• Describethecontributionofthegutmicrobiotatoweightgainandobesity-associatedpathologies,andthe underlying mechanisms • Discusschallengesandinconsistenciesinthefield• Provideanoverviewoftheopportunitiesbywhichthemicrobiomecouldbetargetedtopreventobesityand/or its associated pathologies

THuRSDAy, APRIl 27, 2017MiniReview11:NutritionBeyondFood16:30 – 17:30Alberta / New Brunswick

MiniReview12:Microbiome16:30 – 17:30 (Chair: Phillip Sherman)Mt. Stephens Hall



DysbiosisandNon-AlcoholicFattyLiverDisease:IsThereaRelationship?Johanne Allard, MD FRCPDr. Johane P. Allard is Professor of Medicine at the University of Toronto, Toronto, Canada and is crossed-appoint-ed at the Department of Nutritional Sciences and Institute of Medical Sciences. She is also a Senior Scientist at the Toronto General Research Institute. She trained in gastroenterology at McGill University before completing a research fellowship funded by the National Institute of Nutrition at the University of Toronto. Dr. Allard is a clinician investigator, with a research focus in nutrition and gastrointestinal disorders. She is currently conducting several studies funded by peer-reviewed agencies in patients requiring nutrition support, people with non-alcoholic fatty liver disease (NAFLD) and patients with morbid obesity undergoing bariatric surgery. She is also conducting research on malnutrition in Canadian hospitals and has developed a research program on the intestinal microbiome related to the Metabol-ic-Syndrome. She is the recipient of several CIHR grants looking at the association between the intestinal microbiome and obesity/metabolic syndrome which include assessing the effect of fecal microbiota transplant on the outcomes of these patients. Her publications are primarily in the area of micronutrients, oxidative stress, malnutrition, nutrition support, NAFLD. For NAFLD, she has published on nutrition, gene expression, intestinal microbiota and metabolic syndrome. Dr. Allard is also the Director of the Division of Gastroenterology at the University of Toronto and the Direc-tor of the Nutrition Support Program at the University Health Network (UHN). She works with a multidisciplinary nutri-tion support team and is the Chair of the Nutrition Review Committee. She is also the past-chair the Royal College of Physician and Surgeon Examining Board in Gastroenterology and co-founder of the Canadian Nutrition Society and member of its Advisory Board. She has been the co-chair of the Canadian Malnutrition Task ForceLearning Objectives:• Reviewwhatisnon-alcoholicfattyliverdisease(NAFLD),itsassociationwithmetabolicsyndromeandclinicalimpact• ReviewthecompositionandroleofIMinmetabolicsyndromeandNAFLD • ReviewtheeffectofinterventionstudiesonIM,metabolicsyndromeandNAFLDI. Diet II. Bariatric surgeryIII. Fecal transplantIV. Probiotics

Gut Microbiota as a Potential Mediator of the Metabolic Effects of Bariatric SurgeryAndre Tchernof, PhDDr. Andre Tchernof is Professor at Laval University School of Nutrition since 2000. After a Bachelor’s degree in Biochemistry (1991), a Master’s degree (1992) and a Doctoral degree (1996) in Physiology-Endocrinology at Laval University, he underwent two postdoctoral trainings in Molecular Endocrinology (Laval University Medical Center, 1996-97) and in Endocrinology & Metabolism at the University of Vermont (1997-2000). He then obtained salary awards from the Fonds de la recherche en santé du Québec and Canadian Institutes of Health Research (2000-2012). His research projects have been funded among others by the Canadian Institutes of Health Research, the Canadian Diabetes Association and the National Science and Engineering Research Council. He also co-directed the Research Chair in Bariatric and Metabolic Surgery and is co-director of the Institutionally-approved Obesity Tissue Bank at Institut Universitaire de Cardiologie et Pneumologie de Québec. He is currently the Principal Investigator of a Canadian Institutes of Health Research Team Grant on bariatric care, the REMISSION study. He contributed to more than 150 publications in peer-reviewed journals. His research interests relate to the meta-bolic complications of obesity and body fat distribution, with a particular emphasis on adipose tissue physiology. Experimental approaches combine cellular biology techniques with biochemistry, genomics, transcriptomics and clinical investigation in humans. Published work has involved collaborations with many surgeons from various surgery services at Laval University-affiliated hospitals, including studies on the impact of bariatric surgery. His research allows clinical observations to be linked with the cellular characteristics or mechanisms underlying pathophysiological conditions such as abdominal obesity and related cardiometabolic complications.The learning objectives:• Describethesurgicalprocedurescurrentlyusedforthetreatmentofsevereobesityandtheireffects• Describethechangesingutmicrobiotaobservedfollowingvariousbariatricoperations• Addresssomeoftheputativemechanismsinvolvedingutmicrobiota-mediatedimprovementsfollowingbariatricsurgery

THuRSDAy, APRIl 27, 2017MiniReview12:Microbiome16:30 – 17:30Mt. Stephens Hall


TheWeightofLiving:PersonalPerspectivesJodi Krah, PEC memberCurrently Jodi is a Patient Advocate for people living with Obesity as well as manager for Habitat for Humanity Niagara and has sat on various charitable boards in Ontario. She sits on the Science Committee as the Public Engagement Committee representative for CON. Mrs. Krah has a Bachelor of Fine Arts with Distinction from Brock University and a Diploma in Broadcasting from Niagara College. She has had a long career in senior exec-utive management in the retail industry. Jodi has had obesity throughout her entire life, starting at a very young age. Through 4 decades she gained and lost hundreds of pounds and spent thousands of dollars to reduce her weight. 9 years ago Jodi lost over 100 pounds through non-surgical methods at the Wharton Medical Clinic and struggles to maintain her weight loss.

Assessing Nutritional Intake in Canadian Children and AdolescentsMary R. l’Abbe, PhDDr. Mary L’Abbé is the Earle W. McHenry Professor and Chair of the Department of Nutritional Sciences, Faculty of Medicine, at the University of Toronto, where she leads a research group on Food and Nutrition Policy for Population Health. Her research examines the nutritional quality of the Canadian food supply, food intake patterns, and consumer research on food choices related to obesity and chronic disease. Dr. L’Abbé a member of several committees of the WHO including the Nutrition Guidance Expert Advisory Group on Diet and Health and the Global Coordinating Mechanism for NCDs. Dr. L’Abbé was co-chair of the Canadian Trans Fat Task Force and Chair/Vice-Chair of the Sodium Working Group. Before joining the University of Toronto, Dr. L’Abbe was Director, Bureau of Nutritional Sciences at Health Canada. Dr. L’Abbé holds a PhD in nutrition from McGill University and has authored over 180 peer-reviewed scientific publications, book chapters and government reports.Learning Objectives:• TounderstandthequalityofthefoodchoicesofCanadianchildrenandadolescents,relativetothe recommendations in Eating Well with Canada’s Food Guide• TobetterunderstandtherolethateatinglocationandoccasionplayinthenutrientintakesofCanadian children and adolescents

RecentTrendsinthePrevalenceofOverweightandObesityamongCanadianChildrenCelia Rodd, MD, MSc, FRCPCDr. Celia Rodd is an Associate Professor in the Department of Pediatrics and Child Health at the University of Manitoba; she recently moved to Winnipeg after working for 20 years at the Montreal Children’s Hospital, McGill University. At McGill University, she had the pleasure of being the Program Director for Pediatric Endo-crinology for 15 years. She trained at the University of Toronto (BSc, MD, Clinical Endocrinology Fellowship), McGill University (Pediatrics Residency), the University of Minnesota (Research Endocrinology Fellowship) and at the London School of Hygiene and Tropical Medicine (Masters of Epidemiology). Celia’s clinical and research interests focus on calcium homeostasis and bone physiology and their associated disorders. She is particularly interested in defining optimal vitamin D intake for healthy Canadian children and ensuring com-pliance with current guidelines. Celia has worked with the Canadian Pediatric Endocrine Group to develop optimized growth charts in Canada based on the 2006-2007 WHO growth charts. She has published over 80 peer-reviewed manuscripts in a wide spectrum of endocrine and diabetes related topics. Additionally, she has been funded by numerous agencies including Canadian Institute of Health Research.Learning Objectives:• Changesingrowthchartsoverthepast2decades• Newchartsformonitoringcentraladiposity(e.g.waistcircumference,waist:heightratios)• RecentprogressineffortstocontaintheNorthAmerican‘obesityepidemic’• Theimportanceofsocioeconomicdeterminantsinthedevelopmentofoverweight/obesityinCanada


FRIDAy, APRIl 28, 2017MiniReview13:PopulationHealth–Surveillance08:15 – 09:30 (Co-Chairs: Ian Janssen & Chris Ardern)Alberta / New Brunswick


Canadian24-HourMovementGuidelinesforChildrenandYouthMark Tremblay, PhDProfessor Tremblay has a Bachelor of Commerce degree in Sports Administration and a Bachelor of Physical and Health Education degree from Laurentian University. His graduate training was from the University of Toronto where he obtained his M.Sc. and Ph.D. from the Department of Community Health with a specialty in Exercise Science. Dr. Tremblay is the Director of Healthy Active Living and Obesity Research (HALO) at the Children’s Hospital of Eastern Ontario Research Institute and Professor of Pediatrics in the Faculty of Medicine, University of Ottawa. He is a Fellow of the American College of Sports Medicine, Chair of the Active Healthy Kids Global Alliance, Chair of the Canadian Physical Activity Guidelines Committee, Founder of the Sedentary Behaviour Research Network, and former Dean of Kinesiology at the University of Saskatchewan. Dr. Tremblay has published more than 330 scientific papers and book chapters in the areas of childhood obesity, physical activity measurement, exercise physiology, sedentary physiolo-gy and health surveillance. His h-index is 50 and his published research has been cited >11,000 times according to Scopus. He has delivered >700 scholarly conference presentations, including >140 invited and keynote addresses, in 20 different countries. Dr. Tremblay received an honorary doctorate from Nipissing University, the Queen Elizabeth II Diamond Jubilee Medal, the Lawson Foundation 60th Anniversary Award and the Canadian Society for Exercise Physi-ology Honour Award for his leadership contributions to healthy active living in Canada. Dr. Tremblay’s most productive work has resulted from his 28-year marriage to his wife Helen, yielding four wonderful children.Learning Objectives:• Understandtherationalefor,andproceduresusedtodevelop,theCanadian24-HourMovementBehaviour Guidelines for Children and Youth.• Appreciatetheimportanceoftheintegratedcompositionofsleep,sedentarybehaviourandphysical activities over the 24-hour period on health.• Adjusthealthylivingcounsellingpracticeswithschool-agedchildrentopromotethenewCanadian24-Hour Movement Behaviour Guidelines for Children and Youth.• KnowwheretoseekfurtherinformationontheCanadian24-HourMovementBehaviourGuidelinesfor Children and Youth.

TheWeightofLiving:PersonalPerspectivesIan Patton, PEC memberI have been involved in CON for several years as a researcher and trainee. I have also struggled with my weight my entire life and am a recent Bariatric Surgery patient. I have worked as an obesity expert and lived as an obese person. My involvement with the CON Public Engagement Strategy was a natural fit and some-thing I am very passionate about. I am excited to help introduce the public to the deep knowledge base of the network and brilliance of CON members.

Physiological Determinants of Energy MetabolismEric Doucet, PhD, MSc, BScEric Doucet is a Professor at the School of Human Kinetics at the University of Ottawa. He obtained his Ph.D. in Physiology and Endocrinology from Université Laval. His research program focuses specifically on understanding the contribution of physiological and endocrine factors to variations in energy balance and body weight regulation. He has published numerous articles in highly specialized journals in this area. He serves as Editor for the British Journal of Nutrition, the Journal of the Nutrition Society, the Journal of Obesity and Frontiers in Physiology.Learning Objectives:• Tounderstandtherelationshipthatexistsbetweenbodymassandenergyexpenditure.• Tounderstandtheconceptofadaptivethermogenesis(metabolicadaptation)thatoccursduringweightloss.• Tobeabletodescribetheeffectsofslowvsfastweightlossonenergyexpenditure.


FRIDAy, APRIl 28, 2017MiniReview13:PopulationHealth–Surveillance08:15 – 09:30Alberta / New Brunswick

MiniReview14:EnergyMetabolism&BodyComposition08:15 – 09:30 (Co-Chairs: Mary Ellen Harper & Jennifer Kuk)Mt. Stephens Hall


EffectofFoodsonAppetiteandEnergyIntakeBohdan luhovyy, PhDDr. Bohdan Luhovyy obtained his PhD in physiology in Lviv National University in Ukraine in 2001. From 2002 to 2005, he was a postdoctoral fellow at the University of Pennsylvania. From 2006 until 2011, Dr. Luhovyy was a research associate with Dr. Harvey Anderson at the Department of Nutritional Sciences, University of Toronto. In July 2011, Bohdan joined the Mount Saint Vincent University, and now he is an associate professor in the Department of Applied Human Nutrition and adjunct professor at the Department of Physiology and Biophysics of Dalhousie University in Halifax, Nova Scotia. Learning Objectives:• Tooverviewthehomeostaticandhedonicregulationsoffoodintake• Tocomparetheeffectoffoodsanddrugsonappetitesuppressionandreviewthefood-basedhealthclaims on satiety proposed in Canada and the regulation around the world• Tolearntheeffectofmacronutrientsonfoodintakeregulation• Toidentifywholefoodsandfoodingredientswithknowneffectonfoodintakeregulationinhumans.

Defining and Measuring Sarcopenic ObesityCarla Prado, PhDDr. Carla Prado is an Assistant Professor at the University of Alberta in Canada and a Campus Alberta Inno-vates (CAIP) Chair in Nutrition, Food and Health. She is the Director of the Human Nutrition Research Unit, a state-of-the-art research and training facility. Dr. Prado is an expert in assessing nutritional status through the precise measurement of body composition and energy metabolism. Her research has shown for the first time the prevalence and clinical implications of sarcopenic obesity in cancer, and has provided evidence of the in-dependent effect of body composition on cancer recurrence, treatment and survival. The focus of her current research program is to develop targeted nutrition interventions for the prevention and treatment of sarcope-nic obesity in patients with diverse chronic conditions. She is currently the Principal Investigator of two ran-domized controlled trials investigating the impact of nutrition intervention on body composition and health. Dr. Prado received her Ph.D. from the University of Alberta, Canada, and has completed further training at the Cross Cancer Institute (Canada), the National Institutes of Health (USA) and Newcastle University (UK). She is an Associate Editor of Clinical Nutrition and the Journal of Cachexia, Sarcopenia and Muscle. She serves as a member of the Body Composition Clinical Guidelines group for the American Society for Parenteral and Enteral Nutrition, and the National Cancer Institute Sarcopenia Workshop Planning Committee. Learning Objectives:• Todiscusstheprevalenceandrelevanceofsarcopenicobesity• Todiscussassessmenttoolsfortheidentificationofabnormalbodycompositionphenotypes• Todiscussproposedcriteriatodefinesarcopenicobesity


FRIDAy, APRIl 28, 2017MiniReview14:EnergyMetabolism&BodyComposition08:15 – 09:30Mt. Stephens Hall


ImpactofHockeyFansinTrainingProgramonHealthinOverweightMenRobert Petrella, MD, PhD, FCFP (SEM, COE), FACSMDr. Robert Petrella is a Professor in the Department of Family Medicine at Western University, with cross-ap-pointments in Kinesiology and Cardiology. Dr. Petrella is the Medical Director of the Canadian Centre for Activity and Aging and is a practising Physician with St. Joseph’s Health Care London. Throughout 2005-2015, Dr. Petrella was the inaugural Beryl and Richard Ivey Research Chair, as well as Program Leader for the former Aging, Rehabilitation, and Geriatric Care Program of Lawson Health Research Institute (now referred to as the Parkwood Institute Research Program). Dr. Petrella’s research is focused on lifestyle interventions for chronic disease prevention and management. His research is dedicated to furthering multi- and inter-disciplinary research on lifestyle management, physical activity, chronic diseases, and innovative technologies to improve the lives of all Canadians, with a specific focus on vulnerable populations (i.e., men, older adults, indigenous, and those living in rural and remote regions). Dr. Petrella’s publications cross disciplines and span topics including lifestyle prescription, healthy aging, real-world rural and remote practice, cardiovascular disease, diabetes, mobility, osteoarthritis, men’s health, and eHealth (totalling 200 peer-reviewed articles with 6754 citations). Dr. Petrella’s research has also led to 2 patents in chronic disease therapy, 6 trademarks, and the development of 2 smartphone apps to extend research reach.Learning Objectives:• TohighlighttheburdenofMen’sHealthandchallengeinengagingmeninmakinglifestylechanges.• Todescribeaninnovativeengagementstrategyforoverweightandobesemenusingtheirloveofbeinga hockey fan.• TodescribethemainfindingsofHockeyFansinTraining.

IsOneMinuteofExerciseEnough?Jonathan little, PhDDr. Little is an Assistant Professor and CIHR New Investigator at the University of British Columbia, Okanagan Campus. The aims of research conducted in his lab are to optimize exercise and nutritional interventions for improving cardiometabolic health and reducing inflammation in people with, and at risk for, type 2 diabetes. One major focus is on the efficacy and effectiveness of time-efficient high-intensity interval training (HIIT) as a strategy for the treatment and prevention of type 2 diabetes.Learning Objectives:•Tounderstandthebenefitsofintenseexercise•Toshareresearchfindingsandlessonslearned

ExerciseEffectsonInflammationandAdipocyteBiologyDavid Wright, PhDDr. Wright received his PhD in Human Bioenergetics from Ball State University and completed postdoctoral training in the School of Medicine at Washington University in St. Louis. Dr. Wright is currently an Associate Professor and Tier II Canada Research Chair in the Department of Human Health and Nutritional Sciences at the University of Guelph. His research program is focused on studying the interactions between exercise, diet and pharmacological manipulations on adipose tissue and liver metabolism and how this impacts whole body fuel utilization.Learning Objectives:• Theanti-inflammatoryeffectsofexerciseonadiposetissue• Theeffectsofexerciseonmodulatingadiposetissuemetabolism• Howadiposetissuecaninfluencewholebodyfuelmetabolism


FRIDAy, APRIl 28, 2017MiniReview15:PhysicalActivityBenefitsBeyondWeightLoss10:00 – 11:00 (Co-Chairs: David Lau & Marc Bomhof)Alberta / New Brunswick



FRIDAy, APRIl 28, 2017MiniReview16:BariatricSurgeryII10:00 – 11:00 (Co-Chairs: Priya Manjoo & Michael Lyon)Mt. Stephens Hall

SleeveGastrectomy:The#1PerformedBariatricOperation-ACultureShiftoraFadDennis Hong, MD, MSc, FRCSCDr. Dennis Hong is an Associate Professor in the Department of Surgery at McMaster University. He special-izes in Minimally Invasive and Bariatric Surgery. He completed his undergraduate studies in Biology from the University of Western Ontario in 1992. Dr. Hong received his medical degree (M.D.) from the University of To-ronto in 1996. He completed his residency in the Department of Surgery, McMaster University Medical Centre in Hamilton, ON. Then in 2003, he completed a Minimally Invasive Surgery Fellowship at the Legacy Health System in Portland Learning Objectives:• RecognizethegrowingpopularityandvariationofsleevegastrectomyinCanada• Understandmajorcomplicationsofsleevegastrectomy• Understandmajoroutcomeresultsofsleevegastrectomy

RefluxDiseaseanditsImpactonBariatricSurgicalChoiceShahzeer Karmali, BSc MD MPH FRCSC FACS FASMBSDr. Shahzeer Karmali is a minimally invasive gastrointestinal/bariatric surgeon, based at the Royal Alexan-dra Hospital. He is an Associate Professor, Department of Surgery, Faculty of Medicine and Dentistry at the University of Alberta. He completed his surgical residency at the University of Calgary in 2002 and Fellowship training in minimally invasive surgery at Baylor College of Medicine, Houston. Dr. Shahzeer Karmali is appoint-ed to be the Assistant Professor in the Department of Surgery, University of Alberta and is also the General surgery representative, CAMIS Expert Advisory Panel. He is the Executive member of Canadian Association of Bariatric Physicians and Surgeons Member, CAGS Clinical Practice Committee and Committee on Laparos-copy and Endoscopy. He trained at the Methodist Hospital, Houston, Texas, on the DaVinci “S” HD Surgical Robot, at Ohio State University, Columbus, Ohio, on StomaphyX and at Endosastic Solutions, Seattle, Wash-ington on EsophyX.

Bariatric Surgical Outcomes on the National Stage-MBSAQIP and NSQIP Timothy Jackson, BSc, MD, MPH, FRCSC, FACSAfter receiving a Bachelor of Science degree in Life Science from McMaster University in 1999, Dr. Jackson attended medical school at McMaster. Upon completion, he entered the McMaster post-graduate training program in General Surgery. Dr. Jackson became a Fellow of the Royal College of Physicians and Surgeons of Canada in 2009, and was certified by the American Board of Surgery in 2010. In 2006, he attended Harvard University and received a Master of Public Health degree in Quantitative Methods. Currently, his research interests are in surgical quality improvement and surgical outcomes. In 2010, he completed the Harvard Advanced Laparoscopic Surgery Fellowship at Massachusetts General Hospital in Boston. His clinical focus is in bariatric and gastrointestinal tract surgery. Dr. Jackson is a member of the Division of General Surgery at University Health Network based at Toronto Western Hospital. He is an Assistant Professor of Surgery.Learning Objectives:•ToexaminetheMetabolicandBariatricSurgeryAccreditationandQualityImprovementProgram (MBSAQIP) and the associated clinical recommendations•ToreviewtheNationalSurgicalQualityImprovementProgram(NSQIP)• TounderstandhowCanadianhospitalsandprogramsareworkingtomeasurablyimprovesurgicaloutcomes


11:00 – 11:30 (SNP Chair: Rebecca Liu)Alberta / New BrunswickPecha Kucha Presentations 1 Note: Pecha Kucha posters will be on display for viewing from Wednesday April 27 to Friday April 28, inclusive. See below for the Pecha Kucha oral presentation schedule and location of Pecha Kucha poster board.

PK Poster Board # Abstract # Title Speaker Institution

PK1.1 3147 Food, Eating, and Weight: Language, Sarah Nutter & University of Calgary Discourses, and Debates in the Obesity Shelly Russell-Mayhew Calgary, AB Field PK1.2 3079 Food Insecurity, Diet Quality and Obesity Diana Tarraf University of Ottawa in African and Caribbean Households in Ottawa, ON PK1.3 3168 Addressing Weight Bias in a Provincial Jenifer Bennett Alberta Health Services Health Services Organization Edmonton, AB

11:00 – 11:30 (SNP Chair: Alexa Ferdinands) Mt. Stephens HallPecha Kucha Presentations 2 Note: Pecha Kucha posters will be on display for viewing from Wednesday April 27 to Friday April 28, inclusive. See below for the Pecha Kucha oral presentation schedule and location of Pecha Kucha poster board.


PK2.1 3127 A Systematic Review and Meta-Analysis Lisa Kakinami Concordia University of Weight Loss Intentions and Strategy Montreal, QC Use Among Youth

PK2.2 3087 Fasting and Postprandial Glucose, Insulin Maha Alsaif University of Alberta and Glucagon-like Peptide 1 (GLP-1) Levels Edmonton, AB in Children with Prader-Willi Syndrome (PWS)

PK2.3 3092 Prevalence of Comorbid Conditions Paola Luca University of Calgary Pre-existing and Diagnosed at a Tertiary Calgary, AB Care Pediatric Weight Management Clinic

PK2.4 3517 The Live 5-2-1-0 Family Physician Toolkit Susan Pinkney & BC Children’s Hospital for Promoting Healthy Childhood Shazhan Amed Research Institute Behaviours in Primary Care – A Pilot Study Vancouver, BC

Pecha Kucha Session Details



11:00 – 11:30 (SNP Chair: Allana Leblanc) Alberta / New BrunswickPecha Kucha Presentations 3Note: Pecha Kucha posters will be on display for viewing from Wednesday April 27 to Friday April 28, inclusive. See below for the Pecha Kucha oral presentation schedule and location of Pecha Kucha poster board.


PK3.1 3197 Smoking Does Not Significantly Worsen Brian W. McCrindle The Hospital for Sick Lipid Changes Related to Increasing Children Adiposity in Adolescents: A Heart Niagara Toronto, ON Healthy Heart Schools’ Program Study

PK3.2 3166 Cardiovascular Fitness and not Physical Alisha N. Jamal Hospital for Scik Children, Activity Mediates the Relationship between University of Toronto Dyslipidemia and Higher Adiposity in Toronto, ON Canadian Youth

PK3.3 3191 Body Fat Percentile Curves for Children and Jennifer McConnell University of Victoria Youth of Asian and European Ancestry Victoria, BC

PK3.4 3183 Growing Little Sprouts: Enhancing Tracy McDonough & KFL&A Public Health Supportive Environments in Childcare Mary Jane Gordon Kingston, ON Settings

11:00 – 11:30 (SNP Chair: Melissa Fernandez)Mt. Stephens HallPecha Kucha Presentations 4Note: Pecha Kucha posters will be on display for viewing from Wednesday April 27 to Friday April 28, inclusive. See below for the Pecha Kucha oral presentation schedule and location of Pecha Kucha poster board.


PK4.1 3195 The Association of Delta-5- and Delta-6- Valérie Lamantia Université de Montréal desaturase Activities with Risk Factors for Montréal, QC Type 2 Diabetes is Dependent on Plasma apoB in Obese Subjects

PK4.2 3118 The Mcmaster Optimal Aging Portal: A tool Sarah Neil-Sztramko McMaster University to provide evidence-based information on Hamilton, ON healthy aging

PK4.3 3052 Trends in Medication Use by BMI and Age Arshdeep K. Randhawa York University over Time in the United States Brampton, ON

PK4.4 3121 Weight Loss, Regression to Normoglycemia, David C. Lau University of Calgary and T2D Development at 3 Years in Early Calgary, AB Weight Loss Responders to Liraglutide 3.0 mg: SCALE Obesity and Prediabetes Trial




11:00 – 11:30 (SNP Chair: Rebecca Liu) Alberta/New Brunswick Pecha Kucha Presentations 5Note: Pecha Kucha posters will be on display for viewing from Wednesday April 27 to Friday April 28, inclusive. See below for the Pecha Kucha oral presentation schedule and location of Pecha Kucha poster board.


PK5.1 3508 Neighbourhood Built Design and Gavin McCormack University of Calgary Socioeconomic Composition and Their Calgary, AB Associations With Weight Status in Canadian Adults

PK5.2 3175 The REFRESH Study Recreation Environment Susan Caswell University of Waterloo and Food Research: Experiences from Hockey Waterloo, ON – Perspectives Revealed Through the Photovoice Method

PK5.3 3158 The Impact of Accelerometer Wear Location Alexandra B. Cooke McGill University on Physical Activity Estimates and the Montreal, QC Relationship with Arterial Health in Adults Treated for Hypertension and Diabetes

PK5.4 3084 The Association Between Functional Skills Andrea Mayo University of New Movements and Obesity-Related Risk Brunswick Factors and Fitness Level Fredericton, NB

11:00 – 13:30 (SNP Chair: Amanda Raffoul) Mt. Stephens Hall Pecha Kucha Presentations 6Note: Pecha Kucha posters will be on display for viewing from Wednesday April 27 to Friday April 28, inclusive. See below for the Pecha Kucha oral presentation schedule and location of Pecha Kucha poster board.


PK6.1 3179 The Economic Impact of Bariatric Surgery: Jillian Vallis Memorial University of A Retrospective Cohort Study Newfoundland St. John’s, NL

PK6.2 3103 Relationship of Weight Loss Expectations Allison A. Holgerson Mayo Clinic to Bariatric Surgery Outcome Rochester, MN PK6.3 3505 Long-Term Impacts of Adding Supervised Aurélie Baillot Université du Québec en Exercise Training to Interdisciplinary Lifestyle Gatineau, QC Management in Subjects Awaiting Bariatric Outaouais Surgery

PK6.4 3171 Psychosocial Predictors of Cognition in Raed J. Hawa UHN, Toronto Western Bariatric Surgery Candidates Toronto, ON Bariatric Surgery Program



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14:00 – 16:00 (Co-Chairs: Sara Kirk & Sonja Wicklum)Alberta/New BrunswickConcurrent Oral Presentations 1: Weight Bias, Stigma and Body Image

Program # Abstract # Title Speaker Institution

O1.1 3139 Dieting and Other Risky Behaviours Among Amanda Raffoul University of Waterloo Adolescent Girls: Implications for Obesity Waterloo, ON Prevention Initiatives

O1.2 3146 What’s in a Name? The Influence of Framing Sarah Nutter & University of Calgary Obesity as a Disease on Weight Bias Angela Alberga Calgary, AB & Concordia University Montreal, QC

O1.3 3091 Association between Weight Discrimination Chris I. Ardern York University and Program Adherence in a Clinical Toronto, ON Weight Management Program

O1.4 3145 Weight-related Attitudes in Children Sarah M. Hutchison University of British Columbia Vancouver, BC

O1.5 3177 “The Weight is Even Worse Than the Eva Pila University of Toronto Cancer”: Exploring Women’s Psychosocial Toronto, ON Experiences with Weight After Treatment for Breast Cancer

O1.6 3506 Impacts and Determinants of Excess Skin Aurélie Baillot Université du Québec en after Bariatric Surgery: a Scoping Literature Outaouais Review

O1.7 3556 Variation in Biases about Obesity and Theodore K. Kyle ConscienHealth People with Obesity in Canada, the U.S., Pittsburgh, PA Mexico, and Brazil

O1.8 3167 “There’s Roots, There’s a Reason Why You’re Denise L. Campbell- Department of Overweight.” – Perspectives of Adults Living Scherer Family Medicine, with Obesity on Barriers to Treatment University of Alberta Edmonton, AB

14:00 – 16:00 (Co-Chairs:David Lau & Danielle Bouchard)Ivor PetrakConcurrent Oral Presentations 2: Clinical Management Adults


O2.1 3101 Improving Obesity Management Education Denise L. Campbell- Department of Family and Training for Family Medicine Residents Scherer Medicine, University of Alberta, Edmonton, AB

O2.2 3122 Characteristics of Individuals Developing Type2 David C. Lau University of Calgary Diabetes in the SCALE Obesity and Prediabetes Calgary, AB Randomized, Double-Blind, Liraglutide vs Placebo Trial

O2.3 3141 Liraglutide: Adjunct Therapy Post-Bariatric Surgery Renuca Modi University of Alberta Edmonton, AB

Concurrent Oral Presentations Details



14:00 – 16:00 Ivor PetrakConcurrent Oral Presentations 2: Clinical Management Adults


O2.4 3174 Competing Visions for Obesity Management Patricia H. Thille The Wilson Centre, in Canadian Primary Care University of Toronto Toronto, ON

O2.5 3100 Weight Loss and Associated Improvements David Macklin University of Toronto in Cardiometabolic Risk Factors with Toronto, ON Liraglutide 3.0 mg in the 3-year part of the SCALE Obesity and Prediabetes Trial

O2.6 3098 Building the Confidence of General Elizabeth A. Sturgiss Australian National Practitioners to Manage Patients with Obesity University – Results from an Australian Pilot Study Canberra, ACT

O2.7 3162 Improved Diagnosis and Follow Up for Obesity Marie-France Langlois CIUSSS de l’Estrie - CHUS with the Implementation of an Integrated and Université de Program in Community Care Sherbrooke, Sherbrooke, QC O2.8 3113 Associations of Body Mass Index with Coronary Tasuku Terada University of Alberta Revascularization Procedures and Outcomes Edmonton, AB

14:00 – 16:00 (Co-Chairs: Kristi Adamo & Jean-Patrice Baillargeon) Mt. Stephens HallConcurrent Oral Presentations 3: Pregnancy & Maternal/Fetal Health


O3.1 3109 Exercise in Pregnancy and Children’s Risk Laetitia Guillemette University of Manitoba Factors: a Systematic Review and Meta-Analysis Winnipeg, MB O3.2 3164 Are Suboptimal in Utero Conditions Associated Soraya Saidj University of Montreal with Obesity and Cardiometabolic Risk Factors Montreal, QC in Offspring Reaching Puberty?

O3.3 3155 Preventing Excessive Gestational Weight Gain: Does Taniya S. Nagpal University of Western Adherence to Prenatal Nutrition and Exercise Ontario Recommendations Improve when You Include London, ON the Family? O3.4 3202 Is There an Association Between Gestational Jonathan M. Rankin University of Ottawa Weight Gain and Infant Physical Activity? Ottawa, ON

O3.5 3204 Clinician Self-Efficacy Pertaining to Initiating Helena Piccinini-Vallis Dalhousie University Discussions About Gestational Weight Gain Halifax, NS O3.6 3536 Obesity and Sleep Disturbances During Benjamin C. Guinhouya University of Lille, EA Pregnancy: Does Gestational Weight Gain 2694, Public Health: Matter? Results From the 3 D Cohort Study Epidemiology and Health care quality, Lille

O3.7 3570 Impact of Maternal Pre-Pregnancy Overweight Andrea Haqq University of Alberta on Infant Overweight Risk at 1 year of age: Edmonton, AB Sex-Specific Differences



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14:00 – 16:00 (Co-Chairs: Gordon Zello & Michael Vallis)Alberta/New BrunswickConcurrent Oral Presentations 4: Nutrition


O4.1 3153 Prospective Associations of Dietary Intake Andraea Van Hulst McGill University on Insulin Sensitivity and Secretion in Montreal, QC Children with Familial Obesity

O4.2 3160 Histological Improvement of Non-Alcoholic Marc R. Bomhof University of Lethbridge Steatohepatitis with a Prebiotic: a Pilot Clinical Trial Lethbridge, AB O4.3 3057 The Effects of Partial Sleep Restriction on Olfactory Jessica McNeil Alberta Health Services Performance and 24h Energy Intake in Men and Women Calgary, AB O4.4 3119 Limited Potential of the Food Craving Chanaka N. Department of Nutritional Inventory and Three-Factor Eating Kahathuduwa Sciences, Texas Tech Questionnaire to Predict Brain Food-cue University, Lubbock Reactivity in Subjects with Obesity Texas, USA. O4.5 3080 Validation of the Canadian Healthy Eating Jacynthe Lafreniere Institute of Nutrition and Index-2007 Functional Food, Laval University Québec, QC

O4.6 3193 Findings from Alberta’s 2016 Nutrition Report Card Alexa Ferdinands University of Alberta on Food Environments for Children and Youth Edmonton, AB O4.7 3062 Stop Sugar Coating Children’s Breakfast Monique Potvin Kent School of Epidemiology, Cereals: Child Targeted Cereals in Canada Public Health and Require Reformulation Preventive Medicine, University of Ottawa Ottawa, ON

14:00 – 16:00 (Co-Chairs: Eric Doucet & Carla Prado)AlhambraConcurrent Oral Presentations 5: Metabolism: Preclinical Insights

Program# Abstract # Title Speaker Institution

O5.1 3130 Single Injection of Rapamycin Blocks Post Therese E. Kenny Memorial University of Restriction Hyperphagia and Body Weight Newfoundland Re-gain in Rats St. John’s, NL

O5.2 3161 Maternal Aspartame Consumption May Induce Jodi E. Nettleton University of Calgary Metabolic Derangements and Impact Central Calgary, AB Pathways Involved in Feeding in Mom and Pups in Rats O5.3 3090 Longitudinal Metabolic Profiling Identifies Differences Heather A. Paul University of Calgary in Maternal Response to Pregnancy and Lactation Calgary, AB Between Lean and Diet-induced Obese Rats



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Parents' Perceptions of the Family - and Community-Based Resources and Support required to Enhance Physical Literacy in Children: an Exploratory Study

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14:00 – 16:00 AlhambraConcurrent Oral Presentations 5: Metabolism: Preclinical Insights

Program# Abstract # Title Speaker Institution

O5.4 3194 Endogenous Cannabinoid and Nitric Oxide Karen M. Crosby Mount Allison University Interactions in the Rat: Potential Implications Sackville, NB for Appetite Regulation

O5.5 3526 Chondroitin Sulfate Prebiotic Improves GLP-1 Jennifer Pichette Laurentian University Response and Glucose Regulation in Mice Sudbury, ON

O5.6 3537 Effects of Glutathione Redox on Mitochondrial Awa Liaghati University of Ottawa Structure and Energetics in Primary Mouse Myoblasts Ottawa, ON O5.7 3538 Influence of ACSL5 Genotype on Fatty Acid Abishankari Rajkumar University of Ottawa Oxidation and Mitochondrial Bioenergetics Ottawa, ON – an ex vivo and in vivo Analysis

O5.8 3553 Thermogenic Phenotype Shares a Negative Kanta Chechi Institut Universitaire de Association with Oxidative Stress-Related Cardiologie et de Parameters in Human Epicardial Adipose Tissue. Pneumologie de Quebec, Universite Laval, Quebec, QC

14:00 – 16:00 (Co-Chairs:Rena LaFrance & Andre Tchnerof)Mt. Stephens HallConcurrent Oral Presentations 6: Bariatric Surgery


O6.1 3176 Health Service Use 12 Months Pre - and 24 Months Jillian Vallis Memorial University of Post-Laparoscopic Sleeve Gastrectomy (LSG) Newfoundland, St. John’s, NL O6.2 3089 Weight Loss and Quality of Life Outcomes in Laurie K. Twells Faculty of Medicine, Surgically Treated Patients In [Province]: a Memorial University Prospective Cohort Study St. John’s, NL

O6.3 3148 Employment and Quality of Life Outcomes Karin Kantarovich University Health Network 2 Years Following Bariatric Surgery Toronto, ON

O6.4 3116 What Bariatric Surgery Recipients Need Before, Rebecca H. Liu Western University During, and After Surgery for Long-term Health London, ON and Well-being: Recipients’ Perspectives

O6.5 3059 Long-term Psychosocial Predictors of Quality of Life Sanjeev Sockalingam TWH Bariatric Surgery and Weight Loss After Bariatric Surgery: the Program, University Toronto Bari-PSYCH Study Results Health Network, University of Toronto, Toronto ON

O6.6 3205 Revision Bariatric Surgery After Laparoscopic Adjustable Vanessa S. Falk Centre for Advancement Adjustable Gastric Band Removal Has High Post-op- Edmonton, AB erative Complication Rates in Minimally Invasive Surgery O6.7 3131 Association of Gastrointestinal Symptoms with Caroline Sheppard University of Alberta, Complications After Bariatric Surgery CAMIS, Edmonton, AB

O6.8 3099 Outcome of Gastric Bypass Surgery in Rosamunda Landspitali University Iceland 2001–2015 Thorarinsdottir Hospital, Reykjavik




14:00 – 16:00 (Co-Chairs: Mary L’Abbe & Hasan Hutchinson)Alberta/New Brunswick Concurrent Oral Presentations 7: Public Health


O7.1 3069 Unhealthy versus Healthy Foods Advertised in Natalie A. Laframboise School of Food and Grocery Store Flyers Nutritional Sciences, Brescia at Western University London, ON

O7.2 3140 Gaps in the Evidence on Interventions to Reduce Amanda Raffoul University of Waterloo Sugar Consumption: a Scoping Review of Waterloo, ON Systematic Reviews

O7.3 3072 Differences in Reach and Effectiveness of a National Melissa A. Fernandez Institution of Nutrition and Healthy Eating Campaign According to Dominant Functional Foods, Université Official Language Laval, Quebec, QC

O7.4 3097 Applying the CAN Approach to School Hot Lunch Cathy Langdon College of Pharmacy and Fundraisers to Promote Healthy Food at School Nutrition, University of Saskatchewan Saskatoon, SK

O7.5 3188 Obesity, Its Associations with the Food Environment, Leia Minaker University of Waterloo and Spatio-temporal Indicators of the Food Waterloo, ON Environment in the Region of Waterloo, Ontario

O7.6 3185 International Interventions on Sugary Drinks and Harsha Kasi Heart and Stroke Best Practices Vishwanathan Foundation Ottawa, ON

O7.7 3154 Examination of Physical Activity and Sedentary Emily Ott Health and Rehabilitation Behaviour Policies in Canadian Childcare Centres Sciences, London, ON

O7.8 3525 The Impact of the Children’s Food and Beverage Monique Potvin Kent University of Ottawa Advertising Initiative’s Uniform Nutrition Criteria Ottawa, ON

14:00 – 16:00 (Co-Chairs: Jean-Philippe Chaput & Mark Tremblay)Alhambra Concurrent Oral Presentations 8: Children & Adolescents


O8.1 3061 Not Just Fun and Games: Toy Advertising Monique Potvin Kent School of Epidemiology, on Television Targeting Children Promotes Public Health and Preventive Sedentary Play Medicine, University of Ottawa, Ottawa, ON

O8.2 3151 Lifestyle Habits and the Development of the Mélanie Henderson Division of Endocrinology, Metabolically Unhealthy Obese Phenotype Department of Pediatrics, in Youth: a Prospective Analysis in the University of Montreal QUALITY Study Montreal, QC

O8.3 3150 Early Life Conditions, Childhood Adiposity Andraea Van Hulst McGill University and Risk Factors for Type 2 Diabetes in Children Montreal, QC Aged 10–12 Years from the QUALITY Study



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14:00 – 16:00 Alhambra Concurrent Oral Presentations 8: Children & Adolescents


O8.4 3060 Neighbourhood Disadvantage During Lisa Kakinami Concordia University Childhood and the Risk of Cardiovascular Montreal, QC Disease Risk Factors and Events from a Prospective Cohort

O8.5 3187 Parents’ Perceptions of the Family- and Shauna M. Burke Western University Community-Based Resources and Support London, ON Required to Enhance Physical Literacy in Children: an Exploratory Study

O8.6 3138 Using Primary Care Electronic Medical Sarah E. Carsley University of Toronto Records to Estimate the Prevalence of Toronto, ON Severe Obesity in Children

O8.7 3107 Maternal and Offspring Intelligence in relation Christina S. Wraw University of Edinburgh to Offspring BMI in Childhood and Edinburgh Adolescence

O8.8 3201 Learning Food Literacy: Educational Emily J. Truman University of Calgary Interventions for Child and Adolescent Health Calgary, AB

14:00 – 16:00 (Co-Chairs: Pascal Imbeault & Eva Pila)Mt. Stephens Hall Concurrent Oral Presentations 9: Physical Activity


O9.1 3189 Evaluation of a Community Driven, Physical Sonja Wicklum University of Calgary Activity Based Wellness Program for Calgary, AB Indigenous Women in Lloydminster, Alberta – the Women Warriors Program

O9.2 3213 Sustained Participation in Running, Sports, Tarun Katapally University of Regina Fitness and Dance Activities Throughout Regina, SK Adolescence and Body Composition in Early Adulthood

O9.3 3081 Impact of Exercise on Olfaction, Gustation Kapria-Jad Josaphat Université de Montréal and Energy Intake in Lean Men – a Montréal, QC Dissociation Profile

O9.4 3210 Neighbourhood Walkability and Its Nicoleta Cutumisu Institute Armand Frappier Association with Child Weight Status in – INRS, Laval, QC Quebec: Findings from the Quality Study

O9.5 3203 Higher Abdominal Fat in Youth and Young Clodagh M. Toomey University of Calgary Adults 3–10 Years Following a Sport-Related Calgary, AB Knee Injury




14:00 – 16:00 Mt. Stephens Hall Concurrent Oral Presentations 9: Physical Activity

Program # Abstract # Title Speaker Institution O9.6 3186 Resistance-Training after Weight Loss has no Luzia J. Hintze University of Ottawa Impact on Body Composition and on Energy Ottawa, ON Expenditure in Overweight and Obese Postmenopausal Women: A MONET Study

O9.7 3132 Active Desks and Excess Body Weight – Marie-Eve Mathieu University of Montreal and A review by the FIT24 Network Sainte-Justine UHC Montreal, QC

O9.8 3546 Association between Physical Activity, Sukhleen Deol York University Obesity, and Cardiometabolic Disease in Toronto, ON South Asians: Canadian Community Health Survey, 2001–2014





Poster Presentations

P1.01 1A Anthropometric, Nutritional, Psychometric, and Biochemical Parameters of Individuals After SG See, Janet and RYGB Bariatric Procedures: A 12-Month Observation P1.02 2A Effects of Vitamin D3 and n-3 Polyunsaturated Fatty Acids on The Development of Metabolic Valle, Marion Syndrome in a Mouse Model of Diet-Induced Obesity

P1.04 4A Behavioural Modification for Adolescents with Obesity/overweight: An explanatory conceptual Chahal, Nita framework for Motivational Interviewing P1.05 5A Gaining Expert Consensus on Defining Metabolically Healthy Obesity (MHO) in Pediatrics: Damanhoury, Samah A Delphi Study P1.06 6A Familial Perceptions of Weight and Health: A Qualitative Analysis Among Parents and Children Pila, Eva

P1.07 7A Early Childhood Exposure to Antibiotics and the Association with Microbiome Changes, Weight Chau, Kim and Diabetes Later in Life: A Systematic Review P1.08 8A Resting Metabolic Rate and Appetite Sensations Are Not Affected by Different the Degree of Hintze, Luzia J. Caloric Restriction: Preliminary Data

P1.10 10A Obesity, Depression and Erysipelas a Clinical Correlation in Workers Ahmed, SanaP1.11 11A Body Mass Index and Risk of Dementia: a Retrospective Cohort Study of 513,775 Korean Adults Ha, Kyoung HwaP1.12 12A Coffee, but not Its Bioactive Compounds, Alleviates Weight Gain, Insulin Resistance, and Liver Shokouh, Pedram Steatosis in a Model of Diet-Induced Metabolic Syndrome

P1.13 13A Discordance of Perceived Weight Status in Canadian University Students Dworatzek, Paula D.

P1.14 14A How Does Obesity Affect the Endocrine System? Poddar, MeghaP1.15 15A Gestational Weight Gain and Childhood Body Mass Index Trajectories: a Primary Care Nova Scotia Piccinini-Vallis, Helena Cohort Study Using EMR Data P1.16 16A Nova Scotia Women’s Gestational Weight Gain Goals Piccinini-Vallis, HelenaP1.17 16B Sustainability of Comprehensive School Health on Body Weight, Healthy Eating and Physical Activity Ofosu, Nicole N.P2.01 15B Formulate, Innovate, Translate: the FIT Solution to Investigating Potential Pathways and Mediators Barnett, Tracie A. in the Environment-Obesity Relation P2.02 14B Minimum Wage and Anthropometric Outcomes in Women: A Longitudinal Study of 24 Conklin, Annalijn I. Low-Income Countries

P2.03 13B Toward Equity-Oriented Obesity-Related Health Promotion Darroch, Francine

P2.04 12B Diet Quality in Relation to Metabolic Syndrome in Cree (Eeyouch) from James Bay, Northern Lavigne-Robichaud, Mathilde Québec, Canada P2.05 11B Are Dental Caries and Trachoma Associated with Weight Status Among Chinese Children? Liu, Jian

P2.06 10B Proportional Responsibility vs Individual Responsibility for Diet and Obesity in the Food System: Savona, Natalie a Complex Systems Analysis P2.07 9B The Effects of Culture on Guideline Discordant Gestational Weight Gain: A Systematic Review Denize, Kathryn M.

P2.08 8B Literature Review Obesity Research Pertaining to Sudbury’s Social Determinants of Health Cerilli, Julia/ Weglewski, ChristinaP2.09 7B Exploring the Effects of Family Characteristics on Indigenous Youth’s Participation in Physical Wilk, Piotr/ Maltby, Alana Activity and Sport P2.10 6B Designing Seating Solutions for Persons with Obesity: An Inter-Professional Collaboration Forhan, Mary

P1.09 9A Clinical Correlations of 2-hour and 5-hour Glucose Tolerance Tests in Subjects with Obesity Rodriguez Flores, Marcela

P1.03 3A Dysfunction of the Orbitofrontal Cortex in Diet-Induced Obesity Naef, Lindsay

POSTER # POSTER POSTER TITlE PRESENTER(S) BOARD #

P4.26 5B Personalizing Obesity Assessment and Care Planning in Primary Care: Patient Experience and Luig, Thea Self-management Outcomes




P3.01 1A Estimations of Calorie Content of Meals Before and After a Menu Labelling Intervention Vanderlee, LanaP4.01 2A Preoperative Endoscopic Evaluation in Bariatric Surgery Jodeiri, Behzad

P4.02 3A Is Depressive Status Associated with Preoperative Weight and Problematic Eating Behaviours Julien, Cassandre A. Among Candidates for Bariatric Surgery?

P4.03 4A The NL Bariatric Surgery Cohort Study: Improvement and Remission of Prediabetes and Type 2 Twells, Laurie K. Diabetes Mellitus 2 years after Laparoscopic Sleeve Gastrectomy

P4.04 5A A Comparison of Circular – vs. Linear – Stapled Gastrojejunostomy in Laparoscopic Roux-en-Y Gastric Miller, Sarah Bypass (LRYGB) in a Tertiary Care Hospital

P4.05 6A Association Between Physical Activity Intensity and Physical Capacity Among Individuals Awaiting Rioux, Brittany V. Bariatric Surgery

P4.06 7A Impulse Control and Weight-Loss after Bariatric Surgery: The moderating effect of Emotion Williamson, Tamara M. Self-Regulation

P4.07 8A Psychotropic Medication Use in Individuals Pursuing Bariatric Surgery Yanofsky, RichardP4.23 9A Toronto Bariatric Interprofessional Psychosocial Assessment Suitability Scale (BIPASS TM): Thiara, Gurneet S. Phase II – Establishing Convergent Validity

P4.08 10A Beyond BMI: NutriSTEP® for the Prevention, and Care and Management of Childhood Obesity Andrade, Lesley/ McDonough, Tracy

P4.09 11A Intensive Gestational Glycemic Management and Childhood Obesity: A Systematic Review and Guillemette, Laetitia Meta-Analysis P4.10 12A Effects of a Multidisciplinary Program of Obesity Treatment of Children and Adolescents that Hintze, Luzia J. Performed a Water-Based Intervention: Difference Between Age Groups

P4.11 13A Exploring Lifestyle Behaviors of Adolescents with Obesity in Weight Management: A Scoping Kebbe, Maryam Review and Stakeholder Consultation P4.12 14A Maternal Low-Dose Antibiotic Consumption During Pregnancy and Lactation in Rats Increases Klancic, Teja Their Body Weight During Lactation But is Reversed with Prebiotic Diet

P4.13 15A The Relationship of Fasting Plasma apoB48 to Cardiometabolic Risk Factors in Adolescents Krysa, Jacqueline

P4.14 16A A Telehealth Program for the Treatment of Overweight and Obesity in Children: Baseline Lasinsky, Anne M. Characteristics of Program Evaluation Participants P4.15 16B Obesity Is Associated with Increased Asthma Prevalence and Asthma Related Health Service Use, in Mccomber, Teri D. a Population Based Study of Nova Scotia Children

P4.16 15B Listen Up! an Exploration of Families’ Perceptions and Preferences Around Weight-Related McPherson, Amy C. Communication Best Practices in Healthcare Settings P4.17 14B Review of a Family Based Child/Youth Obesity Treatment Program Oates, ConstanceP4.18 13B Childhood and Adolescent Obesity Treatment: Expanding the Conversation to Include Families Oates, ConstanceP4.19 12B Do children and adolescents referred to multidisciplinary care for weight management in Alberta Perez, Arnaldo enroll in treatment? A preliminary analysis P4.20 11B Effects of a Multiprofessional Program of Obesity Treatment (MPOT) in Adolescents from the Hintze, Luzia J. Metabolically Healthy Obese (MHO) Phenomenon P4.21 10B The Effect of Peer Support on Knowledge and Self-Efficacy in Weight Management: A Prospective Hibbert, Claire Clinical Trial in a Mental Health Setting

P4.22 9B Optimizing Body Composition and Glycemic Control in the Elderly through Creatine Lemos Pinto, Camila Supplementation and Resistance Exercise

P4.24 8B Association Between Therapeutic Drug Classes and Weight Change in Patients Attending a Kamran Samani, Elham Medically Supervised Weight Loss Clinic


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P4.22 1A Current Weight Management Approaches Used by Primary Care Providers in Multidisciplinary Aboueid, Stephanie Health Care Settings in Ontario

P4.23 2A Pediatric Weight Management: Are Dietitian-led Interventions Successful? Bennett, Tesia

P4.24 3A Children and Youth Nutrition Survey: Monitoring Dietary Patterns During Weight Management Bennett, Tesia Counselling P4.25 4A Differential Health Burden and Clinical Risks Associated with Types of Obesity in Patients with Obesity and Knee Osteoarthritis Godziuk, Kristine

P4.27 6A Effect of Yellow Pea Fiber on Fecal Short-chain Fatty Acids and Bile Acids in Adults with Mayengbam, Shyamchand Overweight/Obesity: a 12-week Randomized Controlled Trial

P4.28 7A Impact of Computer-Based Cognitive Training on Outcomes During a Weight Loss Intervention in an Obese Population Stallard, Ryan M.P4.29 8A Benefits of a Multi-Agency Obese Treatment Program Stallard, Ryan M.P4.30 9A Differences in Short and Long-term Mortality Associated with Body Mass Index Following Terada, Tasuku Coronary Revascularization P4.31 10A Non-invasive Brain Stimulation (NIBS) of the Prefrontal Cortex: a Systematic Review of Vincent, Corita M. Multi-session Treatment Studies Examining Eating-related Outcomes

P4.32 11A Reasons for Attrition In A Publicly Funded Weight Management Program Wharton, Sean

P4.33 12A Effectiveness of a Multidisciplinary Lifestyle-Based Weight Management Program on Improving Zargar, Benyamin the Metabolic Health of Adults with Obesity

P4.34 13A Computer Apps to Assist with Weight Loss: Limited Value in the Present and Opportunities for the Future Tanner, BradleyP4.35 14A Health Markers Improvement While Meeting the Physical Activity Guidelines Only doing Bouchard, Danielle R. Resistance Training in People considered Obese P4.36 15A Increasing BMI in Primary Hip and Knee Arthroplasty; Influencing Length of Stay, Complications Gill, Richdeep and Adverse Events. A Retrospective Review P4.37 16A Impacts of Exercise Training on Quality of Life, Body Image, Anxiety, and Depression in Individuals Saunders, Stephanie with Obesity: A Systematic Literature Review

P4.38 16B Maternal Antibiotic Consumption Alters Expression of Neurotransmitters Associated with Reward- Cho, Nicole Seeking Behavior in Rats

P4.40 14B ENHANCE: A Preliminary Examination of Physiological Outcome Data Following a 12-week Ciszewski, Stefanie Well-being Intervention P4.41 13B Identifying Patient Attributes that Contribute to High Engagement and Long Term Weight Loss Ferguson, Christine

P4.42 14B Applying Shared Decision Making Models in Clinical Practice to Increase Exercise Adherence Hanna, Andrew

P4.43 13B CHANGE Adventure Camp: Obesity Prevention and Health promotion for Children and Families Klein, DougP4.44 12B An Online Training System to Improve the Health of University Students: Rationale and Description Mandich, Gillian E.P4.45 11B Standards for a Bariatric Friendly Care Hospital - Translating Research into Practice O’Connell, Petra

P4.46 10B The Hockey Fans in Training Weight Loss and Healthy Lifestyle Program Can Attract and Retain Petrella, Robert J. Overweight and Obese Men P4.47 9B Effect of Regular Physical Activity on Cardiovascular Risk Factors in Middle-Aged Active and Ramezani, Alireza Non-active Individuals P4.48 8B Dental Professionals Perceptions of Sugar Consumption and Obesity Advice in the Dental Practice Suvan, JeanieP4.49 7B Impact of a Bariatric Support Garment to Manage Excess Skin on Activities of Daily Living Teske, Katelyn



Abstract Details

O1.1Dieting and Other Risky Behaviours Among Adolescent Girls: Implications for Obesity Prevention InitiativesAmanda Raffoul, Scott T. Leatherdale, Sharon I. KirkpatrickUniversity of Waterloo, Waterloo, ON, Canada

Objective: A focus on obesity prevention has dominated public health interven-tions targeted to children and adolescents in recent years. Weight-focused inter-ventions have the potential to elicit unanticipated consequences, such as dieting, which itself is associated with an array of deleterious behaviours that may contribute to poorer health overall. This study was conducted to examine whether dieting is associated with clusters of other risky behaviours two years later among Canadian adolescent girls.Methods: We explored associations between dieting to lose weight and engage-ment in clusters of health-compromising behaviours at follow-up (2 years later) among Ontario girls (N=3,386; grades 9–10 at baseline). Multilevel logistic regres-sion models were used to investigate the relationship between dieting and each of smoking, binge drinking, breakfast-skipping, and clusters of these behaviours.Results: Over half of girls reported dieting (54%), as well as heights and weights corresponding with a healthy BMI (61%). Four in five girls dieting at baseline reported dieting 2 years later. Dieting at baseline was positively associated with each risky behaviour, as well as combinations of these behaviours at follow-up; the highest risk was observed for binge drinking/breakfast-skipping and smoking/binge drinking/breakfast-skipping (RR=1.6). Baseline dieters were more likely to engage in a greater number of risky behaviours than non-dieters, regardless of the actual behaviours.Conclusions: Dieting is longitudinally associated with engagement in other risky behaviours among adolescent girls. Attention is needed to the potential for well-meaning obesity prevention initiatives to unintentionally compromise health through a focus on weight that may drive the uptake of dieting behaviours. O1.2What’s in a Name? The Influence of Framing Obesity as a Disease on Weight BiasSarah Nutter1, Angela S. Alberga2, Shelly Russell-Mayhew1, Cara MacInnis1, John Ellard1

1. University of Calgary, Calgary, AB, Canada, 2. Concordia University, Montreal, QC, Canada

Background: The declaration of obesity as a chronic disease by the Canadian and American Medical Associations has been met with strong debate, including the potential impact of this declaration on weight bias. Objective: The purpose of this research was to experimentally investigate the influ-ence of framing obesity a disease on the attitudes of members of the general public. Methods: Canadian and U.S. participants (N= 309, 15-73) recruited through CrowdFlower were assigned to read one of three articles. Two articles presented ac-curate and identical information about the nature of obesity, with one article stating that obesity has been declared a disease and the other article stating that obesity has not been declared a disease. The third article was a control article unrelated to obesity. Participants completed a number of questionnaires, including weight bias relevant outcome measures. Results: Regression analyses revealed that framing obesity as a disease (vs. control conditions) was associated with more positive affect towards individuals with obesity, indirectly leading to less negative attitudes toward individuals with obesity. Further, for certain individuals framing obesity as a disease (vs. controls) was associ-ated with perceptions that obesity is less personally controllable or higher empathy toward people with obesity, both of which predicted less negative attitudes. Conclusions: Our results suggest that the declaration of calling obesity a disease can positively influence attitudes towards people with obesity and can inform future weight bias reduction interventions.

O1.3Association Between Weight Discrimination and Program Adherence in a Clinical Weight Management ProgramNeda Yeganeh1, Saaqshi Sharma1, Jennifer L. Kuk1, Sean Wharton2, Chris I. Ardern1

1. York University, Toronto, ON, Canada, 2. Wharton Medical Clinic, Toronto, ON, Canada

Background: Weight discrimination is a common occurrence for those living with obesity. While the detrimental health effects are well known, it is unclear if a history of weight discrimination may also impact on adherence to follow-up within a medically supervised weight loss setting.Method: Participants from the Wharton Medical Clinic (Hamilton and Burlington, ON) completed a battery of weight discrimination questions at their first site visit (n=120) and were tracked for program adherence. A series of general linear models were subsequently used to assess the relationship between a history of weight discrimination (yes/no) and program adherence (months and number of program visits). Adjustments were made for baseline body mass index, age, sex, and smoking status.Results: A majority of the clinic sample (77.5%) reported a history of weight discrimination. Overall, no significant difference in treatment time was observed (no wgt dis: 4.3 months; wgt dis: 2.8 months, p=0.23); however, at the end of one month, significantly more patients with a history of weight discrimination remained in the program (no wgt dis: 22.2%; wgt dis: 46.2%), an effect that diminished with time. There were also no differences in the absolute amount of weight loss or the percentage of each group who achieved clinically meaningful weight loss (5% of baseline weight) within 3 months of follow-up.Conclusion: In this sample, having a history of weight discrimination was not associated with differences in program adherence or weight loss outcomes. Further work is necessary to test the persistence of this finding across clinical settings. O1.4Weight-related Attitudes in ChildrenSarah M. Hutchison1, 2, Ulrich Mueller3

1. University of British Columbia, Vancouver, BC, Canada, 2. BC Children’s Hospital Research Institute, Vancouver, BC, Canada, 3. University of Victoria, Victoria, BC, CanadaWeight-related attitudes (WA) refer to negative attitudes toward individuals because they are overweight or obese. These attitudes are widespread among children and adults, and have been proven to be recalcitrant to intervention. To develop more effective interventions it is necessary to understand the origin and development of explicit and implicit WA. Explicit WA tasks require individuals to make evaluations (e.g., self-report) about people who are overweight/ obese, which can be influenced by social desirability. Implicit WA tasks reduce the role of social desirability, such as the Weight Implicit Association Test (IAT), which compares response speeds to fat and thin stimuli. Our goals for the study were to examine the association between two explicit measures of WA to determine if they are tapping into a similar underlying construct and examine age-related differences in explicit and implicit WA. We administered the Anti-fat Prejudice task, the Friendship Selection task, and a Weight IAT to eighty-four 4- to 7-year olds. Results showed that: 1) the two measures of explicit WA were associated, 2) children demonstrated both explicit and implicit WA; and 3) age accounted for 10.6% of the variance in explicit WA, and age accounted for 11.2% of the variance in the Weight IAT. The association between the two explicit tasks is a novel finding as all previous studies have not reported the rela-tions between measures of explicit WA. Taken together, these findings suggest the importance of early intervention to reduce WA and implications for the developmen-tal origins of WA will be discussed.


Abstract Details

O1.5“The Weight is Even Worse Than the Cancer”: Exploring Women’s Psycho-social Experiences with Weight After Treatment for Breast CancerEva Pila1, Catherine M. Sabiston1, Valerie Taylor1, 2, Kelly Arbour-Nicitopoulos1

1. University of Toronto, Toronto, ON, Canada, 2. Women’s College Hospital, Toronto, ON, Canada

Summary: There is a complex association between obesity and breast cancer, whereby excess weight is linked with higher risk of breast cancer development, advanced diagnosis, and increased risk of cancer reoccurrence and mortality. Can-cer-related changes in weight also contribute to worsened mental health, however the psychosocial experiences of weight-concerned women treated for cancer are not well understood. As such, the purpose of this qualitative study was to explore wom-en’s experiences with weight across the cancer trajectory. A purposeful sample of women selected based on criteria for high weight and body image concern (N=11; Mage = 65.31) participated in a semi-structured interview. Five themes were iden-tified: (i) prevalent history of weight cycling and ongoing quest to manage weight; (ii) dominant perceptions of failure around goal-oriented weight management behaviours; (iii) internalized pressures for weight loss in context of risk reduction, and (iv) weight-related concerns notably contributed to psychological distress. Based on these novel findings, the pervasiveness of women’s weight concerns spans far beyond cancer diagnosis and treatment In fact, women’s lifetime perceptions of being ‘high risk’ and concerted efforts to lose weight remarkably contributed to psychological distress. Therefore, improving weight-related psychological distress should be targetted as a clinical priority for women in survivorship. Learning Objectives: (1) Identify the psychosocial impact of weight in women treated for breast cancer. (2) Explore how women make meaning of weight cycling in the context of mitigating risk for breast cancer reoccurance and mortality. O1.6Impacts and Determinants of Excess Skin after Bariatric Surgery: a Scop-ing Literature ReviewElsa Brais-Dussault1, Ahmed J. Romain2, Paquito Bernard3, 4, Caroline Cyr1, Aurélie Baillot1, 5

1. Université du Québec en Outaouais, Gatineau, QC, Canada, 2. University of Montreal Hospital Research Center, Montréal, QC, Canada, 3. Department of Physical Activity Sciences, Université du Québec à Montréal, Montréal, QC, Canada, 4. Institut Universitaire en Santé Mentale de Montréal, Montréal, QC, Canada, 5. Institut de recherche de l’Hôpital Montfort, Ottawa, ON, Canada

Objectives: To gather current knowledge on i) the physical and psychosocial conse-quences of excess skin (ES) after bariatric surgery (BS), and ii) the physical and psycho-social factors associated with the quantity of ES and the discomfort caused by ES.Methods: Searches were performed using Pubmed®, Psyarticles and CINAHL. All studies recorded were screened by two independent reviewers for inclusion criteria: (1) peer-reviewed empirical studies; (2) adults having realized BS; (3) studies reporting con-sequences of ES and/or correlates with the quantity of ES or the discomfort caused by ES.Results: Finally, 24 articles were included in the review, with only one study with longitudinal data, and 58% with quantitative results. The vast majority were published after 2011 (88%) and only 33% were performed in North America. Only three studies assessed objectively the quantity of ES. Physical (e.g. skin problems) (71%), psychoso-cial (e.g. low self-esteem) (63%), functional (e.g. mobility limitations) (17%) and daily life (e.g. finding clothes) (75%) consequences were reported in several studies. Eight studies explored factors associated with ES’ quantity or discomfort. Women declared more ES’ discomfort compared to men (n=6/6). Regarding other factors (pre-surgical Body Mass Index (BMI), current BMI, physical activity level, weight loss and age), no conclusion can be drawn because of conflicting results.Conclusions: Several studies underlined the negative consequences of ES, how-

ever follow-up data with subjective and objective measurements of ES are missing. Further studies on the determinants of ES’ quantity and discomfort are needed to better inform patients and health professionals. O1.7Variation in Biases about Obesity and People with Obesity in Canada, the U.S., Mexico, and BrazilTheodore K. Kyle1, Ximena Ramos Salas2, Bruno Halpern3, Nathalie Dumas4, Joseph F. Nadglowski5, Leah D. Whigham6, Diana M. Thomas7, Rebecca M. Puhl8

1. ConscienHealth, Pittsburgh, PA, USA, 2. Canadian Obesity Network, Edmonton, AB, Canada, 3. Obesity Group, Department of Endocrinology, University of São Paulo, São Paulo, SP, Brazil, 4. Plateforme d’Evaluation en Prevention de l’Obesite, Université Laval, Quebec, QC, Canada, 5. Obesity Action Coalition, Tampa, FL, USA, 6. Paso del Norte Institute for Healthy Living, El Paso, TX, USA, 7. US Military Academy, West Point, NY, USA, 8. Rudd Center for Food Policy and Obesity, University of Connecticut, Hartford, CT, USA

Introduction: Weight bias (WB) is an impediment to progress toward adoption of evidence-based strategies to address obesity. Key elements of WB include blame di-rected at people with obesity (PwO), assumptions of laziness or poor discipline, and social rejection. The present research measured beliefs about the causes of obesity, and beliefs and attitudes about PwO in English and French-speaking Canada (CAen, CAfr), US, Mexico (MX), and Brazil (BR).Methods: Random samples totaling 47,282 adults completed anonymous, volun-tary online surveys between Oct 2016 and Dec 2017. Microsurveys required only one response per participant to reduce fatigue with multiple questions. Likert scales (5 points) measured agreement with 4 narratives regarding causes of obesity, as well as perceptions of blame, social acceptance, laziness, and self-discipline of PwO.Results: Agreement that obesity results from addictive junk food was high in all five populations, highest in BR (mean agreement 3.8±0.1), MX (3.7±0.1) and CAfr (3.7±0.1). Respondents in CA, US, and MX agreed that irresponsibility of individuals is a cause of obesity, while BR respondents disagreed. Belief that PwO should be blamed was highest in MX (3.4±0.1), lowest in BR (3.0±0.1). CAfr respondents agreed more than CAen with addictive junk food causing obesity, social acceptance for PwO, and that PwO are undisciplined.Conclusion: Public beliefs associated with WB vary among these five populations. Beliefs that addictive junk food plays a causal role in obesity is widespread and stronger in Brazil, CAfr, and MX. Tracking these patterns may help for developing and evaluating future interventions to reduce WB. O1.8“There’s Roots, There’s a Reason Why You’re Overweight.” – Perspectives of Adults Living with Obesity on Barriers to TreatmentJacqueline Torti1, 2, Thea Luig3, Michelle Borowitz4, Arya M. Sharma3, 5, Denise L. Campbell-Scherer1, 5

1. Department of Family Medicine, University of Alberta, Edmonton, AB, Canada, 2. School of Public Health, University of Alberta, Edmonton, AB, Canada, 3. Department of Medicine, Division of Endocrinology, University of Alberta, Edmonton, AB, Cana-da, 4. Department of Anthropology, University of Alberta, Edmonton, AB, Canada, 5. Alberta Diabetes Institute, University of Alberta, Edmonton, AB, Canada

Purpose: Obesity is a complex chronic medical condition. Research shows psychoso-cial and socioeconomic issues, as well as psychiatric and medical comorbidities affect patients’ health and ability to manage weight. This study aimed to assess the barriers to weight management by exploring perspectives of adults living with overweight and obesity. An expansion of the 4Ms (mechanical, mental, metabolic, monetary) for obe-sity assessment with patient narratives broadens the discussion on obesity assessment. Method: This was a qualitative study. 28 individual semi-structured interviews were conducted and underwent a thematic analysis.


Abstract Details

Results: Patients discussed mechanical, mental, metabolic, and monetary issues as inseparable from their weight trajectory, decisive for weight management efforts, and causing feelings of frustration with their ability to reduce weight. Mechanical conditions included chronic pain, sleep apnea, hernias, asthma, osteoarthritis, and plantar fasciitis impairing ability to engage in physical activity. Some patients reported weight gain from prescription medication. Patients shared personal stories linking weight to stressful life events, depression, traumatic childhood experiences, fatigue, stress, and addictions. Women described struggling with menopause. Fi-nally, patients discussed limited finances and time constraints affecting their ability to maintain weight management programs. Patients emphasized the need for their providers to “put all this together.” Conclusions: Patients’ felt that obesity is a complex phenomenon with multiple drivers related to their unique story. Our findings highlight the need to assess root causes and drivers of weight gain, comorbidities, and psychosocial barriers to devel-op a care plan that offers realistic and sustainable strategies according to patients’ particular constraints and strengths. O2.1Improving Obesity Management Education and Training for Family Medicine ResidentsDenise L. Campbell-Scherer1, 7, Sonja Wicklum2, Thea Luig3, Erin Cameron6, Shuai Li3, Rena Lafrance4, 5, Alison Connors5, Melanie Heatherington3, Doug Klein1, Karen Moniz1, Arya M. Sharma3, 7

1. Department of Family Medicine, University of Alberta, Edmonton, AB, Canada, 2. Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada, 3. Department of Medicine, Division of Endocrinolo-gy, University of Alberta, Edmonton, AB, Canada, 4. Department of Psychiatry and Pediatrics, University of Alberta, Edmonton, AB, Canada, 5. Primary Health Care, Alberta Health Services, Edmonton, AB, Canada, 6. School of Human Kinetics and Recreation, Memorial University, St. John’s, NL, Canada, 7. Alberta Diabetes Institute, University of Alberta, Edmonton, AB, Canada

Purpose: Obesity has risen to epidemic proportions worldwide. Prevention and management requires a lifecycle approach that needs to be embedded in primary care. Yet, research has shown that medical residents and practicing physicians lack knowledge and confidence to effectively address weight concerns with patients. There is a pressing need to create high quality, evidence-based obesity manage-ment training programs for family medicine residents so they can better support patients. We developed a comprehensive educational program for residents based on the 5As of Obesity Management™ (Ask, Assess, Advise, Agree, Assist- 5As), a framework and suite of resources to improve residents’ knowledge and confidence in weight counselling. Methods: The program, now in its second year, combines lectures with experiential learning methods, including content expert presentations, bariatric suit experi-ence, practice with standardized and in-clinic patients, and narrative reflections. We assessed changes in residents’ attitudes and level of self-confidence. Narrative reflections were analyzed thematically.Results: Preliminary findings from the pilot and second year of the program show increases of residents’ understanding of the complexity and chronicity of obesity. Their uptake of the 5As framework and tools improved confidence and perceived success in their weight management practice. Experiential learning elements of the program proved crucial in increasing residents’ ability to empathically engage with patients and to critically reflect on implications for their practice.Conclusion: Results underscore the need for training programs for family medicine. Furthermore, findings reflect the utility of the 5As to improve residents’ confidence and competency in obesity management counselling.

O2.2Characteristics of Individuals Developing Type 2 Diabetes in the SCALE Obesity and Prediabetes Randomized, Double-Blind, Liraglutide vs Placebo TrialDavid C. Lau1, Matthias Blüher2, Luc Van Gaal3, Domenica M. Rubino4, German Guerrero5, John P. Wilding6

1. University of Calgary, Calgary, AB, Canada, 2. University of Leipzig, Leipzig, Ger-many, 3. Antwerp University Hospital, Antwerp, Belgium, 4. Washington Center for Weight Management and Research, Arlington, VA, USA, 5. Novo Nordisk, Plainsboro, NJ, USA, 6. University of Liverpool, Liverpool, United Kingdom

Background: This 3-year trial examined the effect of liraglutide 3.0 mg, as adjunct to diet+exercise, in delaying onset of T2D in adults with prediabetes and BMI ≥30 kg/m2, or ≥27 kg/m2 with comorbidities.Methods: Individuals were randomized 2:1 to liraglutide 3.0 mg (n=1505) or placebo (n=749), plus 500-kcal/day deficit diet and 150-min/week exercise. Efficacy data are observed means, with LOCF.Results: Compared with the entire randomized population, at baseline, individuals who developed T2D by week 160 (liraglutide 3.0 mg, n=26; placebo, n=46) were older (developed T2D: liraglutide 48.4 years, placebo 49.3; vs entire population: liraglutide 47.5, placebo 47.3), had more dyslipidemia (54%, 46%; vs 33%, 33%), hypertension (73%, 39%; vs 42%, 42%), higher baseline HbA1c (6.1%, 5.9%; vs 5.8%, 5.7%), FPG (6.0 mmol/L, 5.9; vs 5.5, 5.5) and BMI (40.2 kg/m2, 40.4; vs 38.8, 39.0). Time to onset of T2D over 160 weeks was 2.7-fold longer with liraglutide com-pared with placebo (95%CI 1.9;3.9; p<0.0001) (hazard-ratio=0.2). Mean weight loss (0-160 weeks) for the entire study population was 6.1% with liraglutide 3.0 mg vs 1.9% with placebo (estimated difference -4.3% [95%CI -4.9;-3.7], p<0.0001). Over 90% of individuals who developed T2D in both groups lost less body-weight than the treatment group mean. In those with T2D, one hypoglycemic event was reported with liraglutide 3.0 mg vs five with placebo, none severe. Liraglutide 3.0 mg was generally well tolerated.Conclusion: Liraglutide 3.0 mg for 3 years, as an adjunct to diet+exercise, was associated with lower risk of T2D and greater weight loss vs placebo. O2.3Liraglutide: Adjunct Therapy Post-Bariatric SurgeryRenuca Modi1, Sarah Cawsey1, Peter Rye2, Arya Sharma1

1. University of Alberta, Edmonton, AB, Canada, 2. University of Calgary, Calgary, AB, Canada

Background: Patients undergoing bariatric surgery may experience inadequate weight loss, weight plateau or weight recidivism. Limited evidence suggests that these patients may experience additional weight reduction with adjunct anti-obesity pharmacotherapy. We present our experience with the use of GLP-1 agonist Liraglutide up to 3.0 mg daily for further weight loss in patients who have undergone bariatric surgery.Methods: A retrospective chart review of post- bariatric surgery patients who received Liraglutide up to 3.0 mg, for at least six months. The primary endpoints were percent total weight loss at three months (four weeks titration plus twelve weeks of therapy) and six months (four weeks titration plus twenty-four weeks of therapy). Secondary endpoint was the presence of side effects and need to discontinue medication.Results: Data collection ongoing (10 active patients). Of the three female patients with three month data mean percent total body weight loss at sixteen weeks was 12.8 ± 4.29 % (p = 0.012) with a BMI decrease of 5.5 ± 1.45 kg/m2 (p = 0.022). Of the two patients with six month data, mean percent total body weight loss at 24 weeks was 13.1 ± 6.23 % (p = 0.040) with a BMI decrease of 5.3 ± 0.58 kg/m2 (p = 0.05). Both patients achieved a maximum dose of 3 mg. The most common side effects were nausea and vomiting. No patients stopped Liraglutide due to side effects.Conclusion: In our initial experience, post-bariatric surgery patients show signifi-cant additional weight loss with Liraglutide pharmacotherapy.


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O2.4Competing Visions for Obesity Management in Canadian Primary CarePatricia H. ThilleThe Wilson Centre, University of Toronto, Toronto, ON, CanadaTwo Canadian knowledge brokers – the Canadian Obesity Network (CON) and the Canadian Task Force on Preventative Health Care (CTF) - have developed and dis-seminated tools to help primary care clinicians address obesity with patients. What visions of ‘good care’ are embedded in these tools; how consistent are these?

Objective: compare the CON’s 5As of Obesity Management™ for Adults with the CTF 2015 guideline for obesity in adults. Methods: discourse and narrative analyses of the core texts of the CON’s 5As and CTF’s guideline. Analysis focused on how each knowledge broker delineates the problem to be addressed, and how that influences recommended care practices. Results: The CON 5As develops a discourse of obesity as a chronic condition, one with many causes - including non-behavioural ones. The 5As embeds an explicit anti-stigma lens for clinical care, warning against assuming obesity is reversible via changes to eating and physical activity. Obesity becomes obesities in the CON’s 5As; the recommended clinical assessments and treatments orient to this multiplicity. In contrast, the CTF guideline orients to obesity as a behavioural phenomenon. Their recommended solution is singular: offer or refer those diagnosed as overweight or obese to behaviour change programs. Conclusions: The CON and CTF vary significantly in terms of how they envision the problem that weight-related care is to address. The contrast exemplifies controver-sies in this field about obesity causation and stigma. Making explicit these different visions of ‘good care’ may help spur important conversations about what effects clinical practice should aim to create. O2.5Weight Loss and Associated Improvements in Cardiometabolic Risk Factors with Liraglutide 3.0 mg in the 3-year part of the SCALE Obesity and Prediabetes TrialDavid Macklin1, Arne Astrup2, Frank Greenway3, Michel Krempf4, Carel W. Le Roux5, Roberto Vettor6, Soren K. Lilleore7, Ken Fujioka8

1. University of Toronto, Toronto, ON, Canada, 2. University of Copenhagen, Copen-hagen, Denmark, 3. Pennington Biomedical Research Center, Baton Rouge, LA, USA, 4. Université de Nantes, Nantes, France, 5. Diabetes Complications Research Centre, Dublin, Ireland, 6. University of Padua, Padua, Italy, 7. Novo Nordisk, Copenhagen, Denmark, 8. Scripps Clinic, La Jolla, CA, USA

Aims/Objectives: To investigate the effects of liraglutide 3.0mg, as adjunct to diet+exercise, on time to onset of T2D, body-weight and cardiometabolic risk factors over 3 years.Methods: Individuals (BMI ≥30kg/m2, or ≥27kg/m2 with ≥1 comorbidity) were randomized 2:1 to once-daily subcutaneous liraglutide 3.0mg (n=1505) or placebo (n=749) and a 500-kcal/day deficit diet and 150-min/week exercise. Efficacy data are observed means with LOCF.Results: With continued treatment over 160 weeks, time to T2D onset was 2.7-fold longer with liraglutide than placebo [95%CI 1.9;3.9, p<0.0001] (corresponding to a hazard ratio: 0.2); with 3% vs 11% of patients diagnosed with T2D, respectively during treatment. More individuals receiving liraglutide (66%) than placebo (36%) regressed from prediabetes (ADA2010 criteria) to normoglycemia by week 160 (OR 3.6 [3.0;4.4], p<0.0001). Individuals receiving liraglutide 3.0 mg lost more weight than with placebo (6.1% vs 1.9%; estimated treatment difference [ETD] -4.3% [95%CI -4.9;-3.7]), and greater reductions in mean waist circumference (ETD -3.5 [-4.2;-2.8] cm), SBP (ETD -2.8 [-3.8;-1.8] mmHg), triglycerides (ETD -6%[-9;-3]) and hsCRP (ETD 29% [-34;-23]) (all p<0.001). Mean pulse increased with liraglutide vs placebo (ETD 2.0 [1.2;2.7] beats/min, p<0.0001). AE incidence was 94.7%

with liraglutide vs 89.4% with placebo; SAEs 15.1% vs 12.9%. Adjudicated major adverse cardiovascular events (non-fatal myocardial infarction, stroke, cardiovascular death) were low overall (0.19 vs 0.20 events/100 patient-years-of-observation for liraglutide vs placebo).Conclusion: Liraglutide 3.0mg for 3 years, as adjunct to diet+exercise, delayed the onset and reduced the risk of T2D in adults with prediabetes, reduced body weight and improved cardiometabolic risk factors. O2.6Building the Confidence of General Practitioners to Manage Patients with Obesity – Results from an Australian Pilot StudyElizabeth A. Sturgiss1, Emily Haesler2, Nicholas Elmitt1, Chris van Weel3, 1, Kirsty Douglas1

1. Australian National University, Canberra, ACT, Australia, 2. Curtin University, Perth, WA, Australia, 3. Radboud University, Nijmegen, Netherlands

Background: Patients value dietary advice from their general practitioner (GP) but international literature confirms that GPs report low confidence when managing obesity. The Change Program was developed based on Australian guidelines and provides GPs with a handbook and patient toolkit. This structured program assists GPs to manage patients with obesity within their own practice setting.Objective: To assess the impact of participating in a pilot study of a weight manage-ment program on the confidence and self-efficacy of GPs.Methods: A six month pilot study was undertaken in five Australian general practic-es. Each GP was asked to recruit and manage two patients within their practice. GPs completed a survey and interview at the beginning and end of the pilot to assess their confidence and self-efficacy. Bandura’s self-efficacy theory was used to inform the synthesis of data.Results: Eleven of the 12 GPs were able to recruit patients and all 11 partici-pated in the end of pilot interviews. Most GPs reported an improvement in their confidence to provide care to patients with obesity, particularly in the “Assist” and “Arrange” phases of the 5As framework. GPs also reported a change in their usual clinical practice for obesity and had “Asked” and “Assessed” more patients in their day to day work.Conclusions: It is possible to improve the confidence and self-efficacy of GPs through an intensive, structured weight management program. The GPs reported changing their clinical practice even in patients who were not participating in the pilot. O2.7Improved Diagnosis and Follow Up for Obesity with the Implementation of an Integrated Program in Community CareChristine Brown, Suzanne Gosselin, Raymonde Vaillancourt, Irma Clapperton, Marie-France LangloisCIUSSS de l’Estrie - CHUS and Université de Sherbrooke, Sherbrooke, QC, Canada

Objective: Our region has implemented an integrated care framework for the prevention and management of cardiometabolic chronic diseases, including obesity. The aim of this study is to assess the impact of this new Agir sur sa santé program (ASSSE), on the diagnosis and management of patients with obesity.Method: Chart review of a random sample of patients who participated in 7 Community health centers chronic disease programs before implementation (n=1120/2122; 2012-2013) and to the ASSSE program (n=707/2483; 2015) was performed.Results: In both cohorts of patients, 30.5%/33.1% had a BMI ≥ 30 kg/m2, 48.4%/47.1% were females and mean age was 60.9 ± 12.0 and 60.4±12.6 years. In patients with obesity, BMI was reported more frequently following implemen-tation of the ASSSE program (84% vs 100%, p<0.001). However, there was no significant difference in waist circumference reporting (51.8% vs 58.1%, NS).


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Preliminary results show no improvement in the rate of lifestyle counselling or laboratory investigation for co-morbidities (A1c, fasting glucose and lipid profile), except blood pressure that was reported more often with the ASSSE program (79.1% vs 85.9%, p =0.04). Also, 21.8% of patients with obesity received follow-up specifically for weight management compared to only 4.6% before the ASSSE program (p<0.001).Conclusion: Our new integrated care framework recognizing obesity as a separate target chronic disease improves some aspects of the diagnosis and management of patients with obesity. Further analyses will allow us to determine if this integrated approach will results in better outcomes for patients. O2.8Associations of Body Mass Index with Coronary Revascularization Procedures and OutcomesTasuku Terada, Jeffrey A. Johnson, Colleen M. Norris, Raj Padwal, Weiyu Qiu, Arya M. Sharma, Jayan Nagendran, Mary ForhanUniversity of Alberta, Edmonton, AB, Canada

Objective: We explored the associations of obesity with cardiac revascularization procedures and adverse outcomes following each procedure.Methods: Data from 56,722 patients in the provincial registry were analyzed. Patients were organized into five groups based on body mass index (BMI): normal (18.5-24.9 kg/m2), overweight (25.0–29.9 kg/m2), obesity class I (30.0–34.9 kg/m2), obesity class II (35.0–39.9 kg/m2), and obesity class III (≥ 40.0 kg/m2). Using normal BMI as a reference group, BMI-specific associations of: 1) coronary revascularization procedures (coronary artery bypass grafting [CABG] surgery and percutaneous cor-onary intervention [PCI]); 2) incidences of early adverse outcomes following CABG; and 3) longer-term mortality rates following both CABG and PCI were assessed while adjusting for coronary anatomy risks and diabetes status.Results: Patients with obesity and high-risk coronary anatomy were more likely to be treated with PCI compared to patients in the normal BMI group. Following CABG, patients with BMI classified as obese were associated with early infection risks but not with longer-term mortality risks. Following PCI, patients classified as obesity class III in the subgroup of high-risk coronary anatomy were associated with a higher risk of long-term mortality compared to patients with normal BMI (adjusted hazard ratio: 1.34, 95%CI 1.00-1.79).Conclusion: Higher risks of early complications following CABG may explain higher rates of PCI in patients with obesity. However, considering the anticipated higher long-term mortality risks following PCI, clinical appropriateness of treating patients with obesity class III and high-risk coronary anatomy with PCI warrants further investigation. O3.1Exercise in Pregnancy and Children’s Cardiometabolic Risk Factors: a Systematic Review and Meta-AnalysisLaetitia Guillemette1, 2, Scott D. Kehler1, 3, Naomi C. Hamm1, 3, Jonathan M. McGavock1,

2, Todd A. Duhamel1, 3

1. University of Manitoba, Winnipeg, MB, Canada, 2. Children’s Hospital Research Institute of Manitoba, Winnipeg, MB, Canada, 3. St. Boniface Hospital Albrechtsen Research Centre, Winnipeg, MB, Canada

Objective: Prenatal exercise might reduce offspring cardiometabolic risk in childhood. We conducted a systematic review and meta-analysis to clarify this relationship.Methods: We searched Pubmed, MEDLINE, EMBASE, and CENTRAL up to May 2016. Two reviewers independently identified observational studies and random-ized controlled trials (RCTs) evaluating prenatal exercise and offspring cardiomet-abolic outcomes and extracted trial-level data with piloted forms. The primary outcome was birthweight; secondary outcomes included large-for-gestational age status, fat and lean mass, dyslipidemia, and blood pressure. We included 47 studies

and companion articles of the 10 574 citations initially identified and evaluated their internal validity. Data was pooled using random effects models.Results: We included 12 original observational studies (n=165 230 children) and 24 original RCTs (n=4930 children). Observational studies were highly heteroge-nous and had discrepant conclusions. Meta-analyzed RCTs indicated that prenatal exercise did not significantly impact birthweight (mean difference [MD]: -45.8g, 95% confidence interval [CI] -156.1 to 64.5g) or large-for-gestational age status (risk ratio: 1.45, 95%CI 0.97 to 2.17) compared to no exercise. Sensitivity analyses of RCTs showed that prenatal exercise reduced birthweight only in women with a body mass index <25 kg/m2 (MD: -238.5g, 95% CI: -475.1, -1.8g). Other outcomes were too scarcely reported to be meta-analyzed.Conclusions: Prenatal exercise does not significantly impact birthweight or large-for-gestational-age status and is not sufficient to reduce birthweight in offspring of women with overweight. Longer follow up of offspring exposed to prenatal exercise is needed along with measures of relevant metabolic variables (eg. fat mass). O3.2Are Suboptimal in Utero Conditions Associated with Obesity and Cardiometabolic Risk Factors in Offspring Reaching Puberty?Soraya Saidj1, Stéphanie-May Ruchat2, Mélanie Henderson3, Marie-Ève Mathieu3

1. University of Montreal, Montreal, QC, Canada, 2. Université du Québec à Trois-Riv-ières, Trois-Rivières, QC, Canada, 3. University of Montreal, Sainte-Justine University Hospital Center, Montreal, QC, Canada

Objective: This cohort study explores the association between in utero exposure to suboptimal gestational factors (SGF; gestational diabetes, hypertensive disorders, and maternal smoking), obesity and cardiometabolic risk factors (CMR; low level of high density lipoprotein, hypertriglyceridemia, fasting hyperglycemia, and high waist circumference). Methods: This study used data from the longitudinal “Quebec Adiposity and Lifestyle Investigation in Youth” study (QUALITY), which included 630 Caucasian chil-dren enrolled at 8–10 years old at first visit (V1) and 570 children followed at 10-12 years old (V2). Logistic regression was used to investigate the association between SGF, obesity and CMR. Results: A positive association between the number of SGF and obesity was found at V1 (p=0.007). Maternal smoking (p=0.028) and hypertensive disorders (p=0.040) were positively associated with waist circumference in girls at V1. In girls, maternal smoking was positively associated with the difference between V1 and V2 in body mass index (p=0.048) and obesity at V2 (p=0.022). Gestational diabetes tended to be positively associated with the difference between V1 and V2 in fat mass (p=0.066) and trunk fat (p=0.061) in boys, and with waist circumference in girls at V1 (p=0.099). No association was found between the number of SGF and obesity in V2, as well as between SGF and CMR in V1 and V2 (all p-values >0.05). Conclusion: In utero exposure to SGF impacts girls reaching puberty. In order to implement specific health policies, it is essential to explore whether this impact lasts during puberty and young adulthood, and if it appears later in boys. O3.3Preventing Excessive Gestational Weight Gain: Does Adherence to Prena-tal Nutrition and Exercise Recommendations Improve when You Include the Family?Taniya S. Nagpal1, Harry Prapavessis1, Christina Campbell2, Michelle F. Mottola1

1. University of Western Ontario, London, ON, Canada, 2. Iowa State University, Ames, IA, USA

Objective: Nutrition and exercise programs implemented during pregnancy can prevent excessive gestational weight gain (EGWG), however women with a pre-preg-nancy body mass index (BMI) of overweight (BMI≥25.0-29.9kg∙m2) and obese


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(BMI≥30.0kg∙m2) may find it difficult to adhere to two behaviour changes. The purpose was to identify if adherence to a two behaviour change program increases with the addition of a family-based component.Methods: Retrospectively, women with a pre-pregnancy BMI of overweight and obese who participated in the Nutrition and Exercise Lifestyle Intervention Program (NELIP; n=83) and in the Family-based Behavioural Treatment (FBBT) plus NELIP (FBBT+NELIP; n=48) were scored on meeting the goals of each program (3 nutri-tion and 3 exercise points) for a maximum adherence score of 6. Weight gain on each program was assessed according to the Institution of Medicine (2009) guide-lines. Adherence scores were compared between women who gained excessively or appropriately stratified by BMI, within and across programs.Results: Women who gained appropriately had significantly greater overall adher-ence than women who gained excessively in both BMI categories (p<0.05). Women who attended all FBBT sessions (n=10) had greater adherence to the nutrition behaviour change (87%) than those not offered the additional FBBT program (67%) in the obese category (p<0.05).Conclusion: Increasing adherence to prenatal nutrition and exercise behaviour changes by adding a family-based component prevents EGWG in women with a pre-pregnancy BMI of obese and overweight. Specifically, adding a FBBT plan to NE-LIP appears to assist in adherence to the nutrition component of behaviour change.Funded by CIHR O3.4Is There an Association Between Gestational Weight Gain and Infant Physical Activity?Jonathan M. Rankin1, Niko Wasenius1, 2, Alysha L. Harvey1, Kristi B. Adamo1

1. Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada, 2. Folkhäl-san Research Center, Helsinki, Finland

Introduction: Maternal weight-related factors have been associated with develop-mental programming of offspring PA in animal models. However, more research on human infants is required. The purpose of this study was to investigate the associa-tion of gestational weight gain (GWG) and change in total daily physical activity (PA) of infants from 3 to 6 and 12 months of age.Methods: Eight boys and five girls who participated in the MOM trial were includ-ed in this study. PA counts were measured over 24 hours using Actiwatch accelerom-eters. GWG was calculated as the difference between weight measured at delivery from antenatal record and self-reported pre-pregnancy weight. Data was analyzed using linear mixed models.Results: GWG was not associated with the change in PA counts/min from 3 to 6 mo (b = -0.6 counts/min, 95% CI = -5.7– 4.5, p=0.831) when adjusted for pre-pregnancy body mass index. However, an association was found between GWG and the change in PA from 3 to 12 mo (b = -9.6 counts/min, 95% CI = -18.4– -0.8, p=0.033).Conclusion: GWG was inversely associated with change in infant’s PA from early to late infancy. Our findings suggest that maternal weight-related factors may play a role in developmental programming of PA in late infancy. O3.5Clinician Self-Efficacy Pertaining to Initiating Discussions About Gestational Weight GainHelena Piccinini-VallisDalhousie University, Halifax, NS, Canada

Introduction: Excess gestational weight gain (GWG) is a risk factor for a number of adverse outcomes for mothers and their offspring. In Canada over 50% of women gain weight in excess of the recommended amounts. Advice from a prenatal care provider influences guideline-concordance of GWG. Although patients want their

clinicians to address GWG, such discussions tend to occur infrequently. Clinicians perceive lack of confidence as a barrier to initiating discussions about GWG. From a theoretical perspective, confidence is related to self-efficacy (SE). This study aimed to compare clinicians’ SE in initiating discussions about GWG with pregnant women under a variety of conditions and in the context of weight gain in excess of extant guidelines.Methods: A theory-based survey consisting of 42 items relating to the known barriers and facilitators to having discussions about GWG was created and entered into a web based survey system. The items represented various conditions and were clustered into a number of categories: patient, interpersonal, and clinic factors. For each item, participants were asked to rate their SE in starting a discussion about GWG with a patient who had gained more than the recommended amounts on a scale from 0 (“cannot do at all”) to 10 (“highly certain can do”).Results: Seventy-one clinicians completed the questionnaire (78% response rate). SE was overall fairly high. It was highest if the clinician could externalize the reason for undertaking the discussion and lowest with system issues. There were significant differences in SE within all three categories depending on condition. O3.6Obesity and Sleep Disturbances During Pregnancy: Does Gestational Weight Gain Matter? Results from the 3 D Cohort StudyBenjamin C. Guinhouya1, Frédéric Sériès3, Michèle Bisson2, William D. Fraser4, Isabelle Marc2

1. University of Lille, Public Health: Epidemiology and Healthcare Quality, Lille, France, 2. Department of Pediatrics, Research Centre of CHUQ, Laval University, Quebec, QC, Canada, 3. Research Unit in Pneumology, Research Centre, Laval University, Quebec, QC, Canada, 4. Research Centre of CHU Sherbrooke University of Sherbrooke, Sherbrooke, QC, Canada

Objective: We examined the effect of pre-pregnancy body mass index (BMI), together with gestational weight gain (GWG) on sleep abnormalities over the whole pregnancy. Methods: A sample of 2,366 women was recruited in the 1st trimester (TM) and fol-lowed until delivery in the 3D cohort study (Quebec, 2010-2012). Participants were evaluated each TM for their sleep quality and snoring, using the Pittsburgh Sleep Quality Index (PSQI) score and questions directed to their partner. Age, ethnicity, and income level were collected as covariates. A mixed linear modeling and a multi-nomial logistic regression were applied for PSQI score and snoring, respectively. Results: PSQI score was the lowest at TM 2 (β=-1.03; 95%CI: -1.17; -0.89) and highest in TM 3 (β=0.27; 95%CI: 0.10; 0.45). Obese (β=0.48; 95%CI: 0.17; 0.78) and overweight women (β=0.24; 95%CI: 0.00; 0.48) exhibited an overall greater PSQI than normal-weight women. Differences on PSQI according to BMI were no longer significant when either GWG or socio-demographic factors were considered. Snoring was frequently reported in the three TMs (>30%). Obese women almost had up to 4-fold increased risk (OR=3.89; 95%CI: 2.50; 6.06) of being habitual snorer. While GWG did not affect this odds (aOR=3.83; 95%CI: 2.43; 6.03), socio-demographic factors slightly increased the risk of being habitual snorer (aOR=4.04; 95%CI: 2.57; 6.35). Conclusion: Unlike GWG, entering pregnancy with a high BMI is the most critical for the occurrence of sleep disturbances. Factors such as multiparity, advanced age, non-caucasian ethnicity, and low income warrant attention in the surveillance of pregnancy-related sleeping disorders.


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O3.7Impact of Maternal Pre-pregnancy Overweight on Infant Overweight Risk at 1 Year of Age: Sex-specific DifferencesRose Kalu1, Petya Koleva1, Allan Becker2, Andrea Haqq1, Anita Kozyrskyj1

1. University of Alberta, Edmonton, AB, Canada, 2. University of Manitoba, Winni-peg, MB, Canada

Background: Maternal obesity is linked to pregnancy complications such as gestational diabetes, fetal macrosomia, and increased rates of cesarean delivery. It is also a strong determinant of overweight in offspring.Objective: To assess whether maternal pre-pregnancy overweight is associated with infant risk of overweight and to explore possible sex differences.Methods: Weight and height measurements of 976 women were obtained from medical records or maternal report in the Canadian Healthy Infant Longitudinal Development [CHILD] study and infant anthropometrics were measured at age 1 year. “At risk for overweight” was defined as weight-for-length z-score >85th percentile for age and sex according to international reference standards. Mode of delivery, breastfeeding status, infant antibiotic exposure and other covariates were determined from hospital records and maternal report.Results: Maternal pre-pregnancy overweight increased the risk (OR, 1.48; 95%CI: 1.03-2.11) of infant overweight at 1 year, independent of mode of delivery, exclusivity of breastfeeding and exposure to antibiotics. Stratified analyses revealed that boys born to overweight mothers were twice as likely to become at risk of overweight at 1 year whereas there was no significant effect in girls. Our study also revealed that exclusive breastfeeding until 3 months of age lowered the risk of child overweight at one year by 44% (OR, 0.56 ; 95%CI: 0.39–0.80).Conclusions: Maternal pre-pregnancy overweight increases the risk of infant overweight, and this association is more evident in males. O4.1Prospective Associations of Dietary Intake on Insulin Sensitivity and Secretion in Children with Familial ObesityAndraea Van Hulst1, 2, Lucas Leclerc2, Katherine Gray-Donald3, Andrea Benedetti1, Sanyath Radji2, Mélanie Henderson2, 4

1. Department of Epidemiology, Biostatistics and Occupational Health, McGill Uni-versity, Montreal, QC, Canada, 2. Centre de recherche du CHU Ste-Justine, Montreal, QC, Canada, 3. School of Dietetics and Human Nutrition, McGill University, Montreal, QC, Canada, 4. Division of Endocrinology, Department of Pediatrics, University of Montreal, Montreal, QC, Canada

Objective: To assess how dietary intake predicts insulin sensitivity and secretion over a two-year period in children with a family history of obesity.Method: Data stem from the QUALITY cohort, consisting of 630 children with at least one obese parent, recruited at age 8-10 years. Macronutrients (including %car-bohydrates, %fat, %saturated fat, %protein, fibre, sugar-sweetened beverages and portions for fruits and vegetables) were assessed at baseline using 3 non-consecu-tive 24-hr dietary recalls. Insulin sensitivity was assessed by Matsuda Index, and in-sulin secretion by the ratio of the AUC of insulin to glucose at 30min and at 120min after an oral glucose tolerance test. Physical activity (PA) was evaluated by 7-day accelerometry, adiposity (percent fat mass) by DXA. Multivariable linear regression models were minimally adjusted for age, sex, PA, screen time, adiposity, season and pubertal stage. Missing data was accounted for using multiple imputation.Results: Saturated fat intake was deleterious to insulin sensitivity over time: for every 1% increase in baseline saturated fat intake, Matsuda Index decreased by 1.6% (95% CI = -3.2, -0.06) 2 years later, in fully adjusted models. Similarly, every additional daily portion of fruits and vegetables was associated with a 2.4% (95% CI= 0.4, 4.4) improvement in Matsuda Index 2 years later. No dietary component predicted insulin secretion in adjusted models.

Conclusion: Lowering saturated fat intake and increasing daily portions of fruits and vegetables may be beneficial to prevent later development of type 2 diabetes in youth with familial obesity by improving insulin sensitivity, but not insulin secretion O4.2Histological Improvement of Non-Alcoholic Steatohepatitis with a Prebiotic: a Pilot Clinical TrialMarc R. Bomhof1, Jill A. Parnell2, Matt Workentine3, Pam Crotty3, Kevin Rioux3, Saumya Jayakumar3, Maitreyi Raman3, Raylene A. Reimer3

1. University of Lethbridge, Lethbridge, AB, Canada, 2. Mount Royal University, Calgary, AB, Canada, 3. University of Calgary, Calgary, AB, Canada

Background: In obesity and diabetes the liver is highly susceptible to abnormal uptake and storage of fat. In certain individuals hepatic steatosis predisposes to the development of non-alcoholic steatohepatitis (NASH), a disease marked by hepatic inflammation and fibrosis. Although the precise pathophysiology of NASH is un-known, it is believed that the gut microbiota-liver axis influences the development of this disease. With few treatment strategies available for NASH, exploration of gut microbiota-targeted interventions is warranted.Methods: We investigated the therapeutic potential of a prebiotic supplement to improve histological parameters of NASH. In a single-blind, placebo controlled, randomized pilot trial, 14 individuals with liver biopsy confirmed NASH (Non-alco-holic fatty liver activity score (NAS) ≥ 5) were randomized to receive oligofructose (8 g/day for 12 weeks and 16g/day for 24 weeks) or isocaloric placebo for 9 months. The primary outcome measure was the change in liver biopsy NAS score and the secondary outcomes included changes in body weight, body composition, glucose tolerance, serum lipids, inflammatory markers, and gut microbiota.Results: Independent of weight loss, oligofructose improved liver steatosis relative to placebo and improved overall NAS score (P<0.05). Bifidobacterium was enhanced by oligofructose whereas bacteria within Clostridium cluster XI and I were reduced with oligofructose. There were no adverse side-effects that deterred individuals from consuming oligofructose for treatment of this disease.Conclusions: Independent of other lifestyle changes, prebiotic supplementation reduced histologically-confirmed steatosis in patients with NASH. Larger follow-up studies are warranted. O4.3The Effects of Partial Sleep Restriction on Olfactory Performance and 24h Energy Intake in Men and WomenJessica McNeil1, Geneviève Forest2, Luzia Jaeger Hintze3, Jean-François Brunet2, Éric Doucet3

1. Alberta Health Services, Calgary, AB, Canada, 2. Université du Québec en Out-aouais, Gatineau, QC, Canada, 3. University of Ottawa, Ottawa, ON, Canada

Objective: Olfaction can contribute to increasing the drive to eat and may partially explain the consistent increases in energy intake (EI) following sleep restriction. We examined the effects of sleep restriction on olfactory performance. We also evaluated whether changes (∆) in sleep architecture between sessions were related to ∆olfactory performance, and whether ∆olfactory performance were associated with ∆24h EI. Methods: Twelve men and 6 women (age: 23±4 years; BMI: 23±3 kg/m2) com-pleted a habitual sleep and a 50% sleep restriction condition. Sleep was measured inside the laboratory (polysomnography). Olfactory performance (“sniffin sticks”) and 24h EI (validated food menu) were assessed the next day.Results: Women had decreased, and men increased, olfactory performance follow-ing sleep restriction vs. control (F (1, 16) = 8.24, P = 0.01; partial η 2 = 0.34). There were no significant changes in 24h EI between men and women across conditions nor were ∆olfactory performance associated with ∆24h EI. Exploratory analysis


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revealed that decreases in REM sleep duration were associated with increased olfactory performance, but only in women (β=-0.19 minutes, 95% CI for β=-0.34 to -0.03 minutes; P=0.04). Conclusions: These findings suggest that the impact of sleep restriction on olfacto-ry performance differs between sexes; women demonstrating decreased, and men increased, olfactory performance following sleep restriction vs. control. Furthermore, reductions in REM sleep duration were associated with increased olfactory perfor-mance, but only in women. Studies are needed to explore factors that may impact sex differences in olfactory performance following sleep restriction. O4.4Limited Potential of the Food Craving Inventory and Three-Factor Eating Questionnaire to Predict Brain Food-cue Reactivity in Subjects with ObesityChanaka N. Kahathuduwa1, 2, Tyler Davis3, Martin Binks1

1. Department of Nutritional Sciences, Texas Tech University, Lubbock, TX, USA, 2. De-partment of Physiology, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka, 3. Department of Psychological Sciences, Texas Tech University, Lubbock, TX, USA

Objective: To examine whether Food Craving Inventory (FCI) and Three-Factor Eating Questionnaire (TFEQ) subscales predict brain food-cue reactivity (functional magnetic resonance imaging; fMRI), in individuals with obesity.Methods: We extracted baseline data of 32 adults with obesity (BMI 30–39.9kg/m2) who participated in a larger study. FCI, TFEQ and fMRI scans were administered following an 8-hour fast. During fMRI scans, subjects rated images of 120 food and 120 color and visual complexity-matched objects in an event-related paradigm. We pre-processed and analyzed fMRI data using FSL (6.0), extracted the mean food vs. object contrasts (FCR) from pre-specified regions of interest and examined linear correlations between FCR and the subscales of FCI and TFEQ. We further examined correlations between BMI and FCR.Results: Overall food cravings correlated with right anterior cingulate (ACC) FCR (r=-.353). High-fat food cravings correlated with FCR of left and right ACC; r=-.373 and r=-.473). All other correlations between FCI and TFEQ subscales and brain regions were not significant. BMI correlated with left and right amygdala (r=.480 and r=.409), dorsolateral prefrontal cortex (r=.393 and r=.370), insula (r=.459 and r=.527), nucleus accumbens (r=.425, r=.398), precentral gyrus (r=.448 and r=.487), left ACC (r=.402) and right orbitofrontal cortex (r=.400).Conclusion: Negative correlations between ACC FCR and high-fat and overall food cravings indicate possible inhibitory role of ACC on food cravings. Subscales of the FCI and TFEQ do not appear to be reflected in specific brain regions as often implied in the literature. Correlations between BMI and FCR substantiate previous findings. O4.5Validation of the Canadian Healthy Eating Index-2007Jacynthe Lafreniere, Elise Carbonneau, Catherine Laramée, Julie Robitaille, Benoit Lamarche, Simone LemieuxInstitute of Nutrition and Functional Food, Laval University, Québec, QC, Canada

Objective: To validate the Heathy Eating Index based on the 2007 Canadian Food Guide (HEI-C 2007) and determine whether assessment with 24h recalls (24HR) (ei-ther 1,2,3 or 4 days) or a food frequency questionnaire (FFQ) provides reliable results.Methods: Seventy-five women and 75 men filled the R24W a web-based 24HR on 4 occasions as well as a web-based FFQ. Dispersion as well as association of HEI-C 2007 and its components with selected nutrients (fiber, vitamin-C, vitamin-D, calci-um, potassium, magnesium and iron) were assessed. The well-known difference in diet quality between men and women was tested. Sample menus derived from the Canadian Food Guide provided by Health Canada were analysed to verify whether they received a perfect score. We performed agreement analyses to determine if different methods similarly classified participants.

Results: HEI-C 2007 score calculated with either 1,2, 3 or 4 24HR or FFQ ranged from 21.5 to 100. With all methods, significant correlations were found between HEI-C 2007 components (4 CFG groups) and all nutrients tested and scores in women were significantly higher than in men (P<0.001). Sample menus obtained scores above 99.5. HEI-C 2007 as calculated with 2 (Kappa=0.62) or 3 (Kappa=0.78) 24HR showed a substantial agreement with the score obtained with 4 24RH while those calculated with 1 24HR (Kappa=0.35) and FFQ (Kappa=0.36) demonstrated only fair agreement with 4 24HR.Conclusion: These data indicate that assessment of diet quality based on a single 24HR or a FFQ needs to be interpreted with caution when compared with multiple 24HR. O4.6Findings from Alberta’s 2016 Nutrition Report Card on Food Environ-ments for Children and YouthAlexa Ferdinands, Laurie Drozdowski, Kayla Atkey, Candace I. Nykiforuk, Kim D. RaineUniversity of Alberta, Edmonton, AB, Canada

Alberta’s 2016 Nutrition Report Card on Food Environments for Children and Youth is the second annual assessment of how Alberta’s current food environments and nutrition policies support or create barriers to improving children’s eating behaviours and body weights. Given that poor nutrition and obesity are major health concerns facing Canadian children, this assessment aims to increase public, practitioner, and policymaker awareness of the relevance and status of food environments for children, with a focus on health promotion and obesity prevention. The grading system for the Nutrition Report Card evaluates four micro-environments (physical, communication, economic, and social) that each have embedded policies. It also assesses the political macro-environment as a way to understand the factors that support policies within each micro-environment. For the 2016 period, Alberta received a D in all five environments, indicating ample room for improvement. Ultimately, the goal is to conduct these assessments across Canadian juris-dictions to create a national Nutrition Report Card. The Nutrition Report Card Toolkit was developed to help in this process, as it outlines the steps of data collection, grading, and consensus decision-making for individuals interested in conducting their own commu-nity-based assessments. Overall, the Nutrition Report Card can help to improve children’s well-being by serving as a tool for government and non-government organizations, researchers, corporations, and foundations to support and develop enhanced program-ming and policies, as well as to identify areas that require further action and work. O4.7Stop Sugar Coating Children’s Breakfast Cereals: Child Targeted Cereals in Canada Require ReformulationMonique Potvin Kent1, Cher Cameron2, Sarah Philippe21. School of Epidemiology, Public Health and Preventive Medicine, University of Ot-tawa, Ottawa, ON, Canada, 2. Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON, Canada

Objective: A significant number of breakfast cereals are targeted at children. The objective of this study was to analyze the healthfulness of breakfast cereals sold in Canada and to com-pare the nutritional value and healthfulness of child-targeted and not child-targeted cereals.Methods: The nutritional content of 262 unique breakfast cereals found in the 5 largest grocery store chains in Ottawa-Gatineau was collected. The first five ingredients and the number of added sugars present in each cereal were noted from the ingredients list. The various cereal brands were then classified as either “healthier” or “less healthy” using the UK Nutrient Profile Model. Each cereal was assessed by two research assistants to determine if it was child-targeted or not, based on set criteria. Statistical comparisons were made between child and not child-targeted cereals.Results: 19.8% of all breakfast cereals were child-targeted and these were significantly lower in total and saturated fat. Child-targeted cereals were significantly higher in sodium, and sugar and lower in fibre and protein. A significantly higher percentage (84.6%) were categorized as less healthy compared to not child-targeted cereals (64.8%). No child-tar-


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geted cereals were sugar free, and sugar was the second most common ingredient in 75% of cereals. Six breakfast cereal companies had child-targeted product lines that consisted entirely of less healthy cereals. Conclusion: Breakfast cereal companies in Canada need to offer a greater variety of healthier breakfast cereals to children. This could be accomplished by reformulating cereals by reducing the sugar and sodium content, and increasing the fibre content. O5.1Single Injection of Rapamycin Blocks Post Restriction Hyperphagia and Body Weight Re-gain in RatsTherese E. Kenny, Mark Hebert, Phillip Mac Callum, Jesse Whiteman, Katelyn Fallon, Katherine Smith, Jacqueline BlundellMemorial University of Newfoundland, St. John’s, NL, Canada

Given the increasing prevalence of and severity of complications associated with obesity, there is great need for treatments resulting in prolonged weight loss. Losing weight is relatively easy, but long-term maintenance of weight loss requires sustained changes in food intake and energy expenditure strategies, which are unfortunately often taxing, resulting in a return to pre-dieting weight. Therefore, drug therapies may facilitate greater adherence to a restricted diet and prolong weight loss. One such drug is rapamycin (RAP), a mechanistic target of rapamycin (mTOR) inhibitor. Here, we show that a single intraperitoneal injection of RAP dampens the hyperphagic response in calorically restricted rats when they were returned to free feed immediately or 10 days after injection. Moreover, we demonstrate that a single injection of RAP given to calorically restricted rats prevents body weight re-gain when animals are returned to free feed either immediately or 10 days after injection. Furthermore, we extend our previous findings that RAP does not produce malaise or illness, and show that RAP does not produce any behavioural deficits that may inhibit an animal from eating. Thus, we suggest that mTOR may be a useful target in obesity research given that its inhibition may decrease the hyperphagic response following caloric restriction. We are currently investigating neurobiological mechanisms by which RAP may act. O5.2Maternal Aspartame Consumption May Induce Metabolic Derangements and Impact Central Pathways Involved in Feeding in Mom and Pups in RatsJodi E. Nettleton1, Nicole A. Cho1, Teja Klancic1, Jane Shearer1, Stephanie L. Borgland1, Leah Johnston2, Raylene A. Reimer1

1. University of Calgary, Calgary, AB, Canada, 2. Dalhousie University, Halifax, NS, Canada

Objective: Determine the impact of consumption of aspartame or stevia on maternal and offspring metabolic health and brain pathways involved in food consumption behaviour.Methods: Female Sprague-Dawley rats were randomized to one of three groups: 1) High fat/sugar diet (HFS) + water, 2) HFS + Aspartame (APM), 3) HFS + Stevia (STV). A fourth group was maintained on chow and water as a lean control (CTR). Body weight, fecal samples, and oral glucose (OGTT) and insulin tolerance tests (ITT) were conducted at baseline and during pregnancy and lactation. At weaning (3 weeks), dams and 4 offspring from each litter underwent a DXA scan and tissue harvest. Remaining offspring were followed until 18 weeks of age.Results: Total body weight and body fat% was greater in HFS dams than CTR (p<0.05) at weaning, however there was no difference in gestational weight gain. APM had higher glucose levels during gestation ITT compared to CTR and WTR (p<0.025). APM, STV, and WTR had greater levels of Clostridium coccoides compared to CTR (p<0.025) and blunt-ed Clostridium leptum (p<0.025) in their fecal samples during pregnancy. Female APM and STV pups were heavier than CTR and WTR pups at weaning (p<0.05). APM pups had reduced insulin sensitivity and glucose control at age 8 weeks (p<0.05). APM pups had greater mu-opioid receptor, dopamine receptor 1 and 2 mRNA expression in nucleus accumbens (p<0.05) at weaning compared to CTR.

Conclusions: Maternal consumption of aspartame and stevia may compromise glucose control and insulin sensitivity, and central pathways O5.3Longitudinal Metabolic Profiling Identifies Differences in Maternal Response to Pregnancy and Lactation Between Lean and Diet-induced Obese RatsHeather A. Paul, Marc R. Bomhof, Hans J. Vogel, Raylene A. ReimerUniversity of Calgary, Calgary, AB, Canada

Maternal obesity adversely affects both maternal and offspring health. However, there is little known on how lean versus obese mothers differ in their metabolic response to pregnancy and lactation. Here, we sought to identify longitudinal metabolic changes that characterize obese versus lean pregnant and lactating dams in order to identify key differences in how obese dams respond to pregnancy and lactation. Diet-induced obese and lean female Sprague-Dawley rats were bred and maintained on their respective diets throughout gestation and lactation. At parturition, litters were culled to 10 pups. The study concluded at weaning. Serum for metabolic profiling was collected pre-pregnancy, on gestation d14, and lactation d19, and subjected to 1H NMR metabolomics analysis. Body weight and composition, food intake, and glycaemia was assessed. Obese dams were heavier than lean females throughout the study and had higher adiposity at weaning (p<0.05). Obese dams consumed more calories only during gestation (p<0.05). No differences in glycaemia were detected. Metabolic pro-filing indicates that there exists overlap in some, but not all, of the metabolic changes that occured across pregnancy and lactation in these dams. Notably, pre-pregnancy and gestational metabolic profiles of obese dams were more similar to each other than those of lean dams. In comparison, a larger proportion of the metabolic changes that occurred from gestation and lactation were similar between groups. Altogether, longitudinal metabolic profiling is expected to identify key differences in maternal adaptations to pregnancy and lactation that might improve understanding of how maternal obesity adversely affects maternal and offspring health. O5.4Endogenous Cannabinoid and Nitric Oxide Interactions in the Rat: Potential Implications for Appetite RegulationTierza Petersen, Jacob McGavin, Jenna Thebeau, Nicholas Cochkanoff, Karen M. CrosbyMount Allison University, Sackville, NB, Canada

Objective: The dorsomedial nucleus of the hypothalamus (DMH) is an important appetite-regulatory center in the brain. In the DMH, neuronal communication is con-trolled by two interacting signals: endogenous cannabinoids (eCBs) and nitric oxide (NO). It is unknown, however, whether eCBs and NO interact to regulate food intake in the rat. The main objective of this research is to determine whether eCBs and NO interact to regulate appetite and whether the DMH is involved in these effects. Methods: Young male Sprague-Dawley rats were administered a combination of drugs that either activate or inhibit the eCB and NO signaling pathways. Drugs were adminis-tered into the general circulation or directly into the DMH via surgically-implanted guide cannulas. Following the injections, food intake and body weight were measured over a two hour period and brains were subsequently removed for future analysis. Results: When administered into the general circulation, neither eCBs nor NO signifi-cantly altered food intake or body weight. In contrast, when NO signaling was blocked, eCBs actually decreased food intake compared to control animals. When administered di-rectly into the DMH, eCBs and NO increased food intake when delivered in combination. Conclusions: These data suggest that eCBs and NO interact to regulate food intake and body weight. These findings also indicate that eCB and NO differentially affect appetite, depending on whether they are administered into the general circulation or directly into the DMH. Overall, this research will further our understanding of neural regulation of appetite in rats, with potential implications for obesity in humans.


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O5.5Chondroitin Sulfate Prebiotic Improves GLP-1 Response and Glucose Regulation in MiceJennifer Pichette, Nancy Fynn-Sackey, Jeffrey GagnonLaurentian University, Sudbury, ON, Canada

Objective: Incretin hormone therapies are a new and important approach for treating obesity and Type 2 diabetes in Canada. The gastrointestinal incretin hor-mone glucagon-like peptide-1 (GLP-1) increases insulin secretion, improves insulin sensitivity, and suppresses appetite. Recently, the gastrointestinal microbiome has been implicated in metabolic health. Within the colon, sulfate-reducing bacteria (SRB) produce hydrogen sulfide (H2S). As H2S is implicated in the regulation of metabolic hormones, and GLP-1 producing cells are in the same niche as these SRB, we hypothesize that H2S plays a regulatory role in the secretion of GLP-1.Methods: We first examined the direct effect of H2S on GLP-1 secretion and signal-ling using the GLUTag cell line. Next, we fed mice a high fat diet with and without a validated SRB-increasing prebiotic (chondroitin sulfate) for 4 weeks. In these ani-mals we examined the change in SRB using targeted qPCR and H2S measurements, oral glucose tolerance, GLP-1 secretion, and feeding.Results: In vitro experiments showed the H2S caused a dose-dependent increase in GLP-1 secretion. This secretion occurred through activation of the p38 MAPK path-way. In the animals, the chondroitin sulfate group had a significant improvement in their glucose tolerance and GLP-1 response. These results were paralleled with increased levels of fecal H2S and the SRB Desulfovibrio piger.Conclusion: Prebiotics modulating SRB lead to increased H2S, improved glucose homeostasis, and enhanced GLP-1 levels. This work provides mechanistic evidence of how the microbiome can improve metabolic health and may be a potential new strategy in the treatment of obesity and diabetes. O5.6Effects of Glutathione Redox on Mitochondrial Structure and Energetics in Primary Mouse MyoblastsAwa Liaghati, Pauline Caron, Mary-Ellen HarperUniversity of Ottawa, Ottawa, ON, Canada

Objective: Glutathione (GSH) plays a pivotal role in cellular redox poise, which is disordered in many metabolic diseases including obesity. Glutaredoxin-2 (Grx2) is a glutathione transferase in mitochondria and the nucleus. We previously established that Grx2 knockout (Grx2-/-) mice have low GSH:GSSG and mitochondrial dys-function in isolated mitochondria of muscle and heart. Low GSH:GSSG stimulates mitochondrial fusion. Our goal was to study the impact of Grx2-/- on mitochondrial structure and function in intact cells and of insulin treatment on GSH:GSSG.Experimental Approach: Mitochondrial-targeted Grx1-roGFP and HPLC were used in mouse primary cells, and in C2C12 myoblasts to measure mitochondrial and total cellular glutathione redox, respectively. Mitochondrial energetics was assessed us-ing Seahorse XF technology. Mitochondrial structure and ultrastructure are assessed using confocal and electron microscopy approaches, respectively. Results: Compared to wild-type (WT), Grx2-/- myoblasts have a decreased GSH:GSSG, with a markedly increase in GSSG levels. Insulin treatment caused a decrease in mitochondrial GSH:GSSG, but no overall effect at the total cellular level. Mitochondrial ultrastructure is profoundly abnormal, in Grx2-/- compared to WT muscle.Conclusion: Absence of Grx2 causes marked abnormalities in mitochondrial ultra-structure in skeletal muscle and in cellular glutathione redox states. Insulin causes a more oxidized mitochondrial GSH:GSSG, an effect that cannot be detected at the whole cellular level. Analyses of mitochondrial fusion, and energetics are ongoing.

O5.7Influence of ACSL5 Genotype on Fatty Acid Oxidation and Mitochondrial Bioenergetics – an ex vivo and in vivo AnalysisAbishankari Rajkumar1, Awa Liaghati1, Gilles Lamothe1, Robert Dent2, Ruth McPherson3,

1, Éric Doucet1, Remi Rabasa-Lhoret6, 5, Denis Prud’homme4, 1, Mary-Ellen Harper1, Frédérique Tesson1

1. University of Ottawa, Ottawa, ON, Canada, 2. The Ottawa Hospital, Ottawa, ON, Canada, 3. University of Ottawa Heart Institute, Ottawa, ON, Canada, 4. Monfort Hospital, Ottawa, ON, Canada, 5. Institut De Recherches Cliniques De Montreal, Montreal, QC, Canada, 6. Universite de Montreal, Montreal, QC, Canada

The rs2419621 polymorphism in the fatty acid oxidation related protein Acyl-CoA Synthe-tase Long Chain 5 (ACSL5) gene is associated with i) response to lifestyle intervention in individuals with overweight and obesity, and ii) ACSL5 mRNA levels in skeletal muscle. The objectives were to study the effect of rs2419621 genotype on fatty acid oxidation and respiration in vivo and ex vivo. Association analysis between ACSL5 genotype and fatty acid oxidation/carbohydrate oxidation levels measured by indirect calorimetry was conducted on 106 individuals with overweight and obesity who participated in the exercise/diet intervention Montréal-Ottawa New Emerging Team (MONET). In addition, mitochondrial high-resolution respirometry was conducted on vastus lateralis muscle biopsies from 8 subjects who participated in the Ottawa Hospital Weight Management Program (n=4 T-allele carriers and n=4 non-carriers) using the Oxygraph-2k system. Compared to non-carriers, rs2419621 [T] allele carriers displayed statistically significant i) greater increase in fatty acid oxidation and greater decrease in carbohydrate oxidation following the MONET lifestyle intervention, and ii) greater increase in complex I and II respiration in the muscle. These results suggest that rs2419621 [T] allele carriers with overweight and obesity are more responsive to lifestyle interventions because their high-er levels of skeletal muscle ACSL5 are associated with more effective fatty acid oxidation and respiration in comparison to non-carriers. O5.8Thermogenic Phenotype Shares a Negative Association with Oxidative Stress-related Parameters in Human Epicardial Adipose TissueKanta Chechi, Pierre Voisine, Patrick Mathieu, Philippe Joubert, Yves Deshaies, Denis RichardInstitut Universitaire de Cardiologie et de Pneumologie de Quebec, Universite Laval, Quebec, Quebec, QC, Canada

Background: Brown fat presence and metabolic activity has been associated with better cardiometabolic profile in humans. We, and others, have previously reported presence of uncoupling protein 1 (UCP1), a marker of brown adipocytes, in human epicardial adipose tissue (eAT).Objective: To characterize the nature and thermogenic properties of human eAT and to assess its physiological relevance.Methods: Samples of eAT, mediastinal- (mAT) and subcutaneous- fat (sAT) were collected from patients (n=53) undergoing heart surgeries, and were utilized either for primary culture or direct gene expression analysis. Results: UCP1 gene expression exhibited significant variability across individuals and fat depots with its expression being highest in eAT and lowest in sAT (P ≤ 0.05). Screening for specific markers identified both eAT and mAT to be beige in nature, with eAT exhibiting a much stronger beige phenotype than mAT. eAT derived primary adipocytes exhibited higher capacity for thermogenesis at the basal level (P ≤ 0.05), and an upregulation of UCP1 mRNA as well as downregulation of mitochondrial coupling ef-ficiency upon stimulation (P ≤ 0.05). Principal component analyses followed by stepwise regression analyses revealed that thermogenic genes share a negative association with oxidative stress-related genes in both eAT and mAT (P ≤ 0.05). In addition, isoproterenol stimulation of eAT resulted in downregulation of secreted proteins included in the GO terms-cell redox homeostasis and protein folding.


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Conclusion: Human eAT exhibits a beige phenotype and ability to undergo thermogenesis under stimulated conditions. Its thermogenic phenotype shares a negative association with oxidative stress-related parameters in humans. O6.1Health Service Use 12 Months Pre - and 24 Months Post-Laparoscopic Sleeve Gastrectomy (LSG)Jillian Vallis, Kendra Lester, Deborah Gregory, Laurie TwellsMemorial University of Newfoundland, St John’s, NL, Canada

Objective: Bariatric surgery is an effective treatment for severe obesity. As surgeries continue to increase in Canada, there is a need for data in order to estimate related health services use (HSU) and to inform health policy. Uncertainties exist about the extent to which surgery is associated with reductions in HSU. The objective of this study is to determine the impact of bariatric surgery on short term HSU in patients undergoing LSG.Methods: A retrospective cohort study examining the effect of bariatric surgery on HSU (e.g., physician, hospital, ER). Eligible patients recruited through the Provincial Bariatric Surgery Clinic provided self-reported HSU data using standardized case report forms at baseline, 12 months’ pre-surgery and every 6 months for 2 years. HSU was compared pre and post-surgery. Results: Two hundred one patients were enrolled. Approximately 82% were female, with a mean age and BMI of 44yrs and 48.8 kg/m2, respectively. Compared to the pre-surgical year, the average number of family physician visits and utilization of out-patient clinic visits, procedures and other healthcare professional visits (e.g., dietician, diabetic nurse educator) were significantly reduced at 2 years post-surgery (p<0.05). ER visits were not significantly reduced after 2 years compared to before surgery. No significant differences were reported in hospital admissions pre- and post-surgery. Conclusions: Bariatric surgery leads to a significant reduction in the short term use of direct health care services in the 2 years following surgery. O6.2Weight Loss and Quality of Life Outcomes in Surgically Treated Patients In [Province]: a Prospective Cohort StudyLaurie K. Twells1, 2, Deborah Gregory1, Kendra Lester1, Dave Pace1, 3

1. Faculty of Medicine, Memorial University, St. John’s, NL, Canada, 2. School of Pharmacy, Memorial University, St. John’s, NL, Canada, 3. Eastern Health, St. John’s, NL, Canada

Objective: [Province] has the highest prevalence of obesity in Canada. In 2011, a publicly funded provincial bariatric surgery program in [Province] began offering laparoscopic sleeve gastrectomy (LSG) to eligible patients. A prospective observa-tional cohort study was implemented to examine weight loss and health related quality of life (HRQoL) over a period of 2 years. Methods: Consecutive eligible and consenting patients were enrolled (n=201). The primary outcome was weight change. HRQoL data was collected using the EQ-5D, Visual Analogue Scale (VAS, 1-100), SF-12v2 and the IWQOL-lite. Results: At baseline, mean (SD) age was 44 (10), mean BMI 48.8 (6.8) kg/m2 and 81.6% were female. Patients presented with: sleep apnea (65.5%), back pain (50.5%), dyslipidemia (47.9%), hypertension (47.9%), GERD (43.6%), osteoarthritis (43.3%), and T2DM (41.8%). Almost 78% (n=156) completed 2-year follow up. Mean absolute weight loss was 37.4 kg (16.4) and %TWL was 27.3% (9.8). EQ-5D findings indicate almost or more than half reported problems with pain/discom-fort, anxiety and depression, usual activities, and mobility with significantly fewer patients reporting problems after 24 months. Pre-surgery patients reported a VAS of 59.7% (18.7) which increased to 79.9% (15.2). Baseline SF-12 physical and mental component summary scores (PCS & MCS) were 36.4 (10.6) and 47.8 (10.7), respec-tively. At follow-up the summary scores were at or approaching Canadian normative

scores (PCS 51.7 (9.0) and MCS 47.8 (11.8)). All changes were significant, p<.05. Conclusions: Bariatric surgery offered in a newly established provincial bariatric surgery program was clinically effective in terms of weight loss and patient reported HRQoL. O6.3Employment and Quality of Life Outcomes 2 Years Following Bariatric SurgeryKarin Kantarovich1, Susan Wnuk1, 2, Stephanie Cassin3, Raed J. Hawa1, 2, Sanjeev Sockalingam1, 2

1. University Health Network, Toronto, ON, Canada, 2. University of Toronto, Toronto, ON, Canada, 3. Ryerson University, Toronto, ON, Canada

Objective: Bariatric surgery is the most effective long-term treatment for severe obesity. While the main objective of this procedure is to facilitate significant weight loss, additional post-operative outcomes include improvements in mental and physical health, and consequently, work capacity. The purpose of our study was to evaluate changes to employment impairment (EI) and quality of life (QOL) in patients 2 years following bariatric surgery.Methods: Prospective data was collected on a cohort of 211 patients who underwent bariatric surgery at the Toronto Western Hospital Bariatric Surgery Program. The Lam Employment Absence and Productivity Scale (LEAPS) and the 36 Item Short Form Survey (SF-36) subscales were used to assess pre- and post-operative EI and QOL, respectively.Results: Significant improvements in work performance 2 years following surgery were noted. Specifically, 68% of participants reported decreased overall EI 2 years post-surgery (Z = -6.423, p < 0.001), and 44% participants reported an increase in work productivity and functioning (Z = -4.671, p < 0.001). Bariatric surgery was also associated with improved QOL, with 96% of patients reporting improvements in physical health (t(176) = -21.603, p < 0.001), and 60% of the patients noting improvements in mental health (Z = -3.231, p = 0.001).Conclusions: The results of the current study provide further evidence to support the significant improvements experienced in work capacity and overall well-being in patients after undergoing bariatric surgery. O6.4What Bariatric Surgery Recipients Need Before, During, and After Surgery for Long-term Health and Well-being: Recipients’ PerspectivesRebecca H. Liu, Jennifer D. IrwinWestern University, London, ON, Canada

Background: Long-term success remains a challenge for many who have undergone bariatric surgery, which suggests there may be important, and as of yet, unmet needs of such recipients. The objective of this cross-sectional study was to gain an understanding of what bariatric surgery recipients perceive they need to best support their long-term health and well-being in the province (Ontario, Canada) and thereafter internationally.Methods: A questionnaire, taking 30-45 minutes to complete, was designed in concert with members of the target audience and distributed via support group ad-ministrators. Descriptive statistics of participants’ demographic/clinical background were analyzed for group comparisons using a chi square test and a two-sample t-test (p<.05). Open-ended responses were analyzed using inductive content analysis and reviewed independently by the authors who discussed any discrepancies in emerging themes until reaching an agreement. Results: One hundred and nineteen (59 provincial; 60 international) respondents completed the questionnaire. Themes for what was most useful included encourage-ment from family, friends, bariatric team members, and peers. Access to immediate follow-up appointments after surgery for nutrition-specific and general post-surgery concerns was reported as needed but not received. Recommendations to address excess skin and creating a mentorship program were proposed.Conclusions: This study provides an understanding of the needs and experiences


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of bariatric surgery recipients, which may help clinicians to address gaps in bariatric programing, provide more effective treatment, and help prevent weight regain among surgery recipients for long-term health and well-being. O6.5Long-term Psychosocial Predictors of Quality of Life and Weight Loss After Bariatric Surgery: the Toronto Bari-PSYCH Study ResultsSanjeev Sockalingam1, Raed Hawa1, Susan Wnuk1, Vincent Santiago2, Timothy Jackson1, Allan Okrainec1, Stephanie E. Cassin2

1. TWH Bariatric Surgery Program, University Health Network, University of Toronto, Toronto, ON, Canada, 2. Ryerson University, Toronto, ON, Canada

Background: Studies exploring the impact of pre-surgery psychiatric status as a predictor of health related quality of life (QOL) after bariatric surgery have been limited to short-term follow-up and variable use of psychosocial measures. In this prospective cohort study, we examined the effect of pre-operative psychiatric factors on QOL and weight loss 2-years after surgery.Methods: 156 patients participated in the Bariatric Psychosocial Cohort Study (Bari-PSYCH), between 2010 and 2014. Patients were assessed pre-surgery for demo-graphic factors, weight, psychiatric diagnosis using a structured psychiatric interview and symptom measures for QOL, depression and anxiety at pre-surgery and at 1 and 2 years post-surgery.Results: At 2-years post-bariatric surgery, patients experienced a significant decrease in mean weight (-48.43 kg, 95%[-51.1,-45.76]) and an increase only in physical QOL (+18.91, 95%[17.01, 20.82]) scores as compared to pre-surgery. Mul-tivariate regression analysis identified pre-surgery physical QOL score (p<0.001), younger age (p=0.005), and a history of a mood disorder as significant predictors of physical QOL. Only a history of a mood disorder (p=0.032) significantly predicted SF36-MCS (p=0.006). Pre-surgery weight (p<0.001) and a history of a mood disor-der (p=0.047) were significant predictors of weight loss 2-years post-surgery.Conclusions: Bariatric surgery had a sustained impact on physical QOL but not mental QOL at 2-years post-surgery. A history of mood disorder unexpectedly increased physical QOL scores and weight loss following surgery. Further research is needed to determine if these results are due to bariatric surgery candidate selection, models of care, and if these effects change long-term. O6.6Revision Bariatric Surgery After Laparoscopic Adjustable Gastric Band Removal Has High Post-operative Complication RatesVanessa S. Falk1, 2, Caroline E. Sheppard1, 2, Kevin A. Whitlock1, Erica L. Lester1, Daniel W. Birch1, 2, Shahzeer Karmali1, 2, Aliyah Kanji1, Christopher J. de Gara1

1. University of Alberta, Edmonton, AB, Canada, 2. Centre for Advancement in Mini-mally Invasive Surgery, Edmonton, AB, Canada

Introduction: While laparoscopic adjustable gastric band (LAGB) has been associated with fewer complications than both laparoscopic Roux-en Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG), it leads to less weight loss and has high failure rates. After LAGB removal, most patients experience weight regain and seek revision. This study reviewed outcomes of patients that underwent revision bariatric surgery after LAGB removal. Methods: All LAGB removals at one institution were reviewed from January 2014 to December 2015. Data was collected for patients who underwent subsequent revi-sion bariatric surgery. Patient demographics, LAGB placement and removal details, time to revision surgery, and postoperative revision complications were analyzed. Statistical analysis was carried out using SPSS 21.0. Results: Five bariatric surgeons carried out 76 LAGB removals. Twenty-three patients (30.2%) went on to have revision surgery in the form of LRYGB (52.2%), LSG (43.5%), and open RYGB (4.3%). The most common reason for band removal was ob-

structive symptoms (43.5%). Median patient age was 48 years (min=29, max=62) and 91% were female. On average, the LAGB was in-situ for 5.0±2.6 years. The average time between LAGB removal and revision surgery was 11.8±4.6 months. Overall revision complication rate was 34.8% with no mortalities. Conclusion: One third of patients sought revision surgery after LAGB removal. While immediate complications from primary LAGB may be lower than other bariatric procedures, revision surgery has high complication rates. Patients need to be aware of these revision risks before opting for LAGB placement. Future research is needed to optimize LAGB revision surgery. O6.7Association of Gastrointestinal Symptoms with Complications After Bariatric SurgeryCaroline Sheppard1, Daniel C. Sadowski2, Christopher J. de Gara2, Daniel W. Birch11. University of Alberta, Centre for the Advancement of Minimally Invasive Surgery, Edmonton, AB, Canada, 2. University of Alberta, Edmonton, AB, Canada

Introduction: Bariatric surgery has been known to cause changes or onset of gas-trointestinal symptoms. Patients may present with symptoms of persistent nausea, reflux, and abdominal pain after bariatric surgery. In many cases, invasive clinical in-vestigations have not been able to determine the etiology of these complaints. This survey will identify the chief gastrointestinal complaints of postoperative patients and identify any trends emerging after surgery.Methods: Patients completed the Gastrointestinal Symptom Rating Scale (GSRS) questionnaire before and 6–12 months after bariatric surgery. The GSRS has previ-ously been validated and tested for reliability.Results: A total of 100 patients completed the preop questionnaire (40 Laparo-scopic Sleeve Gastrectomy [LSG], 60 Laparoscopic Roux-en-Y Gastric Bypass [LRYGB]). The questionnaire response rate was 94%. At follow-up, 2.7% LSG and 10% LRYGB had a surgical complication (i.e. late bleed, ulcer). Additionally, 32% of LSG and 18% of LRYGB presented with chronic abdominal pain and/or reflux. The average scores for each gastrointestinal syndrome were mild at pre-op (1.3–2.4) and remained mild after LSG (1.6–2.5) and LRYGB (1.5–2.3). Only patients with complications after LSG had statistically increased scores for abdominal pain, reflux, and indigestion. However, these average scores were still mild (2.3–2.5). Discussion: This study demonstrates the difficulty assessing and diagnosing patients with complications based on patient symptoms. Regardless that patients have confirmed abdominal complications, these appear to only be associated with a small increase in gas-trointestinal symptom scores for LSG only. This emphasizes the importance of a bariatric clinic follow-up with extensive experience to limit unnecessary clinical interventions. O6.8Outcome of Gastric Bypass Surgery in Iceland 2001–2015Rosamunda Thorarinsdottir, Vilhjalmur Palmason, Bjorn G. Leifsson, Hjortur G. GislasonLandspitali University Hospital, Reykjavik, Iceland

Introduction: Laparoscopic roux-en-y gastric bypass (LRYGB) has been performed at Landspitali University Hospital (LSH) since 2001. The procedure represents an important treatment option for morbidly obese patients. The aim of this study is to evaluate the long-term results of these operations in Iceland.Methods: All 772 consecutive patients undergoing LRYGB at LSH during 2001-2015 were included. Information was collected from a prospective database. Successful weight loss was defined as body mass index (BMI) less than 33 kg/m2 or excess body mass index loss (EBMIL) more than 50%.Results: Mean age of patients was 41 years and 83% were females. Mean pre-operative weight was 127 kg (±20) and mean BMI was 44 (±6). Mean %EBMIL was 80% after 1.5 year, 70% after 5 years and 64% after 10-13 years. 85% of patients had successful weight loss with a mean follow-up time of 7.4 years. Pre-operatively patients on average had 2.8


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obesity related comorbid diseases. 71% of patients with type 2 diabetes were in full remis-sion after surgery. One third of patients with hypertension and one third of patients with hyperlipidemia achieved full remission after surgery. 37 patients (5%) had an early compli-cation and 174 (25%) had a late complication that frequently needed surgical solution. Conclusion: Majority of patients achieved a successful weight loss and most obesity related comorbidities are still in remission 7.4 years after surgery. Early complications were rare but one fourth of patients had late complications. Life long follow-up is of utmost importance after gastric bypass surgery. O7.1Unhealthy versus Healthy Foods Advertised in Grocery Store FlyersNatalie A. Laframboise1, Jamie A. Seabrook1, 3, 4, June I. Matthews1, Paula D. Dworatzek1, 2

1. School of Food and Nutritional Sciences, Brescia at Western University, London, ON, Canada, 2. Schulich Interfaculty Program in Public Health, Western University, London, ON, Canada, 3. Dept of Epidemiology & Biostatistics, Western University, London, ON, Canada, 4. Human Environments Analysis Laboratory, Western University, London, ON, Canada

Objective: To examine the proportion of unhealthy foods advertised in discount ver-sus premium grocery store flyers of three major Canadian food distribution companies.Methods: From September 2015 to August 2016, 192 weekly online flyers were collected from 3 discount and 3 premium grocery store chains. Sixty-nine discount and 61 premium flyers have been analyzed. Health Canada’s Surveillance Tool (2014) was used to score 23,629 food items as unhealthy or healthy based on their alignment with Canada’s Food Guide.Results: The proportions of unhealthy versus healthy foods advertised in discount (61.0% vs. 39.0%) and premium (60.3% vs. 39.7%) grocery stores were similar (p=0.11). There were no significant differences in the mean prices of foods that were unhealthy ($4.53±3.86) versus healthy ($4.47±4.13) (p=0.22). Foods that did not belong to a food group (Other Foods) were advertised the most (30.4%); foods in Milk and Alternatives were advertised the least (10.6%) (p<0.001). By food category, the highest proportions of unhealthy foods advertised were in Other Foods (89.6%), Meat and Alternatives (66.8%), and Milk and Alternatives (61.8%), with the lowest proportions in Vegetables and Fruits (27.0%) and Grains (27.5%) (p<0.001). The highest proportions of unhealthy foods were found in the middle (61.2%) versus the front (55.7%) or back (57.1%) pages of the flyers (p<0.001).Conclusion: Irrespective of the food distribution company or chain, Canadian gro-cery stores are predominantly advertising unhealthy foods. Policies and programs to improve the food environment and restrict unhealthy food marketing should not overlook grocery store flyers. O7.2Gaps in the Evidence on Interventions to Reduce Sugar Consumption: a Scoping Review of Systematic ReviewsSharon I. Kirkpatrick, Merryn Maynard, Amanda Raffoul, Jackie StapletonUniversity of Waterloo, Waterloo, ON, Canada

Background: There is currently considerable attention to the role of sugars in obesity and the potential for interventions to curb sugars consumption. A rapid scoping review of systematic reviews was conducted to identify gaps in the existing evidence on the effectiveness of such interventions.Methods: The databases Medline, EMBASE, CINAHL, and the Cochrane Database of Systematic Reviews were searched to identify systematic review articles related to interventions to reduce sugars intake, published in English since January 2005. Sixteen systematic reviews meeting the inclusion criteria were identified. The inter-ventions included price changes, interventions to alter specific food environments, health promotion and education, and initiatives to limit exposure to advertising.

Results: A common thread among the reviews is the limited scope of available evi-dence combined with the heterogeneity of methods used in existing studies, including lack of consensus on definitions and measures used for sugars intake. There is a paucity of data on intervention implementation and interactions with contextual factors. Further, little is known about differential effects of interventions for population subgroups and potential compensatory behaviours on the part of both consumers and the food industry.Conclusions: Given current gaps in the evidence, implementation of interventions that show promise should be accompanied by careful monitoring to assess intended and unintended consequences, including those related to equity. The application of a systems lens might be useful for considering the broad array of factors that impact the planning, implementation, and evaluation of interventions to alter sugars consumption and associated outcomes, including body weight. O7.3Differences in Reach and Effectiveness of a National Healthy Eating Cam-paign According to Dominant Official LanguageMelissa A. Fernandez1, 2, Sophie Desroches1, 2, Marie Marquis3, Mylène Turcotte1, 2, Véronique Provencher1, 2

1. Institution of Nutrition and Functional Foods, Université Laval, Quebec, QC, Cana-da, 2. School of Nutrition, Univsersité Laval, Quebec, QC, Canada, 3. Département de nutrition, Université de Montréal, Montreal, QC, Canada

Background: The Eat Well Campaign: Food Skills (EWC) was disseminated by Health Canada to promote family meal planning and preparation to Canadian parents primarily with public service announcements (PSA), magazine editorials, TV vignettes, spokespeople and the web, in both official languages. The purpose of this study was to determine whether there were any differences in campaign exposure and effectiveness according to dominant official language.Methods: A representative sample of 2101 Canadian parents were recruited and invited to respond to an online survey. Questions included demographic variables, exposure to key campaign elements and perceived effectiveness of the EWC. Logistic regression models were used to identify differences in reach and effectiveness, controlling for sex, age, region, income, education and religious beliefs.Results: When compared to English-speaking respondents (78%), French-speak-ing respondents (22%) reported significantly higher odds of total exposure to the campaign, PSAs, vignettes and spokespeople, and lower odds of exposure to web elements (P < 0.05). Furthermore, French-speaking parents expressed, as a result of campaign, greater beliefs in the importance of meal planning and including family members, feeling more knowledgeable, and feeling that the campaign was useful (P < 0.05). There were no differences in exposure to magazine elements, adoption of behaviours or relevancy of messages.Conclusion: The campaign was more successful in reaching French-speaking Canadians than English speakers and appeared to be more effective for belief, knowledge and usefulness components of meal preparation and planning, but not behavior components. Strategies promoting healthy eating should be tailored to different populations. O7.4Applying the CAN Approach to School Hot Lunch Fundraisers to Promote Healthy Food at SchoolCathy Langdon, Shawna Berenbaum, Susan J. WhitingCollege of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada

Hot Lunch fundraisers are a popular means by which elementary schools across Saskatoon raise extra funds for their students. Despite recommendations to serve healthy foods that meet provincial guidelines, the criteria schools use for choosing a lunch vendor is usually focused on profit potential alone.Purpose: To highlight observations from a new lunch vendor whose menu meets


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nutrition guidelines for Saskatchewan schools and aligns with Wansink’s CAN approach to positively affect food choice and consumption.Method: The menu adheres to the CAN approach by being Convenient (pre cut fruits and veggies), Attractive (popular and familiar favourites such as Mac and Cheese and Blueberry Pancakes, that are priced competitively) and Normative (exclusively fruit and veg as ‘sides’ make these choices seem normal).Observations: Preliminary data suggests that the CAN approach may positively affect food choices in this lunch fundraising environment. To date all schools using this vendor are offering the fruit and vegetable sides as part of their lunch (including sides is optional) and 87% of families are selecting these healthy sides as part of their child’s lunch.Conclusion: The prevalence of childhood overweight/obesity coupled with the acknowledgement that schools can and should play a role in promoting healthy food suggests that lunch fundraisers are an ideal opportunity to model healthy eating. Using the CAN approach in a lunch fundraising program has the potential to compete with less nutritious foods available to schools and increase acceptance of healthy foods. O7.5Obesity, Its Associations with the Food Environment, and Spatio-temporal Indicators of the Food Environment in the Region of Waterloo, OntarioJane Law, Leia Minaker, Henry Luan, Matthew QuickUniversity of Waterloo, Waterloo, ON, Canada

This paper reports findings from our study on obesity, its association with the food environment, and the creation of spatio-temporal indicators for assessing the food environment in the Region of Waterloo, Ontario. Previous Canadian research has found different aspects of the local food environment to be related to body weight, but the evidence is mixed in terms of the strength of the relationship, and the mechanisms by which the food environment influence dietary and weight-related outcomes. Cross-sectional study designs dominate this field of research and thus, little is known about relationships between the food environment and body weight over time. Our study developed local indicators to estimate the probability of an area’s accessibility to unhealthy food based on the geographic locations of food outlets in each census area in the Region of Waterloo in more than one time period. The probability for each area was calculated under a Bayesian spatio-temporal framework using a binomial distribution that models the count of unhealthy food outlets as a proportion of all food outlets in each area and time period. Our results identified an average increasing trend of accessibility to unhealthy food and varying trends in local areas. Maps showing the geographic variation of the trends of acces-sibility to unhealthy food provide evidence for municipal policymakers to intervene at the local level to reduce accessibility to unhealthy food, which may reduce obesity rates in those areas and the study region. O7.6International Interventions on Sugary Drinks and Best PracticesHarsha Kasi VishwanathanHeart and Stroke Foundation, Ottawa, ON, Canada

Sugary drinks are the single largest contributor of sugar in the diet, and consump-tion is associated with many chronic diseases. This presentation will discuss inter-national interventions on sugary drinks as a strategy to encourage healthy weights in children, and how these experiences can inform and be applied to the Canadian context. The presentation will provide a brief overview of the global landscape of sugary drink levies and how successful these models have been for revenue gener-ation and decreases in purchasing trends of sugary drinks. It will then present the revenue potential for Canada based on tax models. It will also reflect on policy and programming options for revenue expenditure, and describe how these strategies can influence health behaviours and outcomes in Canada.

O7.7Examination of Physical Activity and Sedentary Behaviour Policies in Canadian Childcare CentresEmily Ott1, 2, Leigh Vanderloo1, 2, Patricia Tucker3, 2

1. Health and Rehabilitation Sciences, London, ON, Canada, 2. University of Western Ontario, London, ON, Canada, 3. School of Occupational Therapy, London, ON, Canada

Objective: Currently, there is a gap in the research dedicated to the examination of childcare policies aimed at targeting young children’s (under 5 years) physical activity and sedentary behaviours. The purpose of this study was to compare the existence and characteristics of physical activity and sedentary behaviour policies in childcare centres across Canada.Methods: Using a modified version of the Environment and Policy Assessment and Observation Self-Report tool (EPAO-SR), an online survey was distributed via email to the directors/administrators of childcare centres across Canada to elicit information on the characteristics of existing physical activity and sedentary behaviour policies. Fol-lowing aspects of the Dillman technique, two reminder emails were sent to encourage survey completion and to secure a strong response rate from across the country.Results: A total of 1,158 childcare representatives accessed the survey, while 514 provided complete data. Of these, 295 (44%) centres indicated having a written physical activity policy for young children, while 178 (29%) reported a written policy regarding sedentary behaviours. In addition, when asked about the Canadian Physical Activity and Sedentary Behaviour Guidelines for the Early Years, 102 (19%) and 177 (33%) of centres correctly recalled the minimum amount of time that children should be physically active and the amount of screen time children should be limited to each day, respectively.Conclusions: Physical activity and sedentary behaviour policies in childcare are not common in Canada. These results provide important findings to consider when developing recommendations for physical activity and sedentary behaviour policies for childcare centres. O7.8The Impact of the Children’s Food and Beverage Advertising Initiative’s Uniform Nutrition CriteriaMonique Potvin Kent1, Jennifer Smith1, Elise Pauzé1, Mary L’Abbé2

1. University of Ottawa, Ottawa, ON, Canada, 2. University of Toronto, Toronto, ON, Canada

Objective: In 2007, 16 food companies pledged to advertise only “healthier dietary choices” to children under 12 in the Canadian Children’s Food and Beverage Advertising Initiative (CAI). In 2015, uniform nutritional criteria were implemented by participating CAI companies. This study aimed to evaluate these new criteria. Methods: A quasi-experimental pre-post study with a control group was carried out. Television ratings data were purchased for 19 food categories from Nielsen Media for May 2013 and 2016 for 34 television stations in Toronto. Television programs with a child viewership of ≥35% were determined and 10% of these were randomly selected. Food ads that appeared in each program were identified and nutritional information was collected on each product. Healthfulness was defined using PAHO and U.K. Nutri-ent Profile Models (UK NPM). Pre-post statistical comparisons were made.Results: 100% of all the advertised foods in 2016 were classified as excessive in at least one nutrient (PAHO) while the U.K. NPM classified 76% of the ads as “less healthy”. There were no changes in these classifications between 2013 and 2016. In 2016, it was 1.8 times more likely that advertised foods were classified as excessive in sodium compared to 2013. There were no changes in the healthfulness of adver-tised CAI products between 2013 and 2016. Conclusions: The CAI uniform nutritional criteria have not improved the healthful-ness of foods advertised to children on television during their preferred viewing. Govern-ment regulation is needed to restrict unhealthy food marketing viewed by children.


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O8.1Not Just Fun and Games: Toy Advertising on Television Targeting Chil-dren Promotes Sedentary PlayMonique Potvin Kent1, Clive Velkers2

1. School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada, 2. Queen’s University, Kingston, ON, Canada

Objective: Sedentary activities including watching television have been associated with an increased risk of obesity in children. While watching television, children are exposed to a significant number of advertisements. The purpose of this study was to examine the volume of television toy advertising targeting Canadian children, to determine if it promoted active or sedentary play, targeted males or females more frequently, and has changed over time.Methods: Data for toy/game advertising on twenty-seven television stations in Toronto for the month of May in 2006 and 2013 was purchased from Nielsen Media Research. A content analysis was performed on all ads to determine what age group and gender was targeted and whether physical or sedentary activity was being promoted. Comparisons were made between 2006 and 2013.Results: There were 3.35 toy ads/hour/children’s specialty station in 2013 (a 15% increase from 2006). Eighty-eight percent of toy ads promoted sedentary play in 2013, a 27% increase from 2006 levels while toy ads promoting active play decreased by 33%. In both 2006 and 2013, a greater number of these ads targeted males, and between 2006–2013, toy ads promoting sedentary play increased significantly for both males and females.Conclusion: The current levels of toy advertising promoting sedentary play in Canada are troubling. Future research should explore whether such advertising influences children’s preferences for activities and levels of physical activity. O8.2Lifestyle Habits and the Development of the Metabolically Unhealthy Obese Phenotype in Youth: a Prospective Analysis in the QUALITY StudyAndraea Van Hulst2, 3, Jean-Baptiste Roberge2, Marie-Eve Mathieu2, 4, Sanyath Radji2, Tracie A. Barnett5, Mélanie Henderson1, 2

1. Division of Endocrinology, Department of Pediatrics, Université de Montréal, Montreal, QC, Canada, 2. Centre de recherche du CHU Ste-Justine, Montreal, QC, Canada, 3. Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada, 4. Departments of Kinesiology, Université de Montréal, Montréal, Montreal, QC, Canada, 5. Epidemiology and Biostatistic Unit, INRS-Institut Armand-Frappier, Laval, QC, Canada

Objective: We determined what lifestyle habits predicted the metabolically unhealthy obese (MUO) versus the metabolically healthy obese (MHO) phenotypes over a 2-year period in youth.Methods: The QUALITY cohort comprises Caucasian youth (n= 630) with at least one obese biological parent. Of the 148 obese children at age 10-12 years (BMI ≥ 97th percentile for age and sex), we defined MHO youth (n=58) as those with none of the following: triglycerides > 1.2 mmol/L, fasting glucose > 6.1 mmol/L, HDL-cholesterol < 1.04 mmol/L, or blood pressure > 95th percentile for age, sex, and height. In contrast, MUO had at least one of these risk factors (n=90). Lifestyle habits were assessed at age 8–10 years, including accelerometry-based physical activity; self-reported hours of screen time; and dietary intake using 3 non-consecutive 24-hour recalls. Sleep duration was de-rived from nightly accelerometer non-wear time. Logistic regression analyses were used to determine how baseline lifestyle habits predicted later MUO vs MHO status. Models were minimally adjusted for age, sex, pubertal stage and physical activity.Results: Children who consumed higher saturated fat (OR = 1.28, p=0.008), more sugar-sweetened beverages (OR=1.42, p=0.044) and less fruits and vegetables (OR = 0.83, p=0.043) at baseline were more likely to be MUO 2 years later. Other lifestyle behaviours did not predict MUO or MHO phenotypes.Conclusions: Specific lifestyle habits, in particular diet, may be important targets to prevent obese children from developing metabolic complications as they enter puberty.

O8.3Early Life Conditions, Childhood Adiposity and Risk Factors for Type 2 Diabetes in Children Aged 10-12 Years from the QUALITY StudyAndraea Van Hulst1, 2, Gilles Paradis1, Andrea Benedetti1, Mélanie Henderson2, 3

1. Department of Epidemiology Biostatistics and Occupational Health, McGill Univer-sity, Montreal, QC, Canada, 2. Centre de recherche du CHU Ste-Justine, Montreal, QC, Canada, 3. Department of Pediatrics, University of Montreal, Montreal, QC, Canada

Aim: We examined whether birth weight and postnatal growth during infancy are associated with insulin sensitivity in children, and assessed potential mediation of associations by childhood adiposity.Methods: Data from a longitudinal cohort of 630 Quebec Caucasian children with a parental history of obesity (QUALITY) were used. In a sub-sample of children born at term, weight and length from 0–2 years of age were obtained retrospectively and transformed to sex specific weight-for-length z-scores (n=395). Percentage of body fat was measured by dual-energy x-ray absorptiometry at age 8–10 years. Accelerometry based moderate-to-vigorous physical activity and self-reported daily hours of screen time were measured at age 10–12 years. Insulin sen-sitivity was measured by the homeostatic model assessment of insulin resistance (HOMA-IR) and an oral glucose tolerance test-based index (Matsuda insulin sensitivity index (ISI)) at age 10–12 years. Multiple linear regressions and path analysis were used.Results: Higher birth weight was associated with improved insulin sensitivity: 1 z-score increase in weight-for-length at birth was associated with an 8.2% increase in Matsuda-ISI (95% CI: 2.9; 13.6) and 6.5% decrease in HOMA-IR (95% CI: -11.9; -1.0). These associations were independent of childhood adiposity, lifestyle behaviors, and gestational age. Postnatal growth was not directly associated with insulin dynamics, however faster postnatal growth was positively associated with adiposity at 8–10 years which in turn predicted decreased Matsuda-ISI and increased HOMA-IR.Conclusion: Our results add to the growing body of evidence regarding the impor-tance of prenatal and postnatal growth for later type 2 diabetes risk factors in children. O8.4Neighbourhood Disadvantage During Childhood and the Risk of Cardio-vascular Disease Risk Factors and Events from a Prospective CohortLisa Kakinami1, Lisa A. Serbin1, Dale M. Stack1, Alex E. Schwartzman1, Jane E. Ledingham2

1. Concordia University, Montreal, QC, Canada, 2. University of Ottawa, Ottawa, ON, Canada

Objectives: To investigate the effect of childhood neighbourhood level SES on the development of CVD risk factors or events during adulthood. Methods: Participants were from the XXX cohort (n=3792, Mage=9.0). SES were measured as the percentage of adults in the neighbourhood (1) with household income <$10,000/year, (2) unemployed, (3) single-parent, or (4) with education < high-school from the 1976, 2001, and 2006 census micro data sets. CVD risk factors and events were obtained from medical records. Multivariable proportional hazards regressions with childhood neighbourhood SES as the primary predictor, and cur-rent neighbourhood SES as time-varying on the first occurrence of CVD risk factors or events were conducted separately for males and females. Analyses adjusted for age, frequency of medical visits, and parental history of CVD.Results: During 30 years of follow-up, 28% developed a CVD risk factor, and 13% had a CVD event. Nearly 2/3 experienced some upward social mobility since childhood. Males from disadvantaged neighbourhoods during childhood were 2.70 (95% CI: 1.43-5.10, p=0.002) and 1.77 (95% CI: 1.03-3.05, p=0.04) times more likely to develop a CVD risk factor or experience an event, respectively than males not from dis-advantaged neighbourhoods. Females from disadvantaged neighbourhoods during childhood and adulthood were 1.87 (95% CI: 1.19-2.95, p=0.007) and 1.15 (95% CI: 1.03-1.28, p=0.01) times more likely to develop a CVD risk factor.Conclusion: Despite upward social mobility in adulthood, both males and females with childhoods in disproportionately disadvantaged neighbourhoods are at an increased risk for shorter survival times to CVD risk factors or events.


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O8.5Parents’ Perceptions of the Family- and Community-Based Resources and Sup-port Required to Enhance Physical Literacy in Children: an Exploratory StudyShauna M. Burke, Kristen ReillyWestern University, London, ON, Canada

Objective: Physical literacy is defined as the knowledge, confidence, motivation, and physical competence to engage in physical activity for life (Whitehead, 2010). The purpose of this exploratory study was to identify parents’ perceptions of the resources, tools, and opportunities required at both family and community levels to improve children’s physical literacy. Methods: Parents of children aged 16 years and younger, living in Ontario, Canada, were recruited via social media (i.e., Facebook and Twitter) and word-of-mouth. Participants completed an online questionnaire containing items related to what information, resources, and/or support would be needed, both at home and in the community, to improve children’s physical literacy. Qualitative data underwent thematic analysis assisted by QSR NVivo 10. Results: Participants (n = 81, MAge= 39.2 years) were predominantly female (93.8%) and married (79.0%). At the familial level, parents expressed the need for accessible family-friendly activities, flexible work schedules, and better time management skills in order to enhance children’s physical literacy. At the community level, parents identified improved quality of physical education, reduced costs of exercise/activity programs, increased access to non-competitive physical activity opportunities, and the development of exercise-conducive infrastructure as potential physical literacy-related facilitators. Conclusions: Preliminary findings provide an overview of the diverse resources and supports that parents perceive as necessary to improve children’s physical liter-acy. This research highlights several areas, in both home and community environ-ments, that could be targeted via the development and promotion of interventions and resources designed to enhance physical literacy in children and families. O8.6Using Primary Care Electronic Medical Records to Estimate the Prevalence of Severe Obesity in ChildrenSarah E. Carsley1, 3, Karen Tu2, 1, Jacqueline Young2, Patricia Parkin3, 1, Catherine Birken3, 1

1. University of Toronto, Toronto, ON, Canada, 2. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada, 3. The Hospital for Sick Children, Toronto, ON, Canada

Objectives: There are no prevalence estimates of severe obesity (SO) in Canadian children. Electronic medical records (EMRs) may be a feasible source of height and weight data. The study objectives were to determine the quality of data collected in primary care EMRs and the prevalence of SO in children 0–19 years. Methods: Height and weight data for children <19 years were extracted from EMRs through the Electronic Medical Records Administrative Linked Database (EMRALD), a network of family practices across Ontario. A complete and accurate set of growth measurements was defined as having a non-missing value for height, weight, age, and sex that fell within cut-points for biologically plausible values for BMI-for-age. BMI z-scores were calculated using the World Health Organization Growth Standards and Reference. Prevalence was calculated for the time period between 2012–2016. SO was defined as a BMI z-score >+3. Results: Overall, 84% of children had at least 1 complete set of growth measure-ments to calculate a BMI z-score. 34.4% of observations were missing zBMI data. A total of 41,963 children less than 19 years of age with complete and accurate height/length, weight, sex and age were selected from the EMRALD database. The prevalence of SO in children 0–4, 5–9, 10–14, and 15–19 years was 1.33%, 2.61%, 2.93%, and 3.75%, respectively. Conclusions: Severe obesity prevalence in Ontario appears to be increasing with age. EMRs may be a valid source of data to provide estimates of obesity and SO in children who attend primary care.

O8.7Maternal and Offspring Intelligence in relation to Offspring BMI in Child-hood and AdolescenceChristina S. Wraw1, Ian J. Deary1, Geoff Der2, Catharine R. Gale1, 3

1. University of Edinburgh, Edinburgh, United Kingdom, 2. University of Glasgow, Glasgow, United Kingdom, 3. University of Southampton, Southampton, United Kingdom

Objective: To examine the associations between both maternal and offspring’s intelligence and offspring’s body mass index (BMI) in childhood and adolescence.Method: Participants were members of the National Longitudinal Survey of Youth 1979 (NLSY-79) Children and Young Adults cohort (n=11,512) and their biological mothers who were also members of the NLSY-79 (n=4,932). Offspring’s IQ was measured with the Peabody Individual Achievement Test. Maternal IQ was measured with the Armed Forces Qualification Test when they were aged 15–23 years. A series of regression analyses tested the association between IQ and offspring’s BMI in middle childhood (age 5–7.99 years), late childhood (age 8–10.99 years), early adolescence (age 11–13.99 years), and middle adolescence (age 14–18.99 years) for boys and girls separately, while adjusting for potential confounding and mediating factors (including maternal education and pre-pregnancy BMI).Results: After adjustment for potential confounding factors, a SD increment in girl’s IQ was associated with a lower BMI in middle adolescence (beta=-0.12, 95% C.I. -0.17 to -0.07, p<0.001). After adjustment for potential mediating factors, maternal IQ was inversely associated with daughter’s BMI across all four age-groups, ranging from (beta=-0.10, 95% C.I. -0.16 to -0.03, p=0.004) in late childhood to (beta=-0.17, 95% C.I. -0.23 to -0.11, p<0.001) in middle adolescence. Maternal IQ was inversely associated with son’s BMI in middle childhood (beta=-0.09, 95% C.I. -0.16 to -0.03, p=0.007) after adjustment for potential mediating factors. There was no evidence of a boy’s IQ-BMI association.Conclusion: Lower maternal and offspring intelligence may lead to higher offspring BMI, particularly in girls. O8.8Learning Food Literacy: Educational Interventions for Child and Adolescent HealthEmily J. TrumanUniversity of Calgary, Calgary, AB, Canada

In light of poor eating habits and childhood obesity, food education is needed to enable young Canadians to make informed choices in a complex food landscape. Food literacy—a concept describing proficiency in food related skills and knowledge—has become a popular way to promote food education in a range of contexts, including promotional and educational campaigns from public health, industry and cultural institutions. But what is its potential for improving child and adolescent health? This presentation examines existing food literacy studies focusing on educational inter-ventions in order to: 1) identify program objectives and outcomes, and 2) assess their overall success in improving child/adolescent health. Method: A scoping review of food literacy research was undertaken which located 1049 abstracts on the topic, identifying 14 original articles on food literacy interven-tions. From these, data was extracted on study type, objective, population addressed, and outcome. Results: The majority of studies identified focused on child or adolescent populations (64%), and half of the studies took place in school environments. 59% of the studies reported improvements in food skills and knowledge, 30% reported changes in food-related attitudes, and 12% reported changes in food-related behaviours. Conclusions: While studies on food literacy interventions for children/adolescents are limited, positive improvements in food related skills/knowledge are evident. In addition, school-based intervention programs are ideally positioned to improve child/adolescent health beyond improved food skills/knowledge by establishing “positive food environments” which promote healthy choices and attitudes. School-based food literacy programs have the potential to improve child/adolescent health more broadly.


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O9.1Evaluation of a Community Driven, Physical Activity Based Wellness Program for Indigenous Women in Lloydminster, Alberta – the Women Warriors ProgramSonja Wicklum1, Rita Henderson1, Shelley Wiart2, Lynden (Lindsay) Crowshoe1, Ashlee McGuire3

1. Univerity of Calgary, Calgary, AB, Canada, 2. Lloydminster Native Friendship Centre, Lloydminster, AB, Canada, 3. Alberta Health Services, Calgary, AB, Canada

Objective: Overall, only 14% of Canadian women meet guideline levels of physical activity each week, an issue exacerbated among Indigenous communities facing added barriers to activity. The importance of physical activity is demonstrated by its extensive benefits in the domains of physical, psychological, emotional and socio-cul-tural health. Goals of the Women Warriors Program are to increase physical activity and develop support systems for participants, creating a safe environment to face the chal-lenge of making sustainable, healthy lifestyle changes. The program seeks to provide a cost effective, scalable, proactive solution to obesity and diabetes prevention.Methods: Each Women Warriors program is eight weeks. Weekly sessions include group exercise, round-circle discussion exploring barriers, and brief nutrition education. The exercise varies each week. Participants use a pedometer to track steps weekly. They complete pre/post questionnaires, anthropometric measurements, HRQoL surveys and interviews.Results: Preliminary results show increased average weekly step counts (20,249), increased variety in physical activities performed and increased minutes per week spent exercising (119). Strong motivators for lifestyle change among participants include family and a sense of improved wellbeing, however barriers to participation and making lifestyle changes are overwhelming for many.Conclusions and Future Direction: The Women Warriors program has been well received, is achieving the goal of improving physical activity levels for Indigenous women and is being expanded in length and to a new community - Yellowknife, NWT in 2017. O9.2Sustained Participation in Running, Sports, Fitness and Dance Activities Throughout Adolescence and Body Composition in Early AdulthoodTarun Katapally1, Mathieu Belanger2, Tracie Barnett3, Erin O’Loughlin3, Catherine Sabiston4, Khalid Amin5, Jennifer O’Loughlin3

1. University of Regina, Regina, SK, Canada, 2. University of Moncton, Moncton, NB, Canada, 3. University of Montreal, Montreal, QC, Canada, 4. University of Toronto, Toronto, ON, Canada, 5. University of Saskatchewan, Saskatoon, SK, Canada

Objective: The aim of this study is to investigate whether participation in three types of physical activity (PA)-(sports, running, and fitness and dance) during adoles-cence is a determinant of body composition in early adulthood. Methods: Data were drawn from the Natural History of Nicotine Dependence in Teens study, a prospective investigation of 1294 students initially aged 12–13 years. Baseline data (1999) included self-reported PA and objective anthropometric measurements (height, weight, waist circumference, triceps and subscapular skinfold thickness). Follow-up PA data were collected every 3 months for 5 years (1999–2005). Cycles 21 and 22 took place in 2007–08 and 2011–12. Follow-up anthropometry was conducted in cycles 19 and 22. PA data were grouped into 3 categories using exploratory factor analysis: Sports, Running, and Fitness and Dance. Participants were categorized as having reported involvement in each PA type from 1–5 years during adolescence. Mul-tivariable regression models were developed to estimate the effect of number of years of participation in 3 types of PA during adolescence on body composition measures in late adolescence (cycle 19) and early adulthood (cycle 22).Results: Although descriptive results showed that consistent participation in run-ning during adolescence was associated with lower weight status in early adulthood, upon building multivariable models with baseline body composition measures as

independent variables, this effect was insignificant.Conclusion: With weight status during early adolescence negating the effect of consistent participation in running during adolescence on body composition in early adulthood, it is perhaps ideal to address weight status in early childhood years. O9.3Impact of Exercise on Olfaction, Gustation and Energy Intake in Lean Men – a Dissociation ProfileKapria-Jad Josaphat1, Marie-Eve Mathieu1, 2

1. Université de Montréal, Montréal, QC, Canada, 2. Sainte-Justine UHC Research Center, Montreal, QC, Canada

Objective: This study aims to verify whether physical activity can have an impact on olfaction and gustation and thereby influence food choices. Methods: Ten normal-weight males (18-35y) attended two experimental visits in a counterbalanced fashion. Each visit included a 30-min exercise session on a treadmill at 70% maximal oxygen uptake and a 90-min sedentary period performed in alternate order (Ex_Sed and Sed_Ex). At 08:30 AM as well as immediately before lunch (11:40 AM), participants were submitted to eight visual analogue scales ratings, an olfaction test using Sniffin’ Sticks and a gustation test. An ad libitum buffet-style meal was served at 12:00PM. Results: Desire to eat was reduced by 72% in Sed_Ex and increased by 140% in Ex_Sed (p=0.02). An increase in perceived intensity of 23% for the lemon scent and of 21% for the clove were measured in Sed_Ex whilet in Ex_Sed, the increase was only 18% for the lemon and 3% for clove (p=0.015; p=0.043). In the Sed_Ex visit, decreases in gustatory perceptions were observed in saltiness for 2% plain yogurt (37%), and the appreciation for cracker with regular cream cheese (28%), whereas the decrease was much greater in the Ex_Sed visit (74% and 30%; p=0.042; p=0.045). No anorexigenic effects of exercise were measured along with no dif-ferences in macronutrient intake between visits. There was no correlation between caloric ingestion and variations in gustative and olfactive perceptions.Conclusion: Exercise timing impacts olfactive and gustative responses but there seems to be a dissociation between the changes observed and the total caloric ingestion. O9.4Neighbourhood Walkability and Its Association with Child Weight Status in Quebec: Findings from the Quality StudyNicoleta Cutumisu1, Melanie Henderson2, Marie-Eve Mathieu2, Tracie Barnett1

1. Institute Armand Frappier – INRS, Laval, QC, Canada, 2. University of Montreal & Centre de recherche CHU Ste-Justine, Montreal, QC, Canada

Background: Child inactivity is an important public health issue and efforts to pre-vent inactivity are made around the globe. Mounting evidence shows that meeting the physical activity guidelines is a prerequisite for a heathy weight status and that built environment may influence children’s weight status.Objective: We aimed to elucidate built environment’s influence on weight status at the baseline of an ongoing longitudinal study among a cohort of n=630 Canadian children aged 8–10 years living in Quebec.Methods: We employed Geographic Information Systems to generate built environment measures and to relate individual and built environment data. We employed a generalized additive model to check for non-parametric associations of child’s measured BMI (non-obese vs obese) with area poverty, area disorder, and neighbourhood walkability (calculated for 1000 m network and circular buffers around children’s residences), after controlling for individual covariates (age, sex, parents’ weight status). After establishing the associations’ linearity, we conducted a logistic regression, retaining only children with complete data.Results: We found that children living in a higher circular buffer walkability area were less likely (OR=0.86, 95%CI 0.76, 0.97) to be obese compared with their


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counterparts living in lower circular walkability areas. No associations were found for network buffer walkability, suggesting the importance of informal neighbourhood pathways. Also, child’s weight status was associated with parental weight status.Conclusions: Policy changes are needed to facilitate built environment changes that support families to engage in active transport and other physical activity as a family, thus contributing to their healthier weights. O9.5Higher Abdominal Fat in Youth and Young Adults 3-10 Years Following a Sport-Related Knee InjuryClodagh M. Toomey1, 5, Jackie L. Whittaker2, 3, 1, Raylene A. Reimer1, Alberto Nettel-Aguirre4, 5, 1, Carolyn A. Emery1, 4, 5

1. Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada, 2. Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada, 3. Glen Sather Sport Medicine Clinic, University of Alberta, Edmonton, AB, Can-ada, 4. Cumming School of Medicine, University of Calgary, Calgary, AB, Canada, 5. The Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, AB, Canada

Objective: To examine differences in abdominal fat (AF) between youth with a 3–10 year history of sport-related knee injury and uninjured controls. A secondary objective was to determine the association between injury and AF, using physical activity (PA) as a covariate.Methods: 100 young adults (ages 15–26yrs; 55% female) with a sport-related intra-articular knee injury sustained 3–10 years previously, and 100 uninjured controls matched on age, sex and sport consented to study participation. Abdominal fat (fat mass at L1 to L4 vertebral level; g) was derived using dual-energy x-ray absorptiometry (DXA). PA was measured using the Godin Leisure-Time Questionnaire. Descriptive statistics (mean within-pair difference; 95%CI) were used to compare participants and multivariable linear regression (clustered by matched-pair) was used to explore the association between injury history and AF, using PA and sex as covariates.Results: Previously injured youth demonstrated higher AF (461 g; (95% CI: 228, 694)) than uninjured controls. In multiple linear regression analysis, previous injury was signifi-cantly (p<0.001, r2=0.82) associated with AF (β=0.11, 95% CI 0.1, 0.2). This association was modified by PA (β=-0.02, 95% CI -0.03, -0.01) and sex (β=-0.42, 95% CI -0.6, -0.2).Conclusion: Higher AF may be present in youth with a previous knee injury compared to matched controls. This is an undesirable feature given the recognition of regional fat distribution as a risk factor for disease. Efforts to increase PA in youth with a previous knee injury may be a potential intervention to reduce adiposity and thus impede the progression of negative health-related outcomes. O9.6Resistance-Training after Weight Loss has no Impact on Body Composition and on Energy Expenditure in Overweight and Obese Postmenopausal Women: A MONET StudyLuzia J. Hintze1, Eric Doucet1, Virginie Messier2, Martin Brochu3, Remi Rabasa-Lhoret2

1. University of Ottawa, Ottawa, ON, Canada, 2. University of Montreal, Montreal, QC, Canada, 3. Université de Sherbrooke, Sherbrooke, QC, Canada

Background: To maintain weight loss benefits, weight-loss maintenance is an important objective. Resistance training has been shown to be an effective mode of exercise to decrease fat mass (FM), increase fat-free mass (FFM) and maintain metabolically active tissue, which can be a useful tool for weight-loss maintenance. Objective: To examine the effect of a 12-month resistance training program on weight loss maintenance following a 6-month dietary weight loss intervention. Design: Following a 5.97(4.98)% weight loss, 71 healthy overweight and obese postmenopausal women were randomized to a control group or a resistance-train-ing group (3 x/week first 6 months; 2 x/last 6 months, 70–80 % of 1 RM). Body composition (DXA), visceral adipose tissue and abdominal subcutaneous adipose

tissue (CT scan), resting (indirect calorimetry) and total daily energy expenditure (EE) (doubly-labeled water) were measured. Results: A significant body weight (+0.90kg, + 1.35 % and +1.33 Kg, +1.63 %) and FM regain (+1.32kg, + 4.80 % and 0.81kg, +2.17 % for controls and resistance training, respectively) was observed. Resting and total daily EE did not change after the 12-month follow up period, and no difference was found between groups. Conclusions: Our results suggest that resistance training over a 12-month weight maintenance period does not improve weight loss maintenance, body composition or energy metabolism in post-menopausal women. O9.7Active Desks and Excess Body Weight – A review by the FIT24 NetworkMarie-Eve Mathieu1, Elise Labonté-Lemoyne2, Mickael Begon1, Sylvain Sénécal2, Pierre-Majorique Léger2

1. University of Montreal and Sainte-Justine UHC, Montreal, QC, Canada, 2. HEC Montréal, Montreal, QC, Canada

Objective: This project reports the current knowledge about the benefits of active desks on individuals with excess body weight.Methods: Five databases (Central, Embase, PubMed, Scopus, Web of Science) were investigated. Search included two concepts in phase 1: Desk (e.g., workstation…); and Active (e.g., standing, stepping, walking…). In phase 2, the keywords ‘over-weight’ or ‘obese’ were searched in the titles and/or in the abstracts.Results: Following the removal of duplicates, 973 manuscripts were retrieved. Of those, 109 were retained after reviewing title, abstract, and manuscript as required (phase 1). Twenty-one papers met the overweight or obesity criteria (phase 2). Nine papers only mentioned the effectiveness of active desks in the obesity epidemic (introduction and/or conclusion), and one study is ongoing. The remaining 11 articles evaluated how active desks can have an impact on obese/overweight individuals (treadmill n=6; standing n=3; cycling n=1; multiple n=1). Overall, increased phys-ical activity, standing and stepping times, and daily steps were observed. In addition, reductions in sitting time, body weight, and adiposity following active desk use were obtained, with greater body weight reductions in obese individuals. The use of active desks versus traditional desks led to greater energy expenditures, lower fatigue, lower musculoskeletal discomfort, lower blood pressure, and lower glucose levels. No other metabolic improvements were noted (e.g., insulin and triglycerides).Conclusion: The use of active desks appears to have a positive effect on individuals with excess of body weight. Larger studies comparing responses with normal weight individuals but also monitoring productivity outcomes are needed. O9.8Association between Physical Activity, Obesity, and Cardiometabolic Disease in South Asians: Canadian Community Health Survey, 2001–2014Sukhleen Deol, Hala Tamim, Chris I. ArdernSchool of Kinesiology and Health Science, York University, Toronto, ON, Canada

Background: Individuals of South Asian (SA) decent have a high prevalence of car-diometabolic risk factors such as type 2 diabetes and visceral adiposity. Objective: This study aims to examine the relationship between cardiometabolic health and physical activity (PA) among SAs with and without elevated body mass index (BMI: kg/m2).Methods: Data from SA participants of the 2001–2014 Canadian Community Health Survey were pooled and used in the current analysis (20 y+). PA was defined by self-report [Inactive: less than 1.5 kcal/kg/day (KKD); Moderately Active (MA): 1.5-2.9 KKD, and; Active (A): more than 3 KKD)], and Asian-specific BMI thresh-olds for “increased” (23-27.4 kg/m2) or “higher risk” (more than 27.5 kg/m2) of obesity-related disease were applied. Multiple logistic regression was subsequently used to estimate the odds of 1+ cardiometabolic condition (self-reported diabetes, hypertension, or cardiovascular disease).


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Results: Twenty-three percent of SAs have an “increased” BMI, while 45% are at “higher risk”. Compared to normal weight (NW) SAs (OR=1.00, ref), those within the “increased” (OR=1.78, 95% CI: 1.77-1.79) or “higher risk” (OR=2.97, 2.96-2.99) groups had higher odds of 1+ cardiometabolic condition. Within SAs with “higher risk” (over 27.5 kg/m2), these effects were attenuated by PA (inactive: OR=1.00; MA: 0.63, 0.63-0.64; A: 0.69, 0.68-0.70). Similar, but less pronounced effects of PA were seen in NW and “increased” risk groups.Conclusions: Regular PA was associated with lower odds of obesity-related health risk. Further research is necessary to understand the optimal threshold of PA required for prevention of risk in individuals of SA decent. PK1.1Food, Eating, and Weight: Language, Discourses, and Debates in the Obesity FieldSarah Nutter1, Molly Williamson1, Shelly Russell-Mayhew1, Angela S. Alberga2, Cara MacInnis1, John Ellard1

1. University of Calgary, Calgary, AB, Canada, 2. Concordia University, Montreal, QC, Canada

Researchers and professionals in the obesity field can play an important role in exploring larger influences on discourses regarding food and weight. Exploring discourses and de-bates within the obesity field allows for individuals to better-inform collaborative practice. Objective: Across two studies, this research examined the language, discourses, and debates regarding weight-related topics within the obesity field. In the first study, we investigated the similarities and differences between weight labels that were regarded as common versus socially acceptable. In the second study, we examined the ways in which food, eating, and weight are represented in obesity discourses at obesity conferences.Methods: Study 1: Participants (N=397) reported commonly used and socially acceptable weight labels, which we then correlated with weight bias and beliefs about the controllability of weight. Study 2: We used situational analysis to identify discourses in abstracts from the 2015, 2013, and 2011 CON Summits.Results: We identified tensions in the obesity field surrounding weight labels and discrepancy between socially acceptable terms and preferred terms, such as fat or obese. Situational analysis revealed polarizing positions on themes such as: behaviour modification, obesity as an individual problem, weight as an indicator for poor health, and the role of parents in managing childhood obesity.Conclusion: Tensions regarding preferred terms to describe weight issues suggest the need for increased consideration for weight labels in practice. Further, common discours-es identified in the obesity field indicate that a more harmonious approach may advance health promotion efforts and result in more coherent messaging to the public PK1.2Food Insecurity, Diet Quality and Obesity in African and Caribbean Households in OttawaDiana Tarraf1, Dia Sanou1, Rosanne Blanchet1, 2, Constance P. Nana2, Malek Batal3, Isabelle Giroux2

1. Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON, Can-ada, 2. School of Nutrition, University of Ottawa, Ottawa, ON, Canada, 3. Department of Nutrition, University of Montreal, Montreal, QC, Canada

Objective: Income-related food insecurity (FI), which refers to insufficient financial access to food, can contribute to chronic disease such as obesity and type 2 diabetes, and has been linked with higher health care costs in Ontario. The objective of this study was to examine the link between FI, diet quality and weight status among black households living in Ottawa. Methods: We recruited 258 households having at least one school-aged child, where the mother was born in Sub-Saharan Africa, the Caribbean or Canada, and

who were living in Ottawa during the study period. FI was measured using Health Canada’s Household Food Security Survey Module, diet quality was assessed using a 24-hour recall and the Canadian Healthy Eating Index (HEIC-2009) and anthropometric measurements were done using standardized protocols. Bivariate and logistic regression analyses were used to determine the link between FI, diet quality and weight status. Preliminary Results: In our sample, total HEIC-2009 score was not associated with FI. However, children living in food insecure households were almost 2.3 times more likely to having consumed sugar-sweetened beverages than those living in food secure households (OR=2.290, 95% CI=1.35-3.90). FI was linked with recent arrival to Canada and obesity among mothers.Conclusion: In this sample, FI may be associated with certain indicators of poor diet quality among children and higher rates of obesity among mothers. Strategies that aim to improve diet quality and reduce overweight in this population should target food security. (Funding: Consortium national de formation en santé and the University of Ottawa.) PK1.3Addressing Weight Bias in a Provincial Health Services OrganizationMary Forhan1, Kathy Danzinger2, Jenifer Bennett2

1. University of Alberta, Edmonton, AB, Canada, 2. Alberta Health Services, Edmonton, AB, Canada

Purpose: Weight bias is a phenomenon that is known to impact the quality of healthcare persons with obesity receives. The purpose of this study was to determine to what extent weight bias exists among employees in an urban zone at a large health services organizations and to identify the types of interventions employees believe would help to address weight bias.Method: This study was divided into two separate but related phases. Phase one used a cross sectional, on-line survey made available to all staff. The survey used the Attitudes and Beliefs About Obese Persons Questionnaires (ATOP and BAOP). Phase two used a cross sectional survey that included a summary of the results from phase one and questions about the types of weight bias interventions staff would find most useful and would most likely participate in.Results: An equal amount of nursing, allied health and administrative staff responded to the survey (n=423). Mean ATOP score was 77/120 indicating less pos-itive attitudes toward persons with obesity. Mean BAOP score was 17/44 indicating a stronger belief that obesity is under the control of the individual. Results from phase two are still under review however preliminary results show that employees would like more education about the causes and consequences of obesity and have oppor-tunities to feel more confident in their skills working with patients with obesity.Conclusion: Weight bias exists among employees at a large health services organization. Employees appear to be interested in addressing weight bias through education and skill development. PK2.1A Systematic Review and Meta-analysis of Weight Loss Intentions and Strategy Use Among YouthStephanie Houle-Johnson, Lisa KakinamiConcordia University, Montreal, QC, Canada

Background: Evidence suggests that young females may be more likely to use unhealthy weight loss strategies compared to males, however this has never been systematically assessed. Objective: We conducted a systematic review and meta-analysis of the literature examining sex differences in weight loss strategies among youth. Methods: Relevant articles published after 1990 were identified. Studies conducted in North America with participants under 18 years old, who measured weight loss strategy use were selected. Descriptive statistics were extracted from 19 studies, and weighted Mantel-Haenszel odds ratios with fixed effects were


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used for the meta-analysis. Results: Almost two-thirds of youth report trying to lose weight and the proportion using unhealthy or extreme strategies is as high as 44% and 13%, respectively. In the meta-analysis, compared to males, females were more likely to skip meals (OR: 2.25, 95% CI: 2.04–2.48), use diet pills (OR: 2.54, 95% CI: 1.80-3.58), diuretics (OR: 1.76, 95% CI: 1.30–2.39), vomit (OR: 2.31, 95% CI: 1.92–2.78) and eat smaller portions (OR: 1.36, 95% CI: 1.12–1.64) to lose weight. No sex differences were found for the likelihood of exercising, fasting, or using laxatives to lose weight. Conclusions: Sex differences were noted for some, but not all weight loss strategies among youth. The extant literature is limited by the lack of reporting the use of mul-tiple weight-loss practices used in tandem, and the lack of reporting other socio-de-mographic characteristics such as socioeconomic status. Researchers and practitioners need to be mindful of these characteristics to better target public health initiatives. PK2.2Fasting and Postprandial Glucose, Insulin and Glucagon-like Peptide 1 (GLP-1) Levels in Children with Prader-Willi Syndrome (PWS)Maha Alsaif, Michelle Mackenzie, Carla Prado, Andrea HaqqUniversity of Alberta, Edmonton, AB, Canada

Background: PWS is a unique model of childhood obesity with increased insulin sensitivity. GLP-1 has potent effects to stimulate insulin secretion; however, it is unclear if GLP-1 levels are altered in PWS.Methods: Ten children with PWS and seven controls completed three visits. Fasting and 1h postprandial blood samples (up to 3h) were completed. Participants consumed one of 3 meals: standard (350kcal, 55%CHO, 30%fat, 15%PRO), higher protein/lower carbohydrate (350kcal, 40%CHO, 30%fat, 30%PRO), higher protein/lower fat (350kcal, 55%CHO, 15%fat, 30%PRO). Results: PWS and controls were of similar age and BMI-z score. PWS had lower fast-ing levels of glucose (p=0.033) and a trend for lower insulin and HOMA (p=0.055). Fasting GLP-1 levels in PWS were comparable to controls. Glucose and GLP-1 increased over time in PWS (p=0.031 and p=0.001) but not in controls. However, insulin increased over time in both groups (p<0.0005 and p=0.001). Postprandial glucose and insulin levels were higher in PWS compared to controls at 3h (p=0.003 and p=0.005). PWS had higher glucose at 3h and higher insulin relative to fasting at 1, 2, and 3h compared to controls. Glucose, insulin and GLP-1 AUC were not different between meals in controls.Conclusion: Fasting glucose is lower while insulin and HOMA trend to be lower in PWS, suggesting that PWS are more insulin sensitive than controls. Fasting GLP-1 levels were comparable in PWS and controls, suggesting that it is not the driver of insulin sensitivity. The prolonged insulin and glucose response in PWS are sugges-tive of abnormalities in glucose control. PK2.3Prevalence of Comorbid Conditions Pre-existing and Diagnosed at a Tertiary Care Pediatric Weight Management ClinicGriselle Leon1, Elizabeth deKlerk2, Paola Luca1, 3, Michelle Jackman3, Raylene A. Reimer1, Kimberly E. Connors4

1. University of Calgary, Calgary, AB, Canada, 2. University of British Columbia, Van-couver, BC, Canada, 3. Alberta Children’s Hospital, Calgary, AB, Canada, 4. University of Alberta, Edmonton, AB, Canada

Background: Childhood obesity places individuals at risk for a multitude of physi-cal and mental health problems.Objectives: The aim of this study was to assess the prevalence of obesity related comorbidities diagnosed prior to and after attending a tertiary care pediatric weight management clinic.Methods: A cross sectional retrospective chart review of patients 2–17 years old

seen in a weight management clinic at a tertiary care pediatric hospital from May 2012 to May 2014.Results: 199 patients were included in the review. Comorbidity prevalences were: hypertension 6 (3%), prediabetes 11 (5.5%), type 2 diabetes 3 (1.5%), dyslipidemia 105 (52.8%), non-alcoholic fatty liver disease 31 (15.6%), asthma 45 (22.6%), obstructive sleep apnea 21 (10.6%), and polycystic ovarian syndrome (PCOS) 9 (9.2%). Concerns related to depression and anxiety were present in 20 (10.1%) and 25 (12.6%) patients respectively. The majority of comorbidities were identified prior to joining the clinic. Conditions requiring more specialized tests, such as diabetes and PCOS, were more commonly identified after joining the clinic.Conclusions: These results give further insight into the prevalence of obesity-relat-ed comorbidities in overweight and obese children and adolescents, and demon-strate the importance of screening for these known comorbidities. It is important to have the resources and an experienced multi-disciplinary team to follow children and their families through treatment. PK2.4The Live 5-2-1-0 Family Physician Toolkit for Promoting Healthy Childhood Behaviours in Primary Care – A Pilot StudyShelly Keidar1, 2, Stephanie Shea1, 2, Susan Pinkney1, 2, Katrina Bepple3, Danielle Edwards3, Ilona Hale4, Shazhan Amed1, 2

1. BC Children’s Hospital Research Institute, Vancouver, BC, Canada, 2. Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada, 3. Chilliwack Division of Family Practice, Chilliwack, BC, Canada, 4. East Kootaney Division of Family Practice, Cranbrook, BC, Canada

Purpose: SCOPE is a community-based multi-sectoral childhood obesity prevention initiative that promotes the Live-5-2-1-0 message: 5+ vegetables/fruits; <2-hours of screen time; 1+ hour of active play; and 0 sugary drinks, every day. As part of this initiative, a Live 5-2-1-0 Toolkit (including training) for family physicians (FPs) was piloted in 2 BC communities.Objective: To determine whether the Toolkit improves physician capacity to promote healthy childhood behaviours, and to identify barriers/facilitators to imple-mentation of the Toolkit.Methods: Implementation occurred sequentially in two communities, involving 21 FPs in 6 family practice clinics. FPs completed pre/post-implementation surveys and participated in semi-structured interviews post-implementation. Descriptive statistics and thematic analysis were used for quantitative and qualitative data, respectively.Results: FPs reported increased knowledge of medical evaluation of obese pediat-ric patients (14% to 36%); behavioural goal-setting (36% to 93%); and motivational interviewing (57% to 79%). FPs’ perceived efficacy improved in addressing weight (43% to 93%). Routine promotion of healthy behaviours increased, facilitated by the use of the Live 5-2-1-0 message. Routine measurement of body mass index (BMI) increased (7% to 29%).Barriers to implementation were increased visit time, family buy-in, and patient/staff capacity to measure BMI; the most-noted facilitator was ready-to-use Live 5-2-1-0 resources (i.e. handouts/information sheets/goal-trackers/prescriptions).Conclusions: The Live 5-2-1-0 Toolkit facilitated health promotion by FPs with their pediatric patients. Insufficient clinic staff capacity limited routine BMI measurement. The results will be used to refine the Toolkit and maximize its usability prior to wider dissemination across BC Divisions of Family Practice.


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PK3.1Smoking Does Not Significantly Worsen Lipid Changes Related to Increas-ing Adiposity in Adolescents: A Heart Niagara Healthy Heart Schools’ Program StudyBrian W. McCrindle1, Don Gibson2, Karen Stearne2, Nita Chahal1, Stafford Dobson2, Myriam Lafreniere-Roula1, Cedric Manlhiot1

1. The Hospital for Sick Children, Toronto, ON, Canada, 2. Heart Niagara, Inc., Niagara Falls, ON, Canada

Background: In adults, smoking lowers HDL-cholesterol levels and may increase non-HDL-cholesterol levels by contributing to insulin resistance. The interaction between smoking and adiposity on lipids has not been well-defined for youth. Methods: All grade 9 students (ages 14–15 years) in the Niagara Region, Ontario, underwent screening for cardiometabolic risk factors for school years 2009–2016. BMI and waist to height ratio (WHtR) were calculated, and fingerstick capillary sam-ples assessed total cholesterol and HDL-cholesterol levels. Any current smoking was assessed by self-report questionnaire. Regression analysis was used to determine interactions between smoking and adiposity. Results: Of 17,551 adolescents included (51% males), 16.8% were overweight, 13.6% obese, 14.4% had WHtR>0.5-<0.6, 3.5% had WHtR>0.6, and 4.7% were smokers. For non-smokers, HDL-cholesterol levels were 1.05(0.25)mmol/L for obese, 1.19(0.33) for overweight and 1.32(0.34) for normal weight subjects; for smokers levels were 1.01(0.25) for obese, 1.15(0.31) for overweight and 1.28(0.33) for normal weight subjects. The decrease associated with smoking was not significant (p=0.79), with no interaction with BMI percentile (p=0.22). For non-smokers, non-HDL-cho-lesterol levels were 3.01(0.79) for obese, 2.69(0.69) for overweight and 2.46(0.63) for normal weight subjects; for smokers levels were 2.97(0.75) for obese, 2.76(0.77) for overweight and 2.50(0.69) for normal weight subjects. There was no significant association with smoking (p=0.66), with no interaction with BMI percentile (p=0.37). Findings were similar when WHtR category was used as the measure of adiposity Conclusions: The relationship between lower HDL-cholesterol and higher non-HDL-cholesterol with increasing adiposity was not significantly altered by current smoking in this population-based cross-sectional study of adolescents. PK3.2Cardiovascular Fitness and not Physical Activity Mediates the Relationship between Dyslipidemia and Higher Adiposity in Canadian YouthAlisha N. Jamal1, 2, Chun-Po S. Fan3, Brian W. McCrindle1, 2

1. Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada, 2. Department of Pediatrics, The Hospital for Sick Children, Toronto, ON, Canada, 3. CV Data Management Centre, The Hospital for Sick Children, Toronto, ON, Canada

Objective: We sought to determine if physical activity/fitness mediates the association between adiposity and lipid values in children. Methods: Children <18 years participating in Cycle 1 and 2 of the Canadian Health Mea-sures Survey were included. Weighted descriptive and mediation analysis was performed, adjusted for age, sex, ethnicity, household income and smoking history. Physical fitness was determined from the modified Canadian Aerobic Fitness Test (mCAFT), and physical activity from accelerometry. Results: Data from 4,400 subjects were analyzed. For non-HDL-cholesterol, a higher mCAFT score (higher fitness) reduced the association between a higher non-HDL cholesterol and a higher BMI by 37% (p<0.001), 25% for waist to hip ratio (p<0.001), 40% for waist circum-ference (p < 0.001), and 35% for log-transformed BMI (p<0.001), indicating that higher mCAFT score partially mediates these relationships. Higher mCAFT score partially mediated the relationship between higher total cholesterol/HDL ratio and higher adiposity measures, as well as between lower HDL and higher waist-hip ratio. The relationship between higher adiposity measures and higher total cholesterol was completely explained by mCAFT scores indicating complete mediation. For LDL cholesterol and triglycerides, mCAFT score

completely mediated the relationship between higher LDL and higher log-transformed BMI and the relationship between higher triglycerides and all measures of adiposity. Physical activity level (minutes of moderate to vigorous activity and sedentary time) did not mediate the relationship between any lipid variable and any adiposity variable. Conclusions: Greater physical fitness but not activity level may be associated with more favorable lipid values associated with increasing adiposity in youth. PK3.3Body Fat Percentile Curves for Children and Youth of Asian and European AncestryJennifer McConnell1, Patti-Jean Naylor2, Heather Macdonald3, 4, Lindsay Nettlefold3, Heather A. McKay3, 4, Ryan E. Rhodes2

1. Social Dimensions of Health, University of Victoria, Victoria, BC, Canada, 2. School of Ex-ercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada, 3. Centre for Hip Health and Mobility, Vancouver, BC, Canada, 4. Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada

Understanding the trajectory of body fat accrual across maturity in youth is import-ant. Reference data for regionally- and ethnically-diverse Canadian youth do not currently exist. We created sex- and ethnic-specific percentile curves for body fat percentage (BF%) and BF% velocity for a sample of British Columbian youth of Asian and European Ancestry (reference group). We utilized 4,733 observations from 944 youth (487 girls) aged 9-19 years from the UBC Pediatric Bone and Physical Activity Database. Ethnicity was self-reported and BF% was obtained from whole body dual energy X-ray absorptiometry scans. Analyses were centered by chronological and biological age (years from age at peak height velocity, APHV). We created sex- and ethnic-specific BF% percentile and velocity curves using the GAMLSS method in R. Centile curves were materially different between girls and boys. For girls, centile curves converged across ages; curves above the 50th centile decreased, curves below the 50th increased and all curves increased by age 16. For boys, centile curves above the 25th increased until approximately age 12 then all curves descended and flattened by age 18. Centile curves for Asian and reference group participants were similar in shape for girls but not for boys. Velocity curves were also materially different between girls and boys and illustrate how maturity influences BF% accrual. These BF% percentile and velocity curves for a sample of British Columbian youth illustrate different trajectories of body fat accrual over chronological age and body fat velocity over biological age for girls and boys of different ethnic groups. PK3.4Growing Little Sprouts: Enhancing Supportive Environments in Childcare SettingsTracy McDonough, Mary Jane Gordon, Emma BassettKFL&A Public Health, Kingston, ON, Canada

Objective: Governments and experts have recommended that healthy environments be established within childcare settings to prevent obesity. The objective of this study was to pilot test a process for a local public health unit enabling licensed childcare providers to develop or revise their centre’s policies on nutrition and physical activity.Methods: Participants (“champions”) attended an introductory meeting, completed an assessment of their centre’s nutrition and physical activity environment, set goals including policy-related goals, and developed an action plan. Process and outcome evaluation included: pre- and post-pilot questionnaires for champions; monthly phone call logs; pre- and post-pilot policies; assessment, goal setting and action planning tools; post-pilot interviews with champions and project leads.Results: Thirteen licensed childcare providers participated. At follow up, 8 out of 13 sites reported having revised or created new policies for nutrition, physical activity or both. The largest differences in pre- and post-pilot mean scores was observed for agreement with: “Having written policies and procedure assures children get the


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same care in each classroom, from day to day, and from week to week” and “Our centre has staff capacity to revise and implement current or new policies”. Outcomes reported by champions included adopting a team approach and collaborating to develop policy and an increased ability to compare old and new policies. Champions found the experience to be rewarding and collaborative with public health.Conclusion: This process can be replicated by other public health agencies to en-able childcare providers to develop or revise nutrition and physical activity policies. PK4.1The Association of Delta-5- and Delta-6-desaturase Activities with Risk Factors for Type 2 Diabetes is Dependent on Plasma apoB in Obese SubjectsValérie Lamantia1, 2, 3, Simon Bissonnette1, 2, 3, Yannick Cyr1, 2, 3, Hanny Wassef2, 3, Rémi Rabasa-Lhoret1, 2, 3, Christine Des Rosiers1, 4, May Faraj1, 2, 3

1. Université de Montréal, Montréal, QC, Canada, 2. Institut de recherches cliniques de Montréal, Montréal, QC, Canada, 3. Montreal Diabetes Research Center, Mon-tréal, QC, Canada, 4. Montreal Heart Institute, Montréal, QC, Canada

Objective: Prediabetes is characterized by delayed fat clearance, inflammation, and high insulin secretion (IS) and resistance (IR). High number of plasma apoB-lipo-proteins (apoB) promotes white adipose tissue dysfunction and type 2 diabetes (T2D). Dietary factors, such as omega-3 (n-3) fatty acids (FA) regulate plasma apoB. FA desaturases, delta-5 (D5D) and delta-6 (D6D), convert dietary n-3 and n-6 FA into their bioactive counterparts. They associate with the incidence of T2D positively and negatively, respectively. We hypothesized here that the link between D5D and D6D activities and T2D risk factors is dependent on plasma apoB. Methods/Results: We examined IS and IR in N=81 (40% men, ≥27kg/m2, 45–74 yrs, post-menopausal, non-diabetic and not on n-3 therapy) using intravenous-glu-cose-tolerance test and hyperinsulinemic-euglycemic clamp. Plasma clearance of dietary fat was examined following ingestion of 13C-triolein-labeled-high-fat meal (N=30). Plasma FA in phospholipids were measured by gas chromatography-mass spectrometry and used to estimate D5D and D6D activities from the product-to-pre-cursor ratios. Plasma apoB range was 0.3-1.8g/L and average plasma n-6:n-3 FA was 12:1. Estimated D5D activity correlated negatively with plasma apoB, IR, 2nd phase IS, delayed chylomicron clearance and plasma interleukine-1 receptor antagonist in wom-en. Estimated D6D activity correlated positively with plasma apoB, IR and delayed fat clearance in women. Adjustment for plasma apoB eliminated all associations of D5D and D6D with T2D risk factors, except for that between D5D and chylomicron clearance. Conclusion: In obese subjects on habitual diet, the link between D5D and D6D activities and T2D risk factors is dependent on plasma apoB. PK4.2The McMaster Optimal Aging Portal: a Tool to Provide Evidence-Based Information on Healthy AgingSarah Neil-Sztramko, Maureen Dobbins, Anthony Levinson, John Lavis, Parminder Raina, Brian HaynesMcMaster University, Hamilton, ON, Canada

Summary: There is an abundance of freely available information on the internet relevant to health and wellness, but it is difficult for the general public to know which sources are trustworthy. The McMaster Optimal Aging Portal was launched in 2014 as a resource for high quality, evidence-based information about health, aging and common health conditions, including obesity and weight management. The Portal is a one-stop shop for high-quality information about how to remain healthy, active and engaged as we grow older. Currently, the Portal contains >3300 items related to obesity and healthy weights for citizens, clinicians, public health professionals, policy-makers and researchers, including: • Quality-rated summaries of the best available scientific evidence ·

• Links to full-text systematic reviews• Evaluations of online health resources• Commentaries about scientific research The Portal is committed to providing accessible, evidence-based resources on topics of interests to users, and to developing content, applications, promotion strategies and research interventions to maximize the value. This presentation will provide an update on these activities specific to obesity and weight management. Participants are encouraged to bring a smart device for a demonstration of site features, and propose strategies for how the Portal could fit within their scope of practice.Learning Objectives:• Learn how to access high-quality information about healthy aging via the McMaster Optimal Aging Portal • Search for evidence from the latest published research to answer health questions • Teach patients, research participants, clients, students, staff, and colleagues how to find and critically appraise health information they find online PK4.3Trends in Medication Use by BMI and Age over Time in the United StatesArshdeep K. Randhawa, Jennifer L. KukYork University, Toronto, ON, Canada

It is unclear whether the increased in prescription medication use over time differs by age and obesity status. Data from 56,998 adults from the National Health and Nutrition Examination Survey (NHANES) between 1988 and 2012 was analyzed. There was an increase in medication use over time among older individuals of all body mass index (BMI) groups, but not among younger individuals. In particular, the increases in medication use over time were most prominent in older individ-uals with obesity (p<0.001). For example, 60 year old women with obesity took 1.8 more medications in 2012 than 1988 compared to 1.1 more medications for normal weight while there were minimal differences in 20 year old women with and without obesity (0.4 versus 0.1 medications). BMI, age and time were independent-ly associated with the higher odds of taking antihypertensives, lipid-lowering medication, antidiabetics and analgesics (p<0.05). Conversely, the odds of taking antibiotics were lower over time (p<0.05) while BMI and age were inconsistently associated with the use of antibiotics (p>0.05). In conclusion, older individuals of all BMI groups had increased cardiometabolic and analgesic medication use over time with the increase being most prominent in older individuals with obesity. The rise in medication use in older individuals of all BMI groups may be a function of factors such as more medications available in the market, better disease detection, improved drug insurance coverage and increased drug marketing, but may also reflect differences in how medications are prescribed over time. PK4.4Weight Loss, Regression to Normoglycemia, and T2D Development at 3 Years in Early Weight Loss Responders to Liraglutide 3.0 mg: SCALE Obesity and Prediabetes TrialDavid C. Lau1, Ken Fujioka2, Frank Greenway3, Patrick O’Neil4, Peter B. Jacobsen6, Trine V. Skjøth6, Sten Madsbad7

1. University of Calgary, Calgary, AB, Canada, 2. Scripps Clinic, La Jolla, CA, USA, 3. Pennington Biomedical Research Center, Baton Rouge, LA, USA, 4. Medical Uni-versity of South Carolina, Charleston, SC, USA, 5. University of Liverpool, Liverpool, United Kingdom, 6. Novo Nordisk, Copenhagen, Denmark, 7. Hvidovre Hospital, Hvidovre, Denmark

Background: SCALE Obesity and Prediabetes (NCT01272219) randomized adults with prediabetes and obesity (BMI ≥30 kg/m2), or overweight (≥27 kg/m2) with comorbidities to liraglutide 3.0 mg (N=1505) or placebo (N=749) as adjunct to diet and exercise for 3 years.


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Methods: This post-hoc analysis compared liraglutide 3.0 mg early responders (ERs; ≥5% weight loss [WL] at Week [W] 16) and early non-responders (ENRs; <5% WL at W16). Efficacy outcomes are estimated means in ERs (n=580) and ENRs (n=210) who completed 160 weeks’ treatment. Development of T2D/regression to normoglycemia were analyzed using LOCF.Results: Of those with W16 data, 68.0% receiving liraglutide 3.0 mg (n=1302) were ERs, 32.0% ENRs; 22.3% receiving placebo (n=640) were ERs, 77.7% ENRs. At W160, greater WL (–8.6% and –9.1 kg [ER]; –2.9% and –3.1 kg [ENRs]), lower rates of T2D development (0.5% ERs, 3.2% ENRs) and greater regression to normoglycemia (69.8% in ERs, 55.4% in ENRs) were observed in ERs to liraglutide 3.0 mg vs ENRs. ERs showed greater clinical (FPG, HbA1c, SBP levels) and patient-reported improve-ments vs ENRs (SF-36 score +3.68 vs +1.81 and IWQOL-Lite score +13.40 vs +9.53 [increase in score=improvement]). Adverse events (AEs) and gastrointestinal AEs were similar between groups (87.1% and 75.3% for ERs; 95% and 71.6% for ENRs) while serious AEs and gallbladder disorders were more frequent in ERs (17.7% and 6.3% vs 12.7% and 2.2% for ENRs).Conclusions: Among those treated with liraglutide 3.0 mg for 160 weeks, greater benefits were seen in ERs vs ENRs; overall AE rates were similar. PK5.1Neighbourhood Built Design and Socioeconomic Composition and Their Associations with Weight Status in Canadian AdultsGavin McCormack1, Christine Friedenreich2, 1, Lindsay McLaren1, Melissa Potestio3, Ilona Csizmadi1, Beverly Sandalack1

1. University of Calgary, Calgary, AB, Canada, 2. Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, AB, Canada, 3. Alberta Cancer Prevention Legacy Fund, Alberta Health Services, Calgary, AB, Canada

Objective: Neighbourhood socioeconomic composition and built design are correlates of weight-related behaviours. We investigated the relations between neighbourhood design and socioeconomic status (SES) and their interaction, in relation to waist circumference (WC), waist-to-hip ratio (WHR), and body mass index (BMI) in a sample of Canadian adults Methods: Using stratified random sampling, 12 established Calgary neighbour-hoods built prior to 1980 were selected as recruitment sites. The 12 neighbour-hoods were defined by their design (grid, warped-grid, or curvilinear block patterns) and socioeconomic status quartiles. In 2014, a random sample of households (n=10,500) from the 12 neighbourhoods were mailed a survey package. One adult (aged ≥20 years) per household was invited to participate. The survey package included instructions for completing two online questionnaires capturing physical activity, health, diet, and demographic characteristics. The survey package also included a tape measure and instructions for measuring waist and hip circumfer-ence. N=851 provided complete data. Covariate-adjusted linear regression models estimated associations between BMI, WC, and WHR in relation to neighbourhood design and socioeconomic status and their interaction. Results: WC and BMI were higher among residents of disadvantaged neighbour-hoods, independent of neighbourhood design and covariates. The association between neighbourhood-level SES and WC was modified by neighbourhood design – WC was higher in disadvantaged-curvilinear neighbourhoods and lower in advantaged-grid neighbourhoods. Conclusion: Participants in advantaged neighbourhoods had smaller WC and BMI. Neighbourhood design and socioeconomic composition jointly effected WC. Policies that promote physical activity and healthy diet and that make less obesogenic neighbourhoods affordable to low socioeconomic households are necessary.

PK5.2The REFRESH Study Recreation Environment and Food Research: Experiences from Hockey – Perspectives Revealed Through the Photovoice MethodSusan Caswell1, Rhona Hanning1, Jessica Lieffers2

1. University of Waterloo, Waterloo, ON, Canada, 2. University of Alberta, Edmonton, AB, CanadaObjectives: Unhealthy dietary behaviours are prevalent among Canadian adoles-cents who participate in organized sports. This research aimed to explore, from the perspective of adolescent hockey players, the broad social and physical environ-mental influences of exposure to the recreational food environments on their food choices and behaviours using a modified photovoice method. Parent perspectives of players’ experiences were also explored. Methods: Twenty-four hockey players aged 12–15 were recruited within Ontario to take photographs illustrating their experiences with food choices around participa-tion in recreational hockey. Players interpreted illustrated perceptions in individual interviews. Guided by the SHOWeD method, participant focus groups discussed experiences represented in the photographs. Their experiences were showcased at an exhibit for stakeholders. To gain further insight, five parents were individually interviewed. Interview and focus group transcripts were thematically analyzed. Results: Both players and parents perceived recreational facility food options as unhealthy. Perceptions also overlapped around travel and time constraints. Players reported influences including the importance of nutrition for performance and recovery (i.e., protein, chocolate milk), media and branding (i.e., Tim Horton’s), tournaments, team meals, and moral values. Parents’ perceived influences included tournament meals, and the “traditional” hockey food environment. Conclusions: Results indicate that recreation facilities are only one in a range of environments that influence eating behaviours of adolescent hockey players. Perceptions around brand and product messaging supports how vulnerable adolescents are to advertising and promotion. Players embraced healthier choices associated with performance indicating that value associations are essential to inform messaging and intervention strategies targeting healthy eating behaviours. PK5.3The Impact of Accelerometer Wear Location on Physical Activity Estimates and the Relationship with Arterial Health in Adults Treated for Hypertension and DiabetesAlexandra B. Cooke, Stella S. Daskalopoulou, Kaberi DasguptaMcGill University, Montreal, QC, Canada

Objectives: Accelerometer placement may have important methodological impli-cations for assessing physical activity (PA) levels. Therefore, we aimed to evaluate the impact of wrist and waist accelerometer location on step counts and PA, as well as the relationship between step counts and a responsive clinical outcome, carot-id-femoral pulse wave velocity (cfPWV). Methods: We included a matched sub-group of participants from a larger cohort of 369 adults with HTN and/or T2DM recruited to evaluate the responsiveness of cfPWV to step counts. Accelerometers were worn (Actigraph GT3X+) for the assessment of steps, sedentary time, and moderate-to-vigorous-PA (MVPA). We compared the waist and wrist location (N=47 per group). Pedometers (Yamax SW-200) were worn simultaneously at the waist in all participants. cfPWV was measured using applanation tonometry. Results: Despite comparable pedometer-derived step counts, wrist group participants had significantly higher accelerometer-derived step counts by 3955 steps/day (95% CI 2499, 5411), greater MVPA by 132.9 mins (95% CI 108.9, 156.9), and lower sedentary time by 3.8 hours (95% CI -4.5, -3.2) compared to the waist group. In full cohort of 369 participants, a 1000 step/day increment was associated with a 0.1m/s decrement in cfPWV. In our matched analysis, accelerometer-derived step counts measured at the waist also trended with cfPWV; however, we observed no relationship with wrist-derived steps.


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Conclusion: Our findings demonstrate large differences in PA estimates between the wrist and waist location. Furthermore, misclassification of PA levels specifically due to the wrist location eliminated any sign of a relationship between step counts and a PA-linked clinical outcome. PK5.4The Association Between Functional Skills Movements and Obesity-Related Risk Factors and Fitness LevelAndrea Mayo1, Megan E. Comeau1, Cindy Levesque1, Michel J. Johson2, Danielle Bouchard1, Martin Sénéchal1

1. University of New Brunswick, Fredericton, NB, Canada, 2. Universite de Moncton, Moncton, NB, Canada

Background: It has been hypothesized that children with better fundamental movement skills (FMS) do more physical activities, and thus are healthier.Objective: The main objective of this study was to evaluation the association between FMS and body mass index. Secondary objectives include the FMS scores evaluated with two different tools, and to evaluate the association between FMS and other health indicators.Methods: A total of 145 children were recruited and were tested in schools, after school’s program and summer camps throughout the province of New Brunswick. Fundamentals skills (e.g., kicking, throwing, jumping) were evaluated using the Passport for life (i.e., lateral bound, plank, circuit, run, kick, throw and catch, and the Play Basic (i.e., run, hop, throw, kick and balance walk). Health indicators were body mass index, handgrip strength using a dynamometer, fitness level using the shuttle test, waist circumference, and body fat percentage using bioimpedance.Results: BMI was significantly associated with 67% of FMS using the Passport for life (r ranging from -.18 to -0.32; P<.05), 60% of FMS using the Play Basic (r ranging from -.15 to -0.30; P<.05). In both tools, the association was not significant for kicking and throwing. Similar results were observed for other health indicators.Conclusion: BMI and other health indicators in children are associated with FMS. Because of the study design, it is unknown if interventions that improve physical lit-eracy or health indicators may be one means of improving these so children become or stay active. This needs to be empirically tested. PK6.1The Economic Impact of Bariatric Surgery: A Retrospective Cohort StudyJillian Vallis, Kendra Lester, Deborah Gregory, Laurie TwellsMemorial University of Newfoundland, ST JOHN’S, NL, Canada

Objective: Individuals living with severe obesity report impaired quality of life, increased health services use and costs, and increased indirect costs due to absen-teeism, disability, and reduced work place productivity. The objective of this study is to determine the impact of bariatric surgery on short term economic outcomes in patients undergoing laparoscopic sleeve gastrectomy (LSG).Methods: A retrospective cohort study was used to examine the effect of LSG on economic outcomes using standardized case report forms. Bariatric surgery clinic patients consented to provide self-reported data on: weight loss interventions and mobility aids purchases, workforce productivity, home productivity and employ-ment status at baseline and every 6 months for 2 years. Economic outcomes were compared pre- and post-surgery. Results: Two hundred one patients were enrolled, with 81.6% being female and 91% Caucasian with an average age and BMI of 44yrs and 48.78 kg/m2, respectively. Approximately 76% of patients had purchased weight loss products pre-surgery, which was significantly reduced to 43.8% and 23.8% at 1 and 2 years post-surgery, respectively (p<0.05). Similarly, 5.2% and 3.6% of patients required mobility aids at 1 and 2 years post-surgery, respectively, which was significantly reduced from the 13.2% of patients before surgery (p<0.05). Patients also required less assistance

from others, (15.4% and 8.3% at 1 and 2 years after surgery, compared to 17.3% before surgery, p<0.05).Conclusion: For patients living with severe obesity, bariatric surgery is capable of helping to reduce indirect costs associated with obesity and consequently the financial burden on these individuals. PK6.2Relationship of Weight Loss Expectations to Bariatric Surgery OutcomeAllison A. Holgerson1, Matthew M. Clark1, Gretchen Ames2, Manpreet Mundi1, Todd A. Kellogg1, Karen Grothe1

1. Mayo Clinic, Rochester, MN, USA, 2. Mayo Clinic, Jacksonville, FL, USA

While bariatric surgery is highly effective, individuals often have unrealistic expecta-tions of weight loss following bariatric surgery. It is proposed that these unrealistic expectations might impede outcomes. Expectations for weight loss and relationship to outcomes following bariatric surgery were examined. Participants were 97 (78% female, mage = 48.24, mBMI = 46.72) patients who underwent bariatric surgery (61% gastric bypass, 24% sleeve gastrectomy, 15% biliopancreatic diversion (BPD)). Individuals completed the Goals and Relative Weights Questionnaire identifying how much percentage weight loss they desired (%WLD) to achieve four weight categories: dream, happy, acceptable, and disappointed. Mean %WLD was: dream (45.74%), happy (38.45%), acceptable (32.36%), and disappointed (21.07%). Patients who underwent BPD reported higher than average expectations: dream (55.67%), happy (46.93%), acceptable (40.00%), and disappointed (23.93%). Groupings (high, average, low) were created within desired weight loss categories using standard deviations. Controlling for pre-surgery weight, regression analyses demonstrated that high dream %WLD predicted greater %WL one year post-surgery [F (2, 93) = 7.92, p = .001, R2 = .15, bdream = 4.43 (p = .023)]. This study is the first (to our knowledge) to include BPD patients, who desire more weight loss than patients seeking other procedures. For this sample overall, higher weight loss expectations might have enabled outcomes. Providers should educate patients about surgical weight loss outcomes to foster realis-tic yet bold goals. Future research should examine psychological (i.e. self-efficacy) and medical factors (surgery type) that contribute to positive outcomes for those with high expectations, opposed to those whose expectations might impede efforts. PK6.3Long-Term Impacts of Adding Supervised Exercise Training to Interdisci-plinary Lifestyle Management in Subjects Awaiting Bariatric SurgeryAurélie Baillot1, 2, Warner Mampuya3, 4, Isabelle J. Dionne5, 6, Emilie Comeau7, Marie France Langlois3, 8

1. Université du Québec en Outaouais, Gatineau, QC, Canada, 2. Institut de recherche de l’Hôpital Montfort, Ottawa, ON, Canada, 3. Centre Hospitalier Universitaire de Sherbrooke Research Center, Sherbrooke, QC, Canada, 4. Department of Medicine, Division of Cardiology, Université de Sherbrooke, Sherbrooke, QC, Canada, 5. Research Centre on Aging Health and Social Services Centre, Institute of Geriatrics, Sherbrooke, QC, Canada, 6. Faculty of Physical Activity Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada, 7. Department of Surgery, Division of General Surgery, Université de Sherbrooke, Sherbrooke, QC, Canada, 8. Department of Medi-cine, Division of Endocrinology, Université de Sherbrooke, Sherbrooke, QC, CanadaBackground: We have previously reported the beneficial effects of Pre-Surgical Exer-cise Training (PreSET) on physical fitness and social interactions in subjects awaiting bariatric surgery (BS). However, post-BS data are required to confirm durable long-term effects of PreSET.

Objective: To evaluate the impacts of PreSET on physical activity (PA) level, physical fitness and quality of life (QoL) one year after BS.Methods: Of the 30 subjects randomized in 2 groups (PreSET -endurance and strength training before BS-, and control), 27 were re-evaluated one year after BS. All


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participants received usual care including individual lifestyle counselling before and after BS. At baseline and one year after BS, physical fitness was assessed with symp-tom-limited cardiac exercise test, 6-minute walk test (6MWT), sit-to-stand, half-squat and arm curl tests, and QoL and PA level were obtained with questionnaires. One year after BS, energy expenditure and step number were estimated using an accelerometer.Results: The 6MWT distance (+104 vs. +24m) and half-squat test (+30 vs. +4s) changes were greater in the PreSET group compared to the control group (p≤0.05). The number of steps (6272 vs. 4268) and level of moderate PA (0.6 vs. 0.2 hour/day) were higher in the PreSET group one year after BS (p≤0.04). No significant difference between the 2 groups was observed for the other parameters.Conclusion: The addition of a supervised PreSET to individual lifestyle counselling is effective in improving moderate PA and physical fitness one year after BS. Studies with larger cohorts are now required to confirm these findings. PK6.4Psychosocial Predictors of Cognition in Bariatric Surgery CandidatesMario Moscovici1, 2, Susan Wnuk1, 2, Allan Okrainec1, 2, Raed J. Hawa1, 2, Sanjeev Sockalingam1, 2

1. UHN, Toronto Western Bariatric Surgery Program, Toronto, ON, Canada, 2. Univer-sity of Toronto, Faculty of Medicine, Toronto, ON, Canada

Background: Bariatric surgery is an important treatment option for obesity, however mental health conditions can have a significant impact on post-operative morbidity and successful weight loss. This study aims to identify the relationship between cognition and psychosocial and demographic variables in bariatric surgery candidates. The secondary objective was to identify how cognition relates to quality of life and work impairment in this patient population. Methods: In this cross-sectional study, 302 bariatric surgery candidates were assessed pre-operatively for demographics, cognition (PDQ5), employment impairment (LEAP), depression (PHQ9), anxiety (GAD7), quality of life (SF36) and psychiatric diagnoses (MINI interview). A multivariate ANOVA was performed to identify significant predictors of cog-nition. A sub-group analysis was performed to identify whether self-reported cognition independently predicts work impairment or quality of life while controlling for anxiety and depression. Significance was defined as p<0.05. Results: Anxiety, depression scores, quality of life predictors and work impairment, but not BMI, were significantly associated with cognition in bariatric surgery candi-dates. Cognitive symptoms significantly predicted work productivity but not quality of life after controlling for anxiety and depressive symptoms. Discussion: Anxiety and depressive symptoms are important predictors of cogni-tion in bariatric patients independent of BMI and as a result, cognitive testing using the PDQ5 questionnaire, can provide additional information on the psychosocial burden pre-surgery. Further, this study supports the impact of cognitive symptoms on work productivity independent of anxiety or depressive symptoms or BMI. Further studies are needed to explore changes in these relationships post surgery. P1.01Anthropometric, Nutritional, Psychometric, and Biochemical Parameters of Individuals After SG and RYGB Bariatric Procedures: A 12-Month ObservationKeith Z. Brewster, Janet SeeUniversity of British Columbia, Vancouver, BC, Canada

Background: Though anthropometry is often the primary measure when assessing bariatric surgery, outcomes from these procedures can extend far beyond; both positively and negatively. The aim of this study was to evaluate the effect of sleeve gastrectomy (SG) and Roux-en-Y-bypass (RYGB) on anthropometric, nutrition, psychometric, and biochemical parameters. Methods: 100 participants (50 test and 50 control) were assessed for this study. The test group comprised of 50 bariatric surgical patients (pre-op) while the control

group had similar demographic and anthropometric profiles, but were pursuing non-surgical forms of weight management. Anthropometry (weight, BMI), nutrition (knowledge, motivators), psychometric (depression, anxiety, self-esteem, quality of life) and biochemical analyses (glucose levels, lipid profile) were all measured initially, and at 3 month intervals for 12 months thereafter. Results: Significant differences in anthropometry (weight, BMI), nutrition (knowl-edge), psychometric (anxiety, self-esteem, quality of life) were observed between test and control groups. No differences were observed in glucose levels between proce-dures (SG versus RYGB). Both triglyceride levels and cholesterol fractions decreased after both procedures. Changes in lipid profiles, total cholesterol, and activity of liver enzymes were more notable after RYGB than SG – indicative of liver overload. Conclusions: Results from this study suggest that bariatric surgery can have signif-icant impact on outcomes in patients – far beyond simple anthropometric measures, and is unquestionably more effective in weight management. Furthermore, potential liver overload and absorption limitations suggest that the SG procedure might be considered a primary option when surgical intervention is available. P1.02Effects of Vitamin D3 and N-3 Polyunsaturated Fatty Acids on the Development of Metabolic Syndrome in a Mouse Model of Diet-induced ObesityMarion Valle1, 2, Geneviève Pilon1, 2, Philippe St-Pierre1, 2, Denis Richard1, Edgar Delvin4, Claudia Gagnon3, Émile Levy4, André Marette1, 2

1. Quebec Heart and Lung Institute (IUCPQ)- Laval University, Quebec, QC, Canada, 2. Institute of Nutrition and Functional Foods (INAF)- Laval University, Quebec, QC, Canada, 3. Endocrinology and Nephrology Unit, CHU de Québec Research Centre, Quebec, QC, Canada, 4. Sainte Justine Hospital Research Center - University of Montrea, Montreal, QC, Canada

Background: It has been proposed that vitamin D3 (VD3) and n-3 polyunsaturated fatty acids (n-3 PUFA) improved inflammation and protected from T2D and CVD but their combined effects have never been explored.Objectives: Determine the long-term independent and combined effects of VD3 and n-3 PUFA supplementation on metabolic syndrome in obese mice.Methods: C57BL/J6 mice were fed a high-fat high sucrose (HFHS) diet for 12 weeks. Two groups receive regular 1,400 UI of VD3/kg of food and two groups were supplemented with 15,000 IU of VD3 /kg of food. One of each VD3 group was additionally fed with 4.35g/kg of fish oil rich in n-3 PUFA.Results: Food intake was not different between groups. VD3 supplementation significantly increased the plasma levels of 25(OH)D3, specifically the 3-epi-25(OH)D3 form representing 30% of the total 25(OH)D3 versus ≤3% in the group fed with regular VD3. n-3 PUFA increased energy expenditure as shown by indirect calorim-etry although it did not translate into lower diet-induced weigh gain. Nevertheless, mice fed diets containing n-3 PUFA showed an improved glucose homeostasis during oral glucose tolerance test and lower triglycerides accumulation in liver. VD3 supplementation did not further improve these parameters.Conclusions: These data show that n-3 PUFA treatment can improves features of the metabolic syndrome in HFHS-fed mice. However, combination with VD3 supple-mentation failed to enhance the beneficial effects of n-3 PUFA. We further plan to investigate the impact of these nutrients on gut health, as the VD receptor is known to be expressed in the intestine.


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P1.03Dysfunction of the Orbitofrontal Cortex in Diet-Induced ObesityLindsay Naef, Corey Baimel, Stephanie BorglandUniversity of Calgary, Calgary, AB, Canada

The orbitofrontal cortex (OFC) is involved in the cognitive control of reward processing. It keeps information online and updates behaviour based on changing reward contingencies. Human studies have demonstrated that obesity is associated with lower behavioural adaptation to reward devaluation. The goal of the present experiments was to test the hypothesis that the OFC is impaired in an animal model of diet-induced obesity associated with altered reward devaluation. Mice with diet-induced obesity display deficits in reward devaluation. Furthermore, obese mice exhibit decreased inhibitory input onto pyramidal neurons of the lateral OFC measured with whole cell patch clamp electrophysiology. To determine if decreased inhibitory input to pyramidal neurons leads to impairment in reward devaluation in normal weight animals, we expressed an inhibitory Designer Receptor Exclusively Activated by Designer Drugs (DREADD) in VGAT ires cre mice. Inhibition of GABAer-gic inputs to the lateral OFC by clozapine N-oxide (CNO) administration impairs reward devaluation. Together, these results demonstrate that obesity induces neuroadaptations in the lateral OFC to alter the processing of sucrose rewards, such that obese mice do not accurately update the reward value of rewards. P1.04Behavioural Modification for Adolescents with Obesity/Overweight: an Explanatory Conceptual Framework for Motivational InterviewingNita Chahal1, Janet Rush2, Brian McCrindle1, Katherine Boydell3, Ahlexxi Jelen1

1. Hospital for Sick Children, Toronto, ON, Canada, 2. Hamilton Health Science, Hamilton, ON, Canada, 3. Mental Health Black Dog Institute Hospital Road, Sydney, NSW, Australia

Background: Adolescents with overweight/obesity are at greater risk of developing cardiometabolic disease into adulthood and health promotion strategies are critical in risk reduction. Behavioural management is the preferred first-line intervention for adolescents; a unique population where ambivalence to change is typical. Motivational Interviewing (MI) is considered an effective behavioural strategy for individuals ambivalent to lifestyle change. A comprehensive conceptual framework for MI was sought but not evident in the literature. Theoretical and conceptual frameworks are valuable reference tools for education, research and standard clinical practice. To develop a comprehensive theoretical model for MI, various concepts, contexts, and components from the MI literature were consolidated into an explana-tory, instructive framework.Methods: Analysis of the literature revealed overlapping and recurring theorists, concepts, terms and processes. A descriptive, conceptual framework was developed for MI with application to adolescents experiencing overweight/obesity. Special con-sideration for adolescent growth and development was applied to the framework. Results: Exploration of the literature identified the dynamic interplay of four key elements: the problem (ambivalent behaviour); the person (overweight/obese ado-lescents and biopsychosocial factors); the counsellor (specific attributes following MI training); and the process (stages of change). Conclusion: The MI conceptual framework is a pragmatic, evidence-based tem-plate, useful for clinical practice, teaching, and research/evaluation. While applied to the adolescent who is obese or overweight, it is also useful for application to other clinical situations where lifestyle change is warranted.

P1.05Gaining Expert Consensus on Defining Metabolically Healthy Obesity (MHO) in Pediatrics: A Delphi StudySamah Damanhoury1, Amanda S. Newton2, Geoff D. Ball2

1. Department of Agricultural, Food, and Nutritional Science, Faculty of Agricultural, Life, and Environmental Sciences, University of Alberta, Edmonton, AB, Canada, 2. Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada

Background: The metabolically healthy obesity (MHO) phenotype has been described since the 1980s; however, no standardized definition has been used to define MHO in pediatrics. The purpose of this research is to determine a universal MHO definition in pediatrics. Methods: We are conducting a Delphi study, a structured communication tech-nique to gain consensus from a panel of experts on a universal definition for MHO in pediatrics. We will enroll ~25 participants with expertise in pediatric obesity, car-diometabolic risk, and MHO. We will use an online platform (REDCap®) to conduct multiple survey rounds (at least 3; up to 5). Each survey will include questions relat-ed to a number of issues, including MHO risk factors (e.g., triglycerides), risk factor cut-offs (e.g., triglycerides < 150 mg/dl), and BMI classification systems. After each survey round, expert responses will be anonymized, summarized using descriptive statistics, and used to inform experts’ responses in subsequent rounds. Consensus on the MHO definition will be defined as having 80% agreement among the experts on all questions. Final results will be summarized and shared with participants for final approval on the universal MHO definition in pediatrics. This study will start in fall, 2016; data will be presented at the Canadian Obesity Summit in 2017. Significance: A universal definition of MHO in pediatric has implications for obesity management and health system resource allocation. Applying a consensus-based definition can help to identify individuals for early interventions, prevent inappro-priate interventions for individuals with MHO, and enable comparisons within and between studies. P1.06Familial Perceptions of Weight and Health: A Qualitative Analysis Among Parents and ChildrenAnastasia Dikareva2, Eva Pila1, Catherine M. Sabiston1

1. University of Toronto, Toronto, BC, Canada, 2. Canadian Obesity Network Students and New Professionals, Edmonton, AB, Canada

Youth are susceptible to the physical and psychosocial consequences related to weight management. The family environment is critical in shaping health behaviours related to weight control. However, little is known about communica-tion and perceptions of weight and health within a family context. This multiple case study explored perceptions and communication related to weight and health among parents and children across five families. Through within-case analysis, families identified unique individual and familial perceptions of weight and health. A cross-case analysis revealed barriers and facilitators to healthy behaviours; community weight talk; and parental role modeling in relation to health and weight management. These findings demonstrate the complexity of perceived barriers to health as well as individual and family weight-related perceptions among parents and children. Thus, health promotion interventions should consider the family con-text; communication between parents and children related to weight and health; as well as parenting health practices. Parents play a critical role in cultivating positive weight-related attitudes and healthful behaviors for children. Youth is formative period in life where individuals are vulnerable to weight-related pressures in and out of the home environment.


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P1.07Early Childhood Exposure to Antibiotics and the Association with Microbiome Changes, Weight and Diabetes Later in Life: A Systematic ReviewArchita Srivastava2, Kim Chau1, Lyubov Lytvyn1, Henry Kwon3, Bradley C. Johnston1

1. The Hospital for Sick Children, Toronto, ON, Canada, 2. McMaster University, Hamilton, ON, Canada, 3. Wayne State University, Detroit, MI, USA

Background: The gut microbiota in early childhood is sensitive to modulating factors, such as antibiotic use, which can alter the microbiota and lead to an increased risk of disease later in life. This systematic review aims to evaluate the evidence on the potential impact of early and multiple antibiotic exposures on the gut microbiota and health outcomes later in life.Methods: A search of relevant databases was conducted from inception to June 2016. The keywords used included antibiotic, children, microbiome, overweight, obesity, diabetes.Ob-servational studies or randomized trials involving children (aged 0 to 18 years) evaluating the potential impact of antibiotics in early life on microbial diversity and the incidence of overweight, obesity and diabetes will be included.Target outcome measures include: micro-biota diversity, incidence of overweight (BMI ≥ 25), obesity (BMI ≥ 30), and diabetes (yes/no). Risk of bias and the quality (certainty) of the estimates using Grading of Recommenda-tions, Assessment, Development and Evaluation (GRADE) guidelines will be assessed.Results: Twenty-nine studies were included; twelve studies examined the impact on microbiota changes, thirteen on overweight and obesity, and four studies addressed diabetes. Full results will be presented at the meeting. Conclusions: It is estimated that children by the age of two have received approx-imately three courses of antibiotics and approximately ten courses by the age of ten years. Early-life antibiotic exposure may permanently disturb the microbiota. Find-ings will show the potential impact of antibiotics on health outcomes and highlight the potential importance of judicious use of antibiotics. P1.08Resting Metabolic Rate and Appetite Sensations are Not Affected by Different the Degree of Caloric Restriction: Preliminary DataLuzia J. Hintze4, 3, 1, Gary Goldfield2, 3, 1, Ryan Seguin4, 3, 1, Aleck Damphousse4, 3, 1, Eric Doucet4, 3, 1

1. University of Ottawa, Ottawa, ON, Canada, 2. Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada, 3. School of Human Kinetics, Ottawa, ON, Canada, 4. Behavioral Metabolic Research Unit, Ottawa, ON, Canada

Background: Energy restrictions promote metabolic adaptions in energy expenditure (EE) and energy intake (EI) that collectively decrease body weight and fat losses. However, it remains uncertain whether the degree of energy restiction impacts in the magnitude of the decrease in EE and increase in appetite and EI when weight loss is the same. Objective: To investigate the changes in resting EE, appetite and EI in women who lost the same amount of weight but were engaged in either FAST (-1000kcal, 10-week) or SLOW (-500kcal, 20-week) weight loss program.Methods: The data includes 12 women (5 SLOW and 7 FAST). Resting EE was assessed by indirect calorimetry and appetite ratings (Desire to eat, hunger, fullness and prospective food consumption=PFC) were measured using Visual Analogue Scale. EI was measured with a validated food menu.Results: Resting EE decreased in both groups (SLOW -5.35% FAST -2.81%, p=0.043), similarly to body weight (-6.7% SLOW –5.4% FAST, p<0.001). Fasting PFC increased after weight loss (p=0.05), while fasting hunger tended to increase (p= 0.09). Post prandial appetite was not changed after the program. EI tended to increase in the first week and to decrease by the end of the trial. The most important finding of this study is the absence of differences between the FAST and SLOW for all analyses performed.Conclusions: The preliminary results suggest that different degrees of caloric restriction promote a similar impact on resting EE, fasting appetite sensations and post prandial appetite in women, when final weight losses are similar between groups.

P1.09Clinical Correlations of 2-Hour and 5-Hour Glucose Tolerance Tests in Subjects with ObesityMarcela Rodriguez Flores, Emma Chavez Manzanera, Carlos A. Aguilar Salinas, Eduardo Garcia GarciaInstituto Nacional de Ciencias Medicas y Nutricion, Mexico City, DF, Mexico

Background: Monophasic and biphasic curves in the oral glucose tolerance test (OGTT) identify different patterns of insulin secretion and sensitivity which could predict feeding responses and progression to type 2 diabetes (T2DM). We assessed the impact of a 6-month obesity program according with the participants’ response to a 2-hour and 5-hour OGTT.Methods: Five hundred and ninety-nine men and women with obesity (mean BMI 44±8 kg/m2) aged 37.7±10 years participated in a six-month medical obesity treat-ment program which included counseling to reduce overeating and hypoglycemia. Participants underwent a 2-hour OGTT, and 108 patients had an extended 5-hour test in order to confirm hypoglycemia and/or hyperinsulinemia. Levels of weight loss (WL), and remission of comorbidities were determined according with three different patterns in the OGTT: Hypoglycemia, monophasic, and biphasic curves.Results: Among study participants, 22% had glucose intolerance, 34% had T2DM, and 22% and 31% had biphasic and monophasic patterns, respectively. Men had higher early (basal to 90’) insulin, hypoglycemia and hypertension than women, and women were more likely to have a biphasic pattern and higher glucose from 90’ to 3 hours in the OGTT (p<0.05). The monophasic pattern in the 2-hour OGTT was associated with higher fasting glucose, triglycerides, hypertension, 60’ and 90’ insulin, and new onset T2DM, and with less hypoglycemia (p<0.05), but not in the 5-hour OGTT. WL was only positively associated with presence of hypoglycemia.Conclusion: The monophasic response was associated with worse metabolic profile, which was more prevalent in men with obesity, despite achieving higher WL. P1.10Obesity, Depression and Erysipelas a Clinical Correlation in WorkersSana Ahmed1, Musleh Uddin Kalar2

1. ST International, Lahore, Pakistan, 2. Qureshi Clinic of Family Medicine, Karachi, PakistanObjective: To determine the association of obesity with depression and erysipelas. Introduction: Population based studies have found associations between obesity and depression and researchers have utilized body mass index (BMI) to establish obesity. Probable intervening factors include deprived physical health associated with depres-sion. Erysipelas is an infectious disease of the dermis and subcutaneous tissue due to streptococci. Obesity is a well known risk factor for erysipelas. Methods: Sample size was estimated by using the World Health Organization (W.H.O) software. BMI was assessed from the National Heart, Lung, and Blood Institute U.S. Department of Health and Human Services website. Depression was assessed from Patient Health Questionnaire (PHQ-9) scores and Erysipelas was diagnosed by dermatologist. Predictor or independent variable was obesity and response or depen-dent variables were depression and erysipelas. Binary logistic regression analysis was used to determine the association between dependent and independent variables with a threshold for selection of p<0.05 as statistically significant. Results: Among the sample of 100 workers, 25% were obese and among them 15% had depression and 5% had erysipelas. Binary logistic regression analysis showed depression was (OR 1.77; 95% (CI): 1.57-2.84) and erysipelas was (OR 1.14; 95% (CI): 1.05-2.69), were statistically significant (p<0.001). Conclusion: This study found an association between obesity, depression and erysipelas. Obesity was an independent risk factor for depression and erysipelas. Prospective studies should explore obesity as a possible mediator in the relationship between obesity, depression and erysipelas among workers.


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P1.11Body Mass Index and Risk of Dementia: a Retrospective Cohort Study of 513,775 Korean AdultsKyoung Hwa Ha1, Hyeon Chang Kim2, Dae Jung Kim1

1. Ajou University School of Medicine, Suwon, Korea, 2. Yonsei University College of Medicine, Seoul, Korea

Objective: We investigated the association between body mass index and the risk of Alzheimer’s disease and vascular dementia in a nationwide sample of Korean adults.Methods: Study population was randomly sampled 513,775 adults who were aged 40 years or older and completed health screening tests conducted by the Korea National Health Insurance (NHI) in 2002 or 2003. Body mass index (BMI) was classified into five groups: underweight (<18.5 kg/m2), normal (18.5–22.9 kg/m2), overweight (23.0–24.9 kg/m2), obese class I (25.0–29.9 kg/m2) and obese class II (≥30.0 kg/m2). Diagnoses of Alzheimer’s disease and vascular dementia over 10 years (2004 through 2013) were abstracted from the NHI claim database. Cox proportional hazard regression analysis was conducted with adjusting for age, sex, smoking, alcohol consumption, exercise, and preexisting diseases (diabetes, hypertension, and myocardial infarction). Results: Adjusted hazard ratio (95% confidence interval) for Alzheimer’s disease was 1.08 (1.00-1.16) for underweight, 0.95 (0.92-0.98) for overweight, 0.92 (0.89-0.96) for obese class I, and 0.92 (0.85-1.00) for obese class II, when compared to normal weight. Corresponding hazard ratio (95% confidence interval) for vascular dementia was 0.89 (0.80-0.99), 1.03 (0.98-1.08), 1.04 (0.99-1.09) and 1.02 (0.91-1.14), respectively.Conclusion: Our findings suggested that lower BMI is associated with higher risk of Alzheimer’s disease, but lower risk of vascular dementia. However, obesity seems not to be associated with dementia risk in the Korean adult population.*This research was supported by a grant of the Korea Health Technology R&D Project through the KHIDI, funded by the Ministry of Health & Welfare, Korea (HI13C0715). P1.12Coffee, but not Its Bioactive Compounds, Alleviates Weight Gain, Insulin Resistance, and Liver Steatosis in a Model of Diet-Induced Metabolic SyndromePedram Shokouh1, 2, Per B. Jeppesen1, Kjeld Hermansen3, Christoffer Laustsen4, Mette S. Schmedes5, Hans Stødkilde-Jørgensen4, Søren Gregersen3

1. Department of Clinical Medicine, Aarhus University, Aarhus C, Denmark, 2. The Danish Diabetes Academy, Odense University Hospital, Odense C, Denmark, 3. Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus C, Denmark, 4. MR Research Centre, Aarhus University Hospital Skejby, Aarhus N, Denmark, 5. Department of Food Science, Faculty of Agricultural Sciences, Aarhus University, Årslev, Denmark

Background: Coffee is indicated to mitigate adiposity and insulin resistance (IR), the main features of the metabolic syndrome (MetS). So far, responsible compounds remain elusive. We aimed to compare in-vivo the effects of unfiltered coffee with its main bioactive compounds.Methods: 24 male Sprague-Dawley rats were fed for 14 weeks a high-fat (35%W) food plus 20%W fructose in drinking water, and were randomized into three groups: control, coffee, or chemicals (3-O-caffeoylquinic acid, caffeic acid, and trigonelline). Coffee or chemicals were mixed with drinking water and provided in a dosage equal to 4–5 cups/day in an adult.Results: Coffee decreased food intake and rate and amount of weight gain. Estimated average plasma glucose and surrogate measures of IR (fasting insulin, HOMA-IR, and oral glucose tolerance) were improved only in the coffee group. Liver fat content and plasma triglycerides levels were concomitantly reduced in the coffee group. Coffee augmented RNA expression of Lpl, Pik3ca, Akt2, Cpt1b genes in skel-etal muscle. Liver hyperpolarized-pyruvate MRI did not show significant differences

in the concentration of main pyruvate metabolites. Average urine trigonelline level was 0.0002 mmol/L in control, 0.0377 mmol/L in coffee, and 0.0249 mmol/L in chemicals group at the endpoint.Conclusion: A combination of phenolic acids and trigonelline did not have the same level of effectiveness as coffee in improving the components of the MetS. This finding points to the possible role of other coffee chemicals, and also to the potential synergism between them. More complex combinations need to be evaluated in the future studies. P1.13Discordance of Perceived Weight Status in Canadian University StudentsRenita Lam1, June I. Matthews1, Paula D. Dworatzek1

1. School of Food and Nutritional Sciences, Brescia at Western University, London, ON, Canada, 2. Schulich Interfaculty Program in Public Health, Western University, London, ON, Canada

Objectives: This study aims to investigate university students’ perceptions of their own weight status (underweight, normal, overweight, obese) and the concordance of these perceptions with body mass index (BMI), as well as their weight changes during post-secondary education.Methods: An online survey was sent to all 30,310 undergraduate students at West-ern University inquiring about weight perceptions, self-reported height and weight, and weight change during university.Results: The final sample consisted of 6591 respondents. The majority of students (73.2%) had concordant weight perceptions. Greater proportions of males (35.4%) than females (23.6%) had discordant weight perceptions in relation to their BMI category (p<0.001). Discordant weight perceptions were least likely to occur in the normal weight category (16.0%), compared to the remaining BMI categories of underweight (51.1%), overweight (50.9%), and obese (82.5%) (p<0.001). The majority (83.6%) of normal-weight males with discordant perceptions perceived themselves as underweight, whereas the majority (83.5%) of normal-weight females with discordant perceptions perceived themselves to be overweight. High proportions of discordant males and females in the overweight BMI category considered themselves normal weight (97.7% and 91.9%, respectively). Compared to females, males were significantly more likely to gain weight intentionally during university (5.3% vs. 50.4%, respectively; p<0.001). Conclusion: Although the majority of students had concordant weight perceptions, over a quarter had discordant perceptions. Discordance differed by sex in nor-mal-weight students, but overweight males and females perceived themselves as normal weight. Students who are overweight, but do not recognize it, are unlikely to engage in weight management behaviours. P1.14How Does Obesity Affect the Endocrine System?Megha Poddar, VT ChettyMcMaster University, Hamilton, ON, Canada

Obesity is a chronic, relapsing, medical condition that results from an imbalance of energy expenditure and consumption. It is a leading cause of preventable illness, disability and premature death. The causes of obesity are multi-factorial and include behavioural, socio-economic, genetic, environmental and psychosocial factors. Rarely do endocrine diseases for example, hypothyroidism or Cushing’s disease cause obesity. What is less understood is how the obesogenic environment affects the endocrine system. In this poster review, we will discuss the impact of obesity on multiple endocrine systems including: the hypothalamic-pituitary axis, changes in vitamin D homeostasis, sex steroids and thyroid hormones. We will also examine the renin angiotensin aldosterone system and insulin pathophysiology associated with obesity. We will provide a general overview of the biochemical changes that can be seen in patients with obesity; review possible etiologies of these changes and briefly consider current guidelines on their management.


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P1.15Gestational Weight Gain and Childhood Body Mass Index Trajectories: a Primary Care Nova Scotia Cohort Study Using EMR DataHelena Piccinini-Vallis, Emily BurkeDalhousie University, Halifax, NS, Canada

Introduction: A risk factors for the development of childhood obesity is guideline concordance of women’s gestational weight gain. Children whose mothers gained weight in excess of the guidelines are at higher risk of being obese than children whose mothers gained weight within those recommendations. In NS, 58.4 % of wom-en gain excess weight during pregnancy. Therefore, a high percentage of our children are at risk of becoming obese. In NS, most prenatal care for low risk pregnancies and routine infant/child care occur in the primary care setting. However, no studies have linked these primary care data and compared women’s gestational weight gain concordance with guidelines to the BMI trajectories of their children. The present study was a proof of concept that these samples could be accurately identified and linked to one another in a community-based primary care EMR.Method: This is a retrospective cohort study using EMR data in the Dalhousie Family Medicine clinics. Women’s gestational weight gain was categorized as falling below, within, or above the 2009 IOM guidelines. Women were matched to their children via telephone numbers. Children’s BMI calculations were compared at several time points.Results: 111 mother-child dyads were identified. There were no significant differenc-es in children’s BMI by mother’s guideline concordance, although there was a trend for children whose mothers had gained below the guidelines to have a higher BMI. P1.16Nova Scotia Women’s Gestational Weight Gain GoalsHelena Piccinini-Vallis, Genna BourgetDalhousie University, Halifax, NS, Canada

Introduction: Excessive gestational weight gain (GWG) is associated with adverse outcomes for mothers and their offspring. Guidelines for optimal GWG, based on pre-pregnancy body mass index (BMI) categories, include those published in 2009 by the Institute of Medicine (IOM). However, less than one-third of pregnant women gain weight within the recommended amounts, in part due to women’s lack of knowledge about the guidelines. Objective: The objective of this study was to compare women’s GWG goals using the Theory of Planned Behaviour as a framework, to their actual GWG. The Theory of Planned Behaviour links beliefs (attitudes toward a behaviour, subjective norms, and perceived behavioural control) to an individual’s behavioural intentions and actual behaviours.Method: The Department of Family Medicine at Dalhousie University has two com-munity-based, comprehensive primary care teaching clinics that provide prenatal care to approximately 120 women per year. Over a 6-month period, all women registering at these clinics for their first prenatal visit were asked to complete a questionnaire that measured demographic information and explored their beliefs about GWG.Results: Sixty women participated in the study (94% response rate). Data on actual GWG are still being collected as not all women have delivered yet. Final analyses will occur when all these data are available.

P1.17Sustainability of Comprehensive School Health on Body Weight, Healthy Eating and Physical ActivityNicole N. Ofosu, Kerry A. Bastian, John P. Ekwaru, John C. Spence, Kate Storey, Paul J. VeugelersUniversity of Alberta, Edmonton, AB, Canada

Background: The Comprehensive School Health program, Alberta Project Promoting active Living and healthy Eating in Schools (APPLE Schools), has demonstrated bene-ficial effects on diet, physical activity (PA) and body weight among elementary school grade 5 students (10–11 years old). However, the long-term effects remain unknown.Objective: To assess the sustainability of APPLE Schools effects on healthy eating, PA and body weight.Methods: In the 2015/2016 school year, junior high and high schools (grades 7–12) with both APPLE Schools and non-APPLE elementary schools graduates completed a survey including a 24-hour dietary recall, PA - pedometer-measured step count, and measured height and weight. Multilevel regression methods were used to analyse the changes in diet, steps, and body weights among APPLE Schools and non-APPLE Schools graduates relative to 2008 and 2009 baseline data.Results: APPLE Schools had a positive intervention effect on obesity (OR = 0.39; p=0.037). PA declined in both groups, between 2009 and 2015/2016, though the decline was less pronounced among APPLE Schools graduates (APPLE Schools: -1479 steps/day; p =0.004 and Comparison Schools: -2658 steps/day; p<0.001). Mean servings of vegetables and fruit/day also declined for both groups between 2009 and 2015/2016 (APPLE Schools: 5.98 ± 4.34 to 5.51 ± 4.12 and Comparison Schools: 3.65 ± 2.85 to 3.96 ± 3.53).Conclusion: These findings provide evidence for the sustainability of Comprehen-sive School Health effects on children’s body weight. P2.01Formulate, Innovate, Translate: the FIT Solution to Investigating Poten-tial Pathways and Mediators in the Environment-Obesity RelationTracie A. Barnett1, 2

1. Institut National de Recherche Scientifique, Laval, QC, Canada, 2. CR CHU Sainte-Justine, Montreal, QC, Canada

My program of research focuses on understanding how built environments and social influences contribute to youth’s weight status and how these can best be leveraged to promote healthy weight in youth. Streams include:1. Investigating potential mediating pathways in the environment-obesity relation2. Methodological and technological innovation to characterize obesity and lifestyle behaviours3. Translation to clinical applications and population health My lab consolidates socio-environmental measures with clinical data in order to support a range of original methodological, etiological, and applied research endeavours. The physical and social environments of several ongoing pediatric population-based and clinical studies have been assessed across space and time. Environmental measures include complete geographic and spatial data from multiple sources including on-site and desk-based audits using Google Street View, air-quality and noise, among many. Individual-level measures include indicators based on DEXA, accelerometry, GPS, sociometric badges, open-beacons/radio frequency ID and sleep trackers. Applications are used to map activity spaces and to measure social networks. In Stream 1 we test several hypotheses underlying potential (nocturnal and diurnal) pathways linking neighbour-hoods to obesity. Steam 2 projects are devising objective indicators of Screen Time and of Social Network Characteristics, which would otherwise rely on self-reports. Stream 3 projects are driven by evidence emerging from the etiologic studies, which inform inno-vative strategies for the treatment and prevention of pediatric obesity in a clinical setting. Overall, my program bridges research produced from state of the art methods to clinical innovation, and translates both to clinical applications and its public health extensions.


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P2.02Minimum Wage and Anthropometric Outcomes in Women: a Longitudi-nal Study of 24 Low-Income CountriesAnnalijn I. Conklin1, 2, Ninez A. Ponce2, Catherine M. Crespi2, John Frank3, Jody Heymann2

1. University of British Columbia, Vancouver, BC, Canada, 2. UCLA Fielding School of Public Health, Los Angeles, CA, USA, 3. The University of Edinburgh, Edinburgh, United Kingdom

Objectives: To examine whether an increase in minimum wage contributes to changes in weight status in women in low-income countries.Methods: Longitudinal study of country-level minimum wage data linked to anthro-pometric data on 150,796 non-pregnant adult women in 24 low-income countries, using separate multivariable multilevel growth models. Post-estimation analysis computed the adjusted mean prevalence difference and the relationship between minimum wage and predicted mean probabilities of being underweight or obese.Results: We found that a $10 per month increase in minimum wage was associated with a reduction in underweight in women that accelerated over time (p-interaction=0.025), becoming significant in 2013 (OR 0.986 [.977, .995]). The adjusted underweight prevalence difference was an average decrease of about 0.14 percentage points (PD -.0014 [-.0023, -.0005]). Rising minimum wage was also associated with greater obesity (OR 1.019 [1.008, 1.030]) but did not alter the pace of growth (p-interaction=0.8). A $10 increase in monthly minimum wage resulted in an average increase of about 0.1 percentage points in the adjusted prevalence difference in obesity (PD .0012 [.0004, .0020]).Conclusion: This is among the first longitudinal studies to assess the impact of improved wages on weight outcomes in low-income settings. While rising minimum wage showed a potentially insalubrious effect on obesity, this finding was outbalanced by the robust protective effect of rising minimum wage on under-weight, which strengthened over time. Thus, modest rises in minimum wage may be especially beneficial for addressing the protracted underweight problem in poor countries, particularly south Asia and central and east Africa. P2.03Toward Equity-Oriented Obesity-Related Health PromotionFrancine Darroch, Colleen Varcoe, Annette BrowneUniversity of British Columbia, Vancouver, BC, Canada

Pregnant and/or parenting women who are marginalized by poverty, racism, substance use, and trauma are at elevated risk of negative health outcomes in pregnancy and postpartum. Physical activity and prevention of excessive weight gain may be particularly relevant to address, given the high rates of intersecting issues of overweight/obesity, anxiety, depression, low self-esteem, and physical inactivity. The barriers to healthy pregnancy and postpartum outcomes are often more complex for women experiencing these kinds of social and health inequities. Obesity interventions during pregnancy and postpartum often neglect the lived experiences of women and fail to address the social determinants that impact women such as poverty, community infrastructure, racism, and colonialism. We argue that in order to adequately prevent obesity and address health inequities, there is a need to consider economic, social, cultural and systemic barriers to ensure marginalized women’s inclusion in and access to health resources and programs. Despite evidence of the benefits of physical activity for individuals who have experienced trauma, and although culturally safe and trauma-and violence informed care is increas-ingly integrated in health care, few strategies have focused on adapting these strategies obesity prevention programs. Drawing on lessons learned in healthcare where culturally safe and trauma-and violence informed care have had some successful uptake, we assert that there is a need for a similar approach to obesity interventions. The objective of this presentation is to identify opportunities for integrating culturally safe and trauma-and violence informed physical activity and wellness programming/resources for women experiencing marginalization in Canada.

P2.04Diet Quality in Relation to Metabolic Syndrome in Cree (Eeyouch) from James Bay, Northern Québec, CanadaMathilde Lavigne-Robichaud1, 2, Jean-Claude Moubarac3, Stéfanie Lantagne-Lopez1, 2, Louise Johnson-Down4, Malek Batal3, Elhadji A. Laouan Sidi1, Michel Lucas1, 2

1. Population Health and Optimal Health Practices Research Unit, CHU de Québec Research Centre, Québec, QC, Canada, 2. Department of Social & Preventive Medi-cine, Laval Univeristy, Québec, QC, Canada, 3. TRANSNUT, Department of Nutrition, Faculty of Medicine, University of Montreal, Montreal, QC, Canada, 4. Centre for Indigenous Peoples’ Nutrition and Environment, School of Dietetics and Human Nutrition, McGill University, Montreal, QC, Canada

Objective: To assess the associations between 3 diet quality indexes and metabolic syndrome (MetS) among James Bay Cree (Eeyouch).Methods: Part of the cross-sectional “Nituuchischaayihititaau Aschii” study, 811 adults Eeyouch (355 men, 476 women) from 7 communities in northern Quebec were surveyed study. Three dietary score were calculated from 24-hour food recalls: 1) the alterna-tive-Healthy Eating Index (aHEI-2010), 2) the Food Quality Score (FQS) and 3) the dietary share of Ultra-Processed Products (UPP) according to the Nova Classification. Presence of MetS was based on the International Diabetes Federation. Logistic regressions were used to assess the relationship between dietary scores quintiles with the presence of MetS.Results: MetS prevalence is 56.5% in our sample with 95.4% rates of abdominal adiposity, 50.1% of elevated fasting plasma glucose, 43.4% of high blood pressure, 38.6% of elevated triglycerides and 44.5% reduced high-density lipoprotein cholester-ol (HDL-C). When comparing highest to lowest quintiles adjusted odds ratio (OR) was 0.63 [95 % CI: 0.38-1.05; p-trend=0.05] for aHEI-2010 and 1.04 [95 % CI: 0.62-1.74, p-trend=0.87] for FQS. A higher consumption of UPP (NOVA Classification) was signifi-cantly associated with MetS (OR=1.93 [95 % CI: 1.15-3.21; p-trend=0.04].Conclusions: Although poor diet quality has been associated with increased cardiomet-abolic risk factors, only the dietary share of UPP from the NOVA classification revealed a significant association with MetS in the context of Eeyouch communities from northern Quebec. Indexes tailored to the environmental food context of northern communities are essential to further understand the impact of diet quality in these communities. P2.05Are Dental Caries and Trachoma Associated with Weight Status Among Chinese Children?Jian LiuBrock University, St. Catharines, ON, Canada

Dental caries and trachoma are two common diseases among developing country children. To examine if they are associated with children’s weight status we used the data collected from two screening surveys conducted in Cities of Changsha and Shenzhen, China, in which 5,900 were recruited. Weight and height were measured and BMI was calculated as weight (kg) divided by height (m2). The information of decayed/filled teeth counts of primary den-tition and trachoma were obtained from school general health examination records (SGER). After excluding those who had missing information on weight, height, and SGER, a total of 4,090 (2,197 boys and 1,893 girls) aged 5–9 yrs old were included in this analysis. BMI was standardized for age and sex and conversed to a BMI z-score. Using BMI z-score, subjects were categorized into: underweight (<-2), normal weight (~1.03), overweight (~1.64), and obese (>1.64). Overall, approximately 5.5% of children were underweight and 18% of children were overweight or obese. In comparing to the normal weight, after adjusted for age, gender, grade, and city surveyed, the odds ratios (OR, [95% CI]) of dental caries for underweight, overweight, and obese were 1.12 (0.84–1.49), 0.70 (0.56–0.86), and 0.62 (0.48–0.79), respectively (p for trends <.001); while the ORs of trachoma were 1.65 (0.94–-2.89), 0.90 (0.52–1.57), and 1.92 (1.20 –3.06), respectively. This suggests that dental caries and trachoma are associated with weight status among these Chinese children, but further study may be needed to explore the underlying mechanism for the observed phenomena.


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P2.06Proportional Responsibility vs Individual Responsibility for Diet and Obesity in the Food System: a Complex Systems AnalysisNatalie Savona1, Claire Thompson1, Dianna Smith2, Harry Rutter1, Steven Cummins1

1. London School of Hygiene & Tropical Medicine, London, United Kingdom, 2. University of Southampton, Southampton, United Kingdom

Most interventions to reduce obesity prevalence rely on individuals taking responsi-bility for their health, for example, by using information to make healthy food choices; on a population level, many such interventions are ineffectual. This paper reports on research examining the discourse of ‘responsibility’ for healthy eating, viewed using a complex systems approach. ‘Responsibility’ provides a framework for examining the impact of the food system – as opposed to single variables – on the public’s diet. Qual-itative analysis of corporate and government documents informed focus groups with the public and interviews with representatives from the food industry, government and non-governmental organisations in the United Kingdom. The data show that despite claims of collective responsibility for dietary behaviour, government and corporations use rhetoric and measures that instead emphasise individual responsibility. They also favour ‘downstream’, individual-level interventions such as food labelling rather than more effective, upstream regulatory or fiscal strategies. Problematising the idea of responsibility has highlighted how individuals are allocated most responsibility within the system for their food choices despite having least power over key determinants of those choices: taste, cost, convenience and promotions. Analysis using a complex systems approach helps explain how the mismatch between power and responsi-bility contributes to a food system in which many people are obese. ‘Proportional responsibility’ offers a counterfactual concept, which challenges the dominant policies that attribute ‘ultimate’ responsibility to individuals for maintaining a healthy weight, given that they have minimal influence over the determinants of their diets. P2.07The Effects of Culture on Guideline Discordant Gestational Weight Gain: A Systematic ReviewKathryn M. Denize1, Nina Acharya1, Zachary M. Ferraro2, Alysha L. Harvey1, Kristi B. Adamo1

1. University of Ottawa, Ottawa, ON, Canada, 2. Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada

Background: Discordant pregnancy weight gain, above or below Institute of Medicine (IOM) guidelines, increases the risk of negative health outcomes for both mom and baby. Currently, a large portion of women exceed or do not meet the IOM recommendations. Cul-ture has been identified as a key determinant in achieving appropriate gestational weight gain (GWG). However, the effects of culture on GWG have not been greatly explored. Objective: To systematically review the effect of culture on discordant GWG as defined by the 2009 IOM guidelines. Method: A search was run on the following databases: Ovid MEDLINE, Embase (Ovid), Cochrane, CINAHL, PsychINFO, LILACS, and CUMED, from 1946- July 2016. The search retrieved 1212 abstracts which were then reviewed by two researchers and inclusion/exclusion was assessed by pre-determined criteria. Full articles were reviewed for inclusion prior to data extraction. The final review consisted of 91 papers. Papers that used the current 2009 IOM guidelines were separated for quantitative review (35) and the remaining were analyzed qualitatively. Data was extracted using a standardized form by two independent researchers, with conflicts resolved by consensus. Risk of Bias will be assessed using a modified Cochrane assessment tool, and quality of evidence through the grading of recommendations, assessment, development, and evaluations (GRADE) Approach. Results and Conclusions: The findings from this review will synthesize the current knowledge on how culture influences discordant GWG. We hope to provide insight into culturally appropriate recommendations or feedback that will optimize maternal weight trajectory and downstream child outcomes.

P2.08Literature Review Obesity Research Pertaining to Sudbury’s Social Deter-minants of HealthJulia Cerilli, Christina Weglewski, Alannah Hawes, Chanelle Landriault, Chelsea Mateev, Kimberly Friesen, Rachel Askett, Camille Smith, Desiree Quenneville, Jaimie Geist, Basem Gohar, Taylor Duhamel, Maggie McDougallLaurentian University, Sudbury, ON, Canada

A Statistics Canada (statcan) study revealed that Sudbury has the second highest obesity rate in Canadian Census Metropolitan Areas (CMAs). Surprisingly, there is a lack of research in this particular region that could explain such an alarming statistic. A literature review was conducted to identify gaps and supporting articles that could aide in our understanding of Sudbury’s obesity rates. Using the Social Determinants of Health Model to sift through the literature, it was determined that further research is required to gain better understandings of Sudbury’s unique characteristics. These findings have lead to the development of a research project to further identify Sudbury specific correlates. P2.09Exploring the Effects of Family Characteristics on Indigenous Youth’s Participation in Physical Activity and SportPiotr Wilk1, Alana Maltby1, Martin Cooke2

1. Western University, London, ON, Canada, 2. University of Waterloo, Waterloo, ON, Canada

Objective: Physical activity contributes to the physical, emotional, intellectual, and social dimensions of health and well-being. Unfortunately, participation in physical activity and sport tends to decrease with age, with youth spending less time being active than children. The purpose of this cross-sectional study is to explore the effect of family characteristics (i.e., parental residential school attendance, parental educa-tion, household income, and parental involvement in education) on participation in physical activity and sport among off-reserve Indigenous youth.Methods: Employing the 2012 APS data, the analysis was limited to those who were between the age of 12 and 17, who attended elementary or high school and identified as having single Indigenous identity: First Nations, Métis and Inuit (N=4,910). The analysis was conducted using structural equation modelling tech-niques with observed and latent variables.Results: Parental involvement was found to have a significant effect on participation in physical activity and sport. Furthermore, residential schooling (for both parents) has a nega-tive effect on education and mother’s residential schooling has a positive effect on income, whereas father’s residential schooling has a negative effect on income. Income and father’s education have a positive effect on parental involvement (mother’s education does not). Additionally, income has a direct positive effect on participation in physical activity and sport.Conclusions: The findings suggest that parental involvement plays an important role in mediating the effect of family characteristics on physical activity and sport participation among Indigenous youth. Encouraging parental involvement in youth’s education may be beneficial for promoting increased active behaviours. P2.10Designing Seating Solutions for Persons with Obesity: An Inter-Profes-sional CollaborationMary Forhan, Robert Lederer, Greig RasmussenUniversity of Alberta, Edmonton, AB, Canada

Purpose: Persons living with obesity face many challenges in their everyday lives interacting with objects in the built environment. A considerable problem is finding a suitable place to sit. Most of the chairs that inhabit domestic, work and public spaces are designed with little or no consideration for this user group.Method: A team of instructors from industrial design and rehabilitation medicine offered a course to students enrolled in an industrial design program. The purpose


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of this course was to design a seating solution for persons with obesity. Students spent time in the classroom learning about obesity. Then students spent time interviewing persons living with obesity (clients) to gather information to inform their design. Each student prepared design models and presented them to their clients for feedback.Results: Several diverse seating options were designed and rendered in small-scale models that aim to provide bariatric sensitive and appropriate solutions for use in the community, home and work setting.Conclusion: An inter-professional course in industrial design was effective in producing a range of viable design solutions aimed to foster opportunities for accessible seating for persons living with obesity. P3.01Estimations of Calorie Content of Meals Before and After a Menu Labelling InterventionLana Vanderlee1, 2, Rhona Hanning2, Christian Boudreau2, David Hammond2

1. University of Toronto, Toronto, ON, Canada, 2. University of Waterloo, Waterloo, ON, Canada

Menu labelling is an intervention intended to inform consumers of the energy content of food items in restaurant settings and positively influence eating habits. The current study aimed to examine the influence of menu labelling on consumers’ ability to estimate the calorie content of their meal purchases. Three waves of intercept surveys were conducted at an ‘intervention’ cafeteria and a ‘comparison’ cafeteria, before and after menu labelling was implemented in the intervention cafeteria, with an additional one-year follow-up. Participants who had purchased food in the cafeteria self-reported food and drink items purchased, whether they had noticed menu labelling, and estimated the calorie content for each food and drink item purchased. 2,084 participants had estimates that could be matched with objective nutritional information. Of the sample, 55% noticed menu labelling in the cafeteria, and 13% of the sample were able to accurately estimate the calorie content of their meal within 50 kcal of the actual content. Similar proportions over-estimated (33%) and underestimated (29%) calorie content. There were no significant differences between sites over time in the proportion correctly estimating calorie content; however, those who noticed menu labelling were more likely to correctly estimate the calorie content (p=0.03), as were females (p=0.02), those with higher income (p=0.01) and those who knew daily estimated energy requirements (p=0.006). This study suggests that the impact of the menu labelling intervention was limited to those who noticed nutrition information and some demographic subgroups, and the overall impact on calorie estimation among the general population was limited. P4.01Preoperative Endoscopic Evaluation in Bariatric SurgeryBehzad Jodeiri, Alireza KhalajShahed University, Tehran, Iran

Background: In growing of bariatric surgery as a well-known procedure for treatment of obesity and metabolic disorder, preoperative evaluation has become really important. The purpose of this study was to evaluate the diagnostic yield and incidence of endoscopic finding in large amount of patient in a referral center for bariatric surgery.Methods: During the study period, 522 patients were evaluated by upper endoscopy prior to bariatric surgery in our referral clinic (obesity treatment center of Tehran). The medical records of consecutive obese patients who underwent EGD prior to bariatric surgery between September 2013 and Jun 2015 were reviewed. All data from patient including patient observation, history and endoscopic finding was investigate. Endoscopies were done with two expert endoscopists and experienced endoscopists reviewed all EGD reports.Results: Endoscopic procedures were shown 58.4% of patients have significant

findings The prevalence of endoscopic findings was as follows: gasteroesophageal reflux 26.1%, hiatal hernia 22%, peptic ulcer disease 8.8%, esophageal Barrett’s mu-cosa 1%.There was significant relationship between BMI (body mass index) and reflux disease(p=0.042). Pylori infection was seen in 32.6% of obese patient .The results did not show relationship between endoscopic finding and patient observation.Conclusion: In our patient, endoscopic findings were relatively common and im-portant that maybe change surgical approach and preoperation planning. Routine upper endoscopy before bariatric surgery has a high diagnostic yield and may be reduced postoperative complication. P4.02Is Depressive Status Associated with Preoperative Weight and Problemat-ic Eating Behaviours Among Candidates for Bariatric Surgery?Cassandre A. Julien1, 2, Kim L. Lavoie1, 2, Mélanie Béland1, 5, Henri Atlas4, Ronald Denis4, Pierre Garneau4, Radu Pescarus4, Simon L. Bacon1, 3

1. Montreal Behavioural Medicine Centre (MBMC) at Hôpital du Sacré-Coeur de Montréal (CIUSS-NIM), Montreal, QC, Canada, 2. Department of Psychology, Université du Québec à Montréal, Montréal, QC, Canada, 3. Department of Exercise Science, Concordia Univer-sity, Montreal, QC, Canada, 4. Department of Surgery, Université de Montréal, Montreal, QC, Canada, 5. Department of Psychology, Concordia University, Montreal, QC, Canada

Background: Obesity is associated with high levels of psychological stress and problematic eating behaviours, including emotional eating and eating disorders. However, little is known about potential psychological contributors to weight outcomes in bariatric surgery patients. This study sought to: evaluate whether depression and eating patterns were associated with presurgical weight (absolute weight [Kg] and body mass index [BMI]); and whether depression was associated with eating patterns, in patients awaiting bariatric surgery.Methods: 116 obese patients seeking bariatric surgery (75% women; M[SD] age=46[12] yrs; M[SD] BMI=51[10] kg/m2) were recruited for participation in the Canadian REBORN (REsearch on Bariatric care for Obesity tReatmeNt) cohort study. All patients underwent an interview, had their weight and height measured, and completed the Beck Depression Inventory (BDI-II) and the Dutch Eating Behavior Questionnaire (DEBQ) on the day of their preoperative visit (6-months pre-surgery).Results: Linear regressions, adjusting for age and sex, showed that neither BDI-II nor DEBQ were associated with weight and BMI. However, increased severity of depressive symptoms were significantly associated with increased levels of emotional eating (β=4.96, p=.02) and external eating (β=2.44, p=.019), but not restrained eating (β=-0.93, p=.432). Conclusion: These results suggest that depressive status and eating behaviour patterns are not associated with pre-bariatric surgery weight. However, those with higher depressive symptoms had a greater tendency to eat in response to negative emotions (emotional eating) and food related stimuli (external eating), suggesting that depression may increase problematic eating behaviours in bariatric patients. This may, in turn, have negative implications for patients’ post-operative outcomes. P4.03The NL Bariatric Surgery Cohort Study: Improvement and Remission of Prediabetes and Type 2 Diabetes Mellitus 2 years after Laparoscopic Sleeve GastrectomyKendra K. Lester, Laurie K. Twells, Deborah M. Gregory, Christopher S. KovacsMemorial University, St. John’s, NL, Canada

Objective: To evaluate laparoscopic sleeve gastrectomy (LSG) and its effectiveness on glycemic control in patients with prediabetes and type 2 diabetes mellitus (T2DM).Methods: Patients (n=201) undergoing LSG between May 2011 and May 2014 were followed prospectively. Pre-surgery, patients were defined as prediabetic (HbA1c: 6.0 – 6.4% or FPG: 6.1 – 6.9 mmol/L) or diabetic (HbA1c ≥ 6.5% or FPG ≥ 7.0 mmol/L, self-reported, or antidiabetic medication use). Glycemic control

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and medication use were evaluated at 3, 6, 12, 18, and 24 months post-surgery. Improvement or remission was based on pre-defined criteria related to glycemic control and medication use for a duration of 12 months.Results: Pre-surgery, 28(13.9%) patients with prediabetes and 84(41.8%) with T2DM were identified. Follow-up data was available for 16(57.1%) prediabetics [A1c 5.9(0.3); FPG 5.8(0.6)] and 54 (64.3%) T2DM individuals [A1c 8.0(1.5); FPG 8.7(3.1)]. 13 (81.3%) prediabetics achieved remission [∆A1c -0.6(0.3); ∆FPG -0.7(0.7)] on average in 12.9(3.0) months and 3(18.8%) had no change [∆A1c -0.3(0.2); ∆FPG -0.2(0.5)]. 16(29.6%) T2DM patients achieved complete remission [∆A1c -1.6(0.9); ∆FPG -2.6(2.3)], 8(14.8%) partial remission [∆A1c -1.9(1.3); ∆FPG -2.7(2.0)], 7(13.0%) improvement [∆A1c -1.9(1.4); ∆FPG -2.4(1.2)], and 23(42.6%) had no change [∆A1c -1.7(1.5); ∆FPG -2.5(3.8)]. 24 diabetics achieved remission in an average of 18.4(5.8) months and median time to remission was 23.8 months. All changes were significant (p<.05) except for the no change prediabetic group. 22 (52.4%) of 42 diabetics who completed follow-up no longer take antidiabetic medications.Conclusions: LSG leads to remissions and sustained improvements in glycemic control for prediabetes and T2DM. P4.04A Comparison of Circular- vs. Linear-Stapled Gastrojejunostomy in Lapa-roscopic Roux-en-Y Gastric Bypass (LRYGB) in a Tertiary Care HospitalSarah Miller1, Erwin Karreman2, Steven Pooler3

1. Department of Surgery, College of Medicine, University of Saskatchewan, Saska-toon, SK, Canada, 2. Research and Health Information Services, Regina Qu’Appelle Health Region, Regina, SK, Canada, 3. Department of Surgery, Regina Qu’Appelle Health Region, Regina, SK, Canada

Objectives: Since the introduction of LRYGB, there has been considerable debate about the preference for circular- versus linear-stapled anastomoses based on surgical outcomes. Long-term follow-up data is lacking and as a result, no conclusion about which technique is superior exists. Our research focuses on the differences in success and complication rates between patients undergoing LRYGB procedures using either circular or linear staplers. Methods: A retrospective chart review of LRYGB procedures between 2009-2014 was completed. Average total percent weight loss (TWL) and the incidence of anas-tomotic leak, marginal ulceration, wound infection, and strictures were compared using a repeated measures ANOVA. Complication rates were compared using the Chi-square test. The study was approved through the Research Ethics Board within our health region and university. Results: Of 229 charts, procedures with linear and circular staplers totaled 148 and 81. Data from 59 charts reached a 24-month follow-up. No statistically significant difference in TWL existed between staplers (25.8% circular, 27.9% linear, p>.05). Linear staplers were associated with statistically significant fewer infections (19.5% circular, 2.1% linear, p<.001) and strictures (16.0% circular, 1.4% linear, p<.001), while no statistically significant difference in incidence of marginal ulceration, anastomotic leaks, or bleeding existed.Conclusions: Given success rates, as measured by TWL, are similar between the two groups, utilizing the linear stapler would be preferred based on complication rates. Although there was no statistically significant difference in rates of ulceration, anastomotic leak, or bleeding, the circular stapler was found to be associated with higher rates of wound infections and strictures.

P4.05Association Between Physical Activity Intensity and Physical Capacity Among Individuals Awaiting Bariatric SurgeryBrittany V. Rioux1, Karen Kwok2, Jill Fox1, Dean Gamey3, Neha Bharti3, Ashley Vergis2, Krista Hardy2, Danielle R. Bouchard1, Martin Sénéchal1

1. Faculty of Kinesiology University of New Brunswick, Fredericton, NB, Canada, 2. Faculty of Health Sciences University of Manitoba, Winnipeg, MB, Canada, 3. Faculty of Kinesiolo-gy and Recreation Management University of Manitoba, Winnipeg, MB, Canada

Background: Physical activity is a routine component of lifestyle modification programs implemented prior to bariatric surgery, and one of the goals is to improve patients’ physical capacity. However, the physical activity intensity recommended to meet that goal is unknown.Objective: To assess the association between time spent at different physical activity intensities and physical capacity in patients awaiting bariatric surgery.Methods: A total of 39 women and 13 men were recruited. The primary outcome was physical capacity, measured using six objective tests: 6-Minute Walk, Chair Stand, Sit and Reach, Unipodal Balance (eyes open-eyes closed) and Hand Grip Strength Tests. The primary exposure variable was physical activity intensity (i.e. sedentary, light, moderate, and vigorous) measured by accelerometers.Results: The average body mass index (BMI) was 46.3 ± 5.4 kg/m2. Only 6% (percent) of total time was spent at moderate to vigorous intensity, while 71% was spent sedentary. When adjusted for BMI, age, and sex, four of the six physical capacity tests were significantly associated with moderate intensity physical activity, Beta (SE): 6-minute walk 9.7 (2.7), chair stand 0.3 (0.1), balance (eyes open) 1.8 (0.7), and hand grip strength 1.2 (0.4), and only the 6-minute walk was associated with sedentary activity 1.7 (0.7) (all p< 0.05).Conclusions: These results suggest that physical capacity is associated with time spent at moderate intensity physical activity in individuals awaiting bariatric surgery. The next step is to study if an increase in time spent at moderate intensity will translate to improvements in physical capacity. P4.06Impulse Control and Weight-Loss after Bariatric Surgery: The moderating effect of Emotion Self-RegulationTamara M. Williamson1, Joshua A. Rash1, Jo Ann Telfer2, Tavis S. Campbell1

1. Department of Psychology, University of Calgary, Calgary, AB, Canada, 2. Calgary Adult Bariat-ric Specialty Clinic, Richmond Road Diagnostic and Treatment Centre, Calgary, AB, Canada

Objective: We examined the association between pre-surgical emotion self-regulation (ESR) and impulse control, and weight-loss 12-months following bariatric surgery using a prospective design.Method: Treatment-seeking obese adults were recruited from a local clinic specializing in assessment and support for patients undergoing bariatric surgery. Participants completed the ESR subscale of the Schutte Emotional Intelligence Test (SSEIT) and the Adult Atten-tion-Deficit Hyperactivity Disorder (ADHD) Self-Report Scale (ASRS-v1.1) prior to surgery. Objective measures of body mass index (BMI) were obtained before surgery and 12-months following surgery to calculate percent excess weight loss (%EWL).Results: The sample consisted of 24 adults (80% female; mean age = 46.4 years, SD = 8.43; mean BMI = 52.49, SD = 12.72). Using hierarchical regression, there was a margin-ally significant ESR by ADHD interaction on %EWL, F(1, 20) = 2.93, p = .10, accounting for 10% of variance. This interaction was probed using the Johnson-Neyman technique which tests the conditional effects of ADHD on %EWL at every value of ESR. There was a significant negative association between ADHD and %EWL among individuals who scored below 29 on ESR (0.76 SD below the mean). Discussion: Emotion self-regulation moderated the association between symptoms of ADHD and %EWL, suggesting that impulse control problems may only be detrimental to weight loss outcomes following bariatric surgery for individuals deficient in ESR. This finding has implications for the mechanism by which symptoms of ADHD influence weight-loss following bariatric surgery.


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P4.07Psychotropic Medication Use in Individuals Pursuing Bariatric SurgeryRichard Yanofsky1, 2, 3, Susan Wnuk1, 3, 5, Azi Zheng3, Rachel Nauruzova3, Raed Hawa3, 4,

5, Sanjeev Sockalingam3, 4, 5

1. Department of Psychiatry, University of Toronto, Toronto, ON, Canada, 2. Medical Psychiatry Program, University Health Network, Toronto, ON, Canada, 3. Toronto Western Hospital Bariatric Surgery Psychosocial Program, Toronto, ON, Canada, 4. Department of Psychiatry, University of Toronto, Toronto, ON, Canada, 5. University Health Network, Toronto, ON, Canada

Objective: The aim of this study was to describe psychiatric medication use in indi-viduals seeking bariatric surgery. We investigated self-reported differences in quality of life (QOL) and disability between patients who did and did not use psychotropic medications and differences in demographic characteristics. Methods: Participants were patients enrolled in a bariatric surgery program seeking bariatric surgery. Psychotropic medication use, demographic variables, and self-reported quality of life and disability were analyzed. The 36-Item Short Form Health Survey was used to collect mental and physical QOL data, and the Sheehan Disability Scale was used to assess extent to which work/school, social life and home life or family responsibilities were impaired. Descriptive statistics were used to summarize psychotropic medication use and demographics. T-tests were run on continuous variables and chi-square analyses on categorical variables. Results: The sample of 1251 participants was 78.6% (percent) female and the mean age was 44.99. A total of 466 (37.3%) reported taking one or more psychotro-pic medication. The most commonly prescribed medications were antidepressants (30.4%) followed by benzodiazepines (8.2%). Older individuals were more likely to take medications, as were women (85%). Those taking psychotropic medications reported poorer physical and mental QOL and greater disability. Conclusions: Given the high rates of psychiatric medication use amongst bariatric surgery candidates and the correlation between psychotropic use and poorer QOL and disability scores in this population, it is important for health care practitioners to be aware of both psychiatric difficulties and work collaboratively with patients to address medication malabsorption issues post-surgery. P4.08Beyond BMI: NutriSTEP® for the Prevention, and Care and Management of Childhood ObesityLesley Andrade1, Tracy McDonough2

1. Sudbury & District Health Unit, Sudbury, ON, Canada, 2. KFLA Public Health, Kingston, ON, Canada

Purpose: To inform the use of nutritional screening for the prevention, and care and management of childhood obesity.Objectives: To describe factors influencing the uptake of NutriSTEP® in primary care. Methods: Semi-structured interviews were completed with primary care providers us-ing an interview guide based on a framework for effective implementation of prevention innovations. Thematic analysis was completed with NVivo.Results: Ten interviews were completed with primary care providers using NutriSTEP® as a primary prevention program. Factors that affected successful implementation included: Provider characteristics (e.g. perceived benefit of the innovation, self-efficacy); Characteristics of the innovation (e.g. compatibility, adaptability); Factors related to the prevention delivery system (e.g., organizational capacity, processes, staffing); Communi-ty-level factors; and Factors related to the prevention support system (e.g. training, tech-nical assistance). Primary care providers found using NutriSTEP® feasible and acceptable, and were interested in having it integrated into their Electronic Medical Records (EMRs).Conclusions: Successful implementation of NutriSTEP® requires EMR integration and the development of an evidence-based reference guide (i.e. key health educa-tion messages and local resources for referral) to support primary care providers in addressing nutritional screening results.

P4.09Intensive Gestational Glycemic Management and Childhood Obesity: A Systematic Review and Meta-AnalysisLaetitia Guillemette1, 2, Anita Durksen1, 2, Rasheda Rabbani1, 3, Ryan Zarychanski1, 3, Ahmed M. About-Setta1, 3, Todd A. Duhamel1, 4, Jonathan M. McGavock1, 2, Brandy Wicklow1, 2

1. University of Manitoba, Winnipeg, MB, Canada, 2. Children’s Hospital Research Insti-tute of Manitoba, Winnipeg, MB, Canada, 3. George & Fay Yee Center for Healthcare Innovation, Winnipeg, MB, Canada, 4. St. Boniface Hospital Albrechtsen Research Centre, Winnipeg, MB, Canada

Objective: Treating hyperglycemia in pregnancy reduces macrosomia; however it is unclear if this translates into reduced childhood obesity. We performed a systematic review and meta-analysis to evaluate the efficacy and safety of intensive glycemic management in pregnancy in preventing childhood obesity.Methods: We searched MEDLINE, EMBASE, CENTRAL, and ClinicalTrials.gov up to February 2016 and conference abstracts from 2010 to 2015. Two reviewers independently identified randomized controlled trials evaluating intensive glycemic management interventions for hy-perglycemia in pregnancy and included four of the 383 citations initially identified. Two review-ers independently extracted trial-level data with piloted forms and evaluated internal validity of included studies. Data was pooled using random effects models. The primary outcome was age- and sex-adjusted offspring obesity measured in childhood. Secondary outcomes included offspring waist circumference in childhood and maternal hypoglycemia during the trial.Results: The four eligible trials (n=767 children) similarly used lifestyle and insulin to manage gestational hyperglycemia. We found no association between intensive gestational glucose management and childhood obesity at 7-10 years of age (relative risk 0.89, 95% CI 0.65 to 1.22; 2 trials; n=568 children). Waist circumference also did not differ between treatment and control arms (mean difference -2.68 cm; 95% CI -8.17 to 2.81 cm; 2 trials; n=568 children).Conclusions: Intensive gestational glycemic management is not associated with reduced childhood obesity in offspring, but randomized data is scarce. Long-term follow up of trials should be prioritized and measures of metabolic risk should be captured in future studies. P4.10Effects of a Multidisciplinary Program of Obesity Treatment of Children and Adolescents that Performed a Water-Based Intervention: Difference Between Age GroupsMario M. Castilho1, Carlos A. Lopera1, Ronano P. Oliveira1, Luzia J. Hintze2, Nelson N. Junior1, Victor Hugo d. Medes1, João Carlos Locateli11. State University of Maringá, Maringá, PR, Brazil, 2. Ottawa of University, Ottawa, ON, Canada

Introduction: The obesity has been strongly linked with a high index of mortality world-wide. The multidisciplinary program of obesity treatment (MPOT) focus on the behavioral and lifestyle change. Aquatic exercise is been considered as efficient to treat obesity in adolescents, but biological differences can interfere the effects of a MPOT. Objective: To assess the effects of a MPOT on the body composition and health-related physical fitness (HRPF) of children and adolescents in different age groups.Methods: Pragmatic clinical trial quasi experimental composed by 67 children and adolescents (G1 = 10 to 12 years, G2 = 13 to 15 years, and G3 = 16 to 18 years), assessed both pre and post the intervention period. Were evaluated the anthropometric, body composition and HRPF vari-ables. Was used descriptive statistic (mean and standard deviation) and inferential (Paired t-tests and Wilcoxon to the comparison among different moments, and Anova with Scheffe’s post-hoc and Kruskal Wallis to the comparison among age groups). The significance level was settled in 5%.Results: Were verified significant differences between the sexes to almost all variables, except lean mass (LM) and manual grip strength. The age groups presented differences to WC (G2vsG3), body mass and lean mass (G3vsG1/G2) (p≤ 0,05).Conclusion: A 16-week MPOT was seen as efficient on the body composition and HRPF of children and adolescents; however, was only found significant differences on the body composition comparing age groups.


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P4.11Exploring Lifestyle Behaviors of Adolescents with Obesity in Weight Management: A Scoping Review and Stakeholder ConsultationMaryam Kebbe, Samah Damanhoury, Nadia Browne, Michele Dyson, Tara-Leigh McHugh, Geoff BallUniversity of Alberta, Edmonton, AB, Canada

Objective: To explore the barriers and enablers that adolescents with obesity experience when seeking healthy lifestyle behaviors. Methods: Six databases were searched for articles in English and French from 1980 to June 2016 (search update: December 2016). Articles were eligible for inclusion if the study focused on barriers and/or enablers encountered by 13–17-year-olds with obesity enrolled in a weight management clinic, program, or intervention in areas of nutrition, physical activity, sedentary behavior, and/or sleep. Retrieved articles were screened for eligibility by two independent reviewers; data charting, quality appraisal, and thematic analysis were then completed for included studies. Findings were enhanced by a stakeholder consultation with adolescents with obesity (n=20) and health care professionals (n=20) from Edmonton and Ottawa. Results: We included a total of 17 articles (all English; n=12 qualitative, n=3 mixed methods, n=2 quantitative). Barriers and enablers were grouped at the individual, interpersonal, and organizational levels for nutrition, physical activity, and sedentary behavior; no sleep-related barriers and/or enablers were identified. Limited pleasure in and lack of motivation towards physical activity, together with the availability of unhealthy foods, were the barriers of highest recurrence; of enablers, support at the family-, social-, and professional-level was the most frequently endorsed factor. Conclusions: Adolescents with obesity in pediatric weight management reported a range of barriers to and enablers of making and maintaining healthy lifestyle behavior changes. These data highlight the value of multi-level interventions (clinic, community, home, school) to help overcome barriers and build on enablers. P4.12Maternal Low-Dose Antibiotic Consumption During Pregnancy and Lacta-tion in Rats Increases Their Body Weight During Lactation But is Reversed with Prebiotic DietTeja Klancic, Ashley C. Choo, Nicole A. Cho, Heather A. Paul, Raylene A. ReimerUniversity of Calgary, Calgary, AB, Canada

Background: Antibiotics are the most widely prescribed therapeutic agents. Even though they are life-saving drugs, recent research suggests that early life exposure to antibiotics may increase infant’s risk of obesity. On the other hand, non-digestible prebiotics improve metabolic health resulting in lower body weight and fat mass. Our goal was to identify the potential of prebiotic supplementation during pregnancy and lactation to reduce antibiot-ic-associated obesity risk in Sprague-Dawley rats and their offspring. We hypothesized that adding prebiotics to the dams diet could mitigate antibiotic-induced obesity risk. Methods: 10 week old female Sprague-Dawley rats (n=60) were mated and random-ized into 1 of 4 groups: 1)control (water + AIN-93G diet), 2)antibiotic (low doses of penicillin (LDP) + AIN-93G diet), 3)prebiotic (water + 10% oligofructose (OFS) diet) or 4)antibiotic+prebiotic (LDP+10%OFS diet). Mothers received LDP via drinking water through the third week of pregnancy and lactation as described previously. Dams under-went oral glucose tolerance tests (OGTT) and insulin tolerance tests (ITT) at weaning. DXA was used to determine body composition. Results: Increased body weight during lactation was seen in LDP dams when compared to control, prebiotic and antibiotic+prebiotic groups (p<0.05). At weaning, no differenc-es in glucose levels during the ITT and OGTT was observed in LDP dams. Offspring were followed into adulthood and analysis on their body composition and insulin sensitivity is currently ongoing.Conclusion: Adding prebiotics to the dams diet reversed the antibiotic-associated increase in body weight in dams during lactation. Whether this provides protection for offspring obesity risk remains to be determined.

P4.13The Relationship of Fasting Plasma apoB48 to Cardiometabolic Risk Factors in AdolescentsJacqueline Krysa1, 2, Donna F. Vine1, Lawrence J. Beilin2, Trevor A. Mori2, Spencer D. Proctor1

1. University of Alberta, Edmonton, AB, Canada, 2. University of Western Australia, Perth, WA, Australia

Introduction: Obesity persists from childhood to adulthood and can increase cardiometabolic risk in early adulthood. Fat intolerance (the inability to efficiently metabolize lipids following a high-fat meal) is often observed in obesity and has been shown to be an independent marker of cardiovascular (CVD) risk. An accumulation of (intestinal derived) apoB48-remnant cholesterol following a high fat meal is indicative of fat intolerance. We have previously demonstrated that fasting plasma apoB48 is elevated two-fold in obese pre-pubertal children. However, it is unclear if impaired apoB48-rem-nant cholesterol in childhood remains elevated in obese adolescents.Objectives: To investigate fasting plasma apoB48 as an early biomarker of fat intol-erance and its relationship to other cardiometabolic risk factors in a large adolescent population.Methods: Fasting plasma apoB48, biochemical and anthropometry indices were mea-sured in a cross-sectional analysis of participants from the Western Australian Pregnancy Cohort (RAINE) study at age 17yrs (n=1045). Fasting plasma apoB48 was measured using ELISA, and multiple regression analyses examined the relationship between apoB48 and cardiometabolic risk factors.Results: Fasting plasma apoB48 was 19% higher in male compared to female adoles-cents, and was elevated 21% in adolescents at “high risk” of the metabolic syndrome. There was a positive association between fasting plasma apoB48 and triglyceride, total cholesterol, insulin, HOMA-IR, leptin, waist circumference, skinfold thickness measures. Fasting plasma apoB48 was also inversely associated with HDL-C, and adiponectin.Conclusion: Elevated apoB48-remnant cholesterol may track into adolescence and may be a useful biomarker to identify fat intolerance and cardiometabolic risk in youth. P4.14A Telehealth Program for the Treatment of Overweight and Obesity in Children: Baseline Characteristics of Program Evaluation ParticipantsAnne M. Lasinsky1, Tanis V. Mihalynuk2, Darren E. Warburton1, 3, Danika B. Dickson3, Donna Forsyth-Lukas2, Kiran Kalkat2, Genevieve Larrivee2, Barbara Leslie2, Shannon S. Bredin1, 3

1. University of British Columbia, Vancouver, BC, Canada, 2. Dietitian Services at HealthLink BC, Burnaby, BC, Canada, 3. The Physical Activity Line, Richmond, BC, Canada

Objective: To describe demographic, anthropometric, and behavioural character-istics of a sample of children enrolled in a telehealth program for the treatment of overweight and obesity.Methods: Participant information was obtained through physician referrals and questionnaires administered at program intake.Results: Of 203 children referred to the program, 50 (24.6%) participated in the program evaluation. Of those children included in the evaluation, 48% (n=24) were female and the average age was 11.5 yr (SD=3.4). Referral sources included: 14% (n=7) from a partner treatment program, 52% (n=26) from a physician, and 34% (n=17) self-referred. The geographic distribution of referrals was 18% (n=9) from rural/remote communities and 82% (n=41) from urban communities. Of those with a physician-measured BMI (n=42), 71% (n=30) were above the 99th percentile, 19% (n=8) were within the 95th to 99th percentile, and 10% (n=4) were below the 95th percentile. Children in the evaluation averaged 9.3 hr (SD = 2.2) of sleep per weeknight, although 83% (n=38) of children reported not meeting daily fruit and vegetable intake recommendations.Conclusions: While participants generally reported meeting sleep recommenda-tions, they may require specific counselling related to food and nutrition within a comprehensive physical activity and nutrition telehealth program.


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P4.15Obesity is Associated with Increased Asthma Prevalence and Asthma Related Health Service Use, in a Population Based Study of Nova Scotia ChildrenTeri D. Mccomber1, Crawford W. Revie1, Jennifer P. Taylor1, Paul J. Veugelers2

1. University of Prince Edward Island, Charlottetown, PE, Canada, 2. University of Alberta, Edmonton, AB, Canada

Objective: To determine the association between weight status and asthma prevalence, and asthma related health service usage among children in Nova Scotia (NS), Canada.Methods: Provincial administrative health records were linked with a province-wide school based survey of grade five NS students (n=5513) and used to identify asthma di-agnosis and frequency of asthma related health service visits over a six year period (ages 6–12y). Body mass index values were calculated from children’s measured height and weight; weight status was then categorized as healthy weight (HW), overweight (OW) or obese (OB). Logistic regression modeling was used for the asthma diagnosis outcome, while negative binomial modeling was used for the frequency of asthma related health service use, with weight status as the predictor for both. All models were adjusted by sex, parent income, parent education, and geographic region.Results: The reference category used was children with HW. There was a significantly higher risk of asthma diagnosis if the child’s weight was classified as OB (OR=1.37, 95% CI=1.07, 1.77). OW did not have a significant effect. Children who were obese also exhib-ited significantly higher health service use (β=0.46, 95%CI= 0.11, 0.81).Conclusions: Children with obesity had an increased risk of asthma diagnosis and with increased asthma related health service use. These findings are important for public health stakeholders and policy makers, since the promotion of healthy weights may have broader impacts on chronic conditions in childhood and reduce the usage of health services. P4.16Listen Up! An Exploration of Families’ Perceptions and Preferences Around Weight-Related Communication Best Practices in Healthcare SettingsAmy C. McPherson1, 2, Geoff Ball3, Shauna Kingsnorth1, 2, Alissa Steinberg4, Tara Joy Knibbe1, Michelle Peters1, Nadia Browne3, Judy A. Swift5, Lorry Chen6, Kim Krog6, John Philpott7, Jill Hamilton4, 2

1. Bloorview Research Institute, Toronto, ON, Canada, 2. University of Toronto, Toron-to, ON, Canada, 3. University of Alberta, Edmonton, AB, Canada, 4. Hospital for Sick Children, Toronto, ON, Canada, 5. University of Nottingham, Nottingham, United Kingdom, 6. Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada, 7. Toronto East General Hospital, Toronto, ON, Canada

Background: Paediatric obesity prevention and management guidelines state that all healthcare professionals (HCPs) should have the skills to communicate with chil-dren and parents about weight. There is a need to develop best practices in weight-re-lated communication, drawing upon different sources of information and evidence.Objectives: To explore families’ perceptions and preferences of weight-related communication best practices.Methods: This qualitative study used purposive sampling to recruit 7-18 year olds and their parents attending one of two Toronto children’s hospitals. We conducted separate fo-cus groups and individual interviews with children and parents using an interview guide created with findings from a recent scoping review of weight-related communication best practices. Thematic analysis using a phenomenological approach was employed.Results: Eighteen children (10 boys, 8 girls; age 14yrs ± 2.62) and 21 parents (17 mothers, 1 father, 3 caregivers) participated. Participants endorsed the recommen-dations to start discussions early in life and to involve all stakeholders, although there were some concerns about involving younger children. Discussions of growth and health were preferred over focusing solely on weight. Participants demonstrated variable preferences for weight-related terms proposed in the literature. Families

supported the value of developing trusting and respectful relationships with HCPs as a basis to discuss weight management, although few participants achieved this ideal through their lived experiences. Emerging evidence of using strengths-based approaches and goal-set-ting with families around weight management was supported by participants.Conclusions: Families endorsed many of the evidence-based recommendations regarding weight-related communication, although empirical evaluations of recom-mended approaches are still required. P4.17Review of a Family Based Child/Youth Obesity Treatment ProgramConstance Oates, Lise Leahy, Gina Maloney, Ian Jamieson, Haley Nyboer, Kelly Proulx, Sarah Van Huizen, Erin BrownPeterborough Regional Health Centre, Peterborough, ON, Canada

Background: The PHIT Clinic is a hospital based multidisciplinary treatment program for children/youth and their families living with overweight and obesity and related complications. The family based approach recognizes that parents/caregivers play a fundamental role in their child’s health and well-being, and focuses on helping the whole family to connect to resources within their community. Objectives:The goal of the review is to provide a description of a family centred multidisciplinary program and the characteristics of children/youth and families referred to this program. The report will also provide preliminary outcome data and patient satisfaction information. Method: A review of patients referred to the clinic. BMIz for the individuals were compared at 6 month and 12 month follow up and assessed for a change. Qualita-tive patient satisfaction questionnaires were analyzed. Results: The total referral number of 291 children/youth ranging in age from 0-18 years were reviewed. Of those referred 59% remained active in the program and 23% had completed the program. BMIz scores at 6 month follow up (total n=65) were reviewed. In the 2-5 year old children, 64% had a decreased BMIz, in the 6-12 year old children, 73% had a decreased BMIz, and in the 13-18 year old youth, 59% showed a decreased BMIz. Results at 12 months (n=23) showed a similar trend. Parent and child/youth evaluation forms indicated high rates of satisfaction.Conclusion: This program review provides important information in understand-ing the patient experience and examining the efficacy of a multidisciplinary family centred program. P4.18Childhood and Adolescent Obesity Treatment: Expanding the Conversa-tion to Include FamiliesConstance OatesPeterborough Regional Health Centre, Peterborough, ON, Canada

Background: Attrition has been identified as a key challenge in childhood obesity treatment. The PHIT Clinic is a hospital based multidisciplinary treatment program for children/youth and their families living with obesity and related complications. Engaging families in the conversations about the development and evaluation of the program recognizes the value of a collaborative approach to health improvement. Objectives: The goal of the review is to examine the efficacy of a family centred multi-disciplinary program. The report will include the children/youth and families’ perspectives on both the concept of personal health and wellness and their experience of this family centred treatment program. Method: A review of patients referred to the clinic. BMIz for the individuals were com-pared at 6 month and 12 month follow up and assessed for a change. Qualitative patient satisfaction questionnaires and health and wellness surveys were analyzed. Participants were invited to provide video recorded comments of their experiences in the program.Results: The total referral number of 291 children/youth ranging in age from 0–18 years were reviewed. Of those referred 59% remained active in the program and 23%


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had completed the program. Parent and child/youth group evaluation forms indicated high rates of satisfaction. Survey responses revealed important themes of acceptance, support, and family fun. Video clips provide an opportunity for patient voices to con-tribute and highlight learning, multidisciplinary input, and support as primary needs. Conclusion: This program review provides evaluation and insight into the experi-ences of children/youth and their families who participated in multidisciplinary family centred program. P4.19Do Children and Adolescents Referred to Multidisciplinary Care for Weight Management in Alberta Enroll in Treatment? A Preliminary AnalysisArnaldo Perez1, Maryam Kebbe1, Katerina Maximova1, Maryna Yaskina1, Charlene Nielsen1, Chenhui Peng2, Tanmay Patil3, Nick Holt1, Josephine Ho4, Paola Luca4, Alison Connors2, Tesia Bennett2, Kim BrunetWood2, Tim Baron2, Rena LaFrance2, Kristine Godziuk2, Geoff Ball1

1. University of Alberta, Edmonton, AB, Canada, 2. Alberta Health Services, Edmon-ton, AB, Canada, 3. Alberta Health Services, Calgary, AB, Canada, 4. University of Calgary, Calgary, AB, Canada

Objective: To determine the enrollment rate of children (2.0–11.9 years old) and adolescents (12.0–17.9 years old) referred for weight management to one of three mul-tidisciplinary clinics in Edmonton (Stollery Children’s Hospital; Misericordia Community Hospital) and Calgary (Alberta Children’s Hospital, which also offers care at the South Health Campus), Alberta.Methods: Data analysis for this cross-sectional study will end in spring 2017; prelimi-nary analyses are presented. Data included all referrals received from April 2013 to April 2016. In partnership with Alberta Health Services, participants’ demographic, anthro-pometric, and referral data were retrieved from standardized referral forms and clinic enrollment data were obtained from medical records.Results: In total, 2,014 unique patients were referred during our study period. Of these, 1,644 patients (81.6%) booked a pre-clinical orientation session, 1,124 patients (55.8%) attended this session, 805 patients (40.0%) booked an initial clinic appointment, and 660 patients (32.8%) enrolled in treatment, which we defined as attending an initial clinic appointment. Most patients were referred by physicians (n=1,922; 95.6%), met the criterion for obesity (BMI ≥95th percentile; n=1,806; 89.7%), and were children (n=1,273; 63.5%). Similar proportions of boys (52.2%) and girls (47.8%) were referred. Conclusions: Only one-third of children and adolescents referred for multidisciplinary weight management in Alberta enrolled in treatment. Our ongoing analyses will include examining predictors of enrollment so that future clinical research and quality improve-ment strategies can be designed and tested to enhance enrollment in health services for managing pediatric obesity P4.20Effects of a Multiprofessional Program of Obesity Treatment (MPOT) in Adolescents from the Metabolically Healthy Obese (MHO) PhenomenonJane Maria Remor1, Ronano P. Oliveira1, Carlos A. Lopera1, Luzia J. Hintze2, Nelson N. Junior1, João Carlos Locateli1, Mario M. Castilho1

1. State University of Maringá, Maringá, PR, Brazil, 2. Ottawa of University, Ottawa, ON, CanadaObjective: Evaluate the effects of a MPOT on body composition, cardiorespiratory fitness and metabolic profile of adolescents according to the MHO phenomenon defined by the absence of alterations in glycemia (GLI), triglycerides (TG), HDL-cho-lesterol, Systolic Blood Pressure (SBP) and Diastolic (DBP).Methods: Almost experimental pragmatic clinical trial with 55 adolescents (25 MHO and 30 MUO), evaluated before and after 16 weeks of a MPOT focused on lifestyle changes (Physical Education, Nutrition and Psychology). Were analised body mass (BM), body mass index (BMI), relative fat mass (RFM), lean mass (LM), cardiorespiratory fitness (VO2max), waist circumference (WC), GLI, TG, HDL-c , SBP

and DBP. Inferential analysis (Mann Whitney test t and U) for comparison between groups (significance of 5%).Results: The metabolically unhealthy obese (MUO) presented worse parameters in all baseline variables, with significant differences (p <0.05) for BMI, VO2max, HDL-c, TG, SBP and DBP. After 16 weeks of intervention MHO demonstrated improvements for BM, BMI, RFM and WC, and MUO presented improvements for MC, BMI, RFM, LM, VO2max and WC (p <0.05). The MUO exposed more expressive improvements than the MHO on all variables, excepted for GLI and WC.Conclusion: A 16-week MPOT was effective on body composition and cardiorespi-ratory fitness of MHO / MUO adolescents. It also promoted discreet improvements in MHO / MUO metabolic variables. P4.21The Effect of Peer Support on Knowledge and Self-Efficacy in Weight Management: a Prospective Clinical Trial in a Mental Health SettingClaire Hibbert1, Margaret Hanh2, Emilie Trottier1, Marlie Boville1

1. Ontario Shores Centre for Mental Health Sciences, Whitby, ON, Canada, 2. CAMH, Toronto, ON, Canada

Introduction: Increased body weight is common in people with serious mental illness (SMI) due to pharmacological side effects. Strategies for weight management may include group education, peer support, frequent follow up, and the use of ‘Confidence and Conviction’ (C&C) to gage knowledge and self-efficacy. This study will evaluate the effects of a group-based weight management program on individ-uals’ C&C, body mass index (BMI), health-related quality of life, and diet quality and determine the relationship between these various factors in people with SMI.Methods: Fourteen participants (aged 51.7 ± 12.2 years; 67% female) who were unable to successfully achieve and maintain a 5% weight loss were recruited from a Metabolic and Weight Management Clinic at a mental health care facility. Weight, C&C, a Dietary Screener Questionnaire and the 36-item Short Form Survey Instru-ment were collected at baseline (November 2016) and will be collected at 3, 6, and 12 months. The 12-month weight management program includes bi-weekly group lifestyle education sessions facilitated by a registered dietitian and a registered nurse. Clients also attend monthly individual follow-up throughout the year.Results: At baseline, BMI was 44.1 ± 9.2 kg/m2, conviction was 9.3 ± 1.0, and confidence was 6.6 ± 2.1. Three-month data will be collected in February 2017 and results will be presented. Discussion: It is expected that weight management programming incorporating group peer support will result in clinically meaningful reduction in BMI, improve-ment in health-related quality of life, and improvement in diet quality via the effect of the program on C&C. P4.22Optimizing Body Composition and Glycemic Control in the Elderly Through Creatine Supplementation and Resistance ExerciseCamila L. Oliveira1, Barbara Antunes2, Fábio Lira2, Aline Gomes3, Gustavo Pimentel3, João Mota3

1. University of Alberta, Edmonton, AB, Canada, 2. Sao Paulo State University, Presi-dente Prudente, SP, Brazil, 3. Goias Federal University, Goiania, GO, Brazil

Objective: The aim of this study was to examine the efficacy of low-dose creatine sup-plementation associated with resistance training on body composition, metabolic and inflammatory blood markers in community dwelling elderly individuals. Methods: This was a 12-week, parallel-group, double-blind, randomized, placebo-con-trolled trial. Individuals were randomly allocated into one of the following groups: place-bo plus resistance training (PL + RT) or creatine supplementation plus resistance training (CR + RT). Participants were assessed at baseline and after 12 weeks. Body composition was assessed by dual energy X-ray absorptiometry and blood samples were collected for


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analysis of glucose, insulin, adiponectin, brain-derived neurotrophic factor, interleukin 6, interleukin 10 and monocyte chemo attractant protein-1. Results: Participants (N=27, ~70% with overweight/obesity) were assigned to either the PL + RT (N=14) or CR + RT (N=13) groups. Compared to the PL+RT group, the increase in lean mass was higher in the CR + RT group after the 12-week intervention period (0.6 ± 1.3 kg and 1.8 ± 1.3 kg, respectively; p=0.02) and blood glucose levels were lower (104.4 ± 29.3 mg/dL and 91.5 ± 18.9 mg/dL, respectively; p<0.05). No other differences were observed between groups. An inverse correlation between lean mass with insulin (-0.64, p=0.01) and HOMA-IR (-0.69, p<0.01) was observed in the CR + RT group. Conclusion: Low-dose creatine supplementation in combination with resistance train-ing can improve body composition and glycemic control in the elderly. Moreover, lean mass gain was associated with lower insulin resistance in the supplemented group P4.23Toronto Bariatric Interprofessional Psychosocial Assessment Suitability Scale (BIPASS TM): Phase II – Establishing Convergent ValidityGurneet S. Thiara1, 2, 3, Richard Yanofsky1, 2, 3, Allan Okrainec4, 2, Raed Hawa1, 2, 3, Sanjeev Sockalingam1, 2, 3

1. Department of Psychiatry, University of Toronto, Toronto, ON, Canada, 2. University Health Network, Toronto Western Hospital, Toronto, ON, Canada, 3. Bariatric Surgery Psychosocial Program, Toronto, ON, Canada, 4. Department of Surgery, University of Toronto, Toronto, ON, Canada

Background: Patients who are referred for possible Bariatric Surgery (BS) intervention undergo a series of assessments conducted by an interdisciplinary health care team to determine suitability for surgery. Herein, we report phase II convergent validity findings s of the Bariatric Interprofessional Psychosocial Assessment Suitability Scale (BIPASS) and its relationship to interdisciplinary psychosocial assessment practices for BS. Methods: This study was conducted at the Toronto Western Hospital, a Level 1A bariatric surgery centre of excellence accredited by the American College of Surgeons. Total scores for the validated clinical psychosocial scales: GAD-7, PHQ-9, and SF-36 scores were compared to total BIPASS scores pre bariatric surgery psychosocial assessment. Results: N=50 including both males and female patients. Total BIPASS rater scores demonstrated moderate correlations with clinically validated scales of most notably PHQ9 (Pearson correlation =0.510; p<0.01), GAD-7 total scores (Pearson correlation= 0.312; p<0.068) and SF-36 (Pearson correlation = -0.156; p<0.41) . Conclusion: The preliminary study findings show that the BIPASS has promising convergent validity across psychosocial domains as a clinical tool in the assessment of BS candidates which will help standardize the evaluation process and systematically identify at-risk patients for negative outcomes after BS.

P4.24Association Between Therapeutic Drug Classes and Weight Change in Patients Attending a Medically Supervised Weight Loss ClinicElham Kamran Samani1, Jennifer Kuk1, Sean Wharton2, Christpher Ardern1

1. York University, Toronto, ON, Canada, 2. Wharton Medical Clinic, Toronto, ON, Canada

Introduction: Obesity is a leading public health problem in the developed and developing world. As the prevalence of obesity and its associated comorbidities increases, the number of the medications used by individuals living with obesity is also on the rise. Beyond the utility of these drugs for the treatment of obesity-related chronic diseases, many have unwanted side effects, including weight gain. Objectives: To characterize the number and type of medications used by patients of the Wharton Medical Clinic (WMC), a medically supervised weight management center, and; to determine whether the amount of weight change differs according to therapeutic drug classes or chronic condition.

Methods: Data was derived from a subset of bariatric patients (n=1943) who attended WMC for 3+ months. Study exposures included the number and type of medications taken, and number and type of the chronic diseases experienced. The primary study outcome was relative weight change.Results: Of the 166 medications listed by WMC patients, 26 have side effects that include weight gain. Over 3 months of follow-up, average weight loss was 4.65 kg; percentage weight change was greatest amongst patients with a history of hyperten-sion (4.4%) and least amongst those with a history of stroke (0.6%). Implications: Barriers to weight loss may include pharmacological treatment for pre-existing conditions. These findings have implications for setting realistic weight loss goals for long-term obesity management. P4.22Current Weight Management Approaches Used by Primary Care Provid-ers in Multidisciplinary Health Care Settings in OntarioStephanie Aboueid, Ivy L. Bourgeault, Isabelle GirouxUniversity of Ottawa, Ottawa, ON, Canada

To understand how Primary Care Providers (PCPs) assess the most suitable weight management approach for their clients with obesity and elucidate which approach seems to be most accepted by clients. We conducted 17 interviews with family physicians and nurse practitioners working in multidisciplinary primary care settings in Ontario. All interviews were audiotaped, transcribed, and coded using NVivo software. PCPs reported assessing the most suitable weight management approach based on 1) client level of readiness, 2) previous weight management attempts, and 3) client pref-erence. One-on-one nutrition counselling with the registered dietitian was often the first approach suggested while on site weight management programs were offered to clients with social isolation. Handing out pamphlets was used by some PCPs but most reported that it might be ineffective due to lack of follow up. Medications for weight loss purposes were seldom used since only one PCP reported prescribing them. Most PCPs stressed the importance of lifestyle modification for weight management and ex-pressed the ineffectiveness of the pharmaceutical approach. Furthermore, according to participating PCPs, weight management approaches most accepted by clients were: 1) referral to a dietitian for a personalized approach, 2) weight management programs on site, 3) weight watchers, and 4) fad diets. The least accepted approach was taking medi-cation, as many clients fear their side effects. As part of these multidisciplinary clinics, PCPs reported evaluating various factors in identifying which approach is most suitable for clients. Evidence-based weight management approaches (dietitian services, on site programming) seemed to be most accepted by clients. P4.23Pediatric Weight Management: Are Dietitian-led Interventions Successful?Tesia Bennett, Rena LaFrance, Kim Brunet WoodAlberta Health Services, Edmonton, AB, Canada

Purpose: Outpatient Dietitian Counseling (ODC) is a dietitian-led intervention accessed by referral from a primary healthcare provider. Families meet regularly with a dietitian trained in Pediatric Weight Management. The program is multi-component and includes nutrition, physical activity, sedentary time and sleep. The dietitian and the family’s healthcare provider work together to ensure the family is supported in achieving their health goals. To determine the ODC program success, a Program Evaluation is underway. The primary objective is to determine success at achieving lifestyle behaviour changes in children and adolescents 2-17 years with overweight or obesity. Secondary objectives include changes in anthropometrics and self-reported quality of life.Methods: This prospective, longitudinal, observational study commenced Decem-ber 1, 2015 and will continue until 243 participants have been recruited. All families who attend an initial appointment are invited to participate. Written informed con-sent is received from the caregiver(s) before entry. Data collection occurs at baseline,


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6, 12, 18 and 24 months. Data elements include food frequency using the Child and Youth Nutrition Survey (CYNS) , physical activity, sedentary time and sleep using the Physical Activity and Sedentary Time questionnaire (PAST), health-related quality of life using thePedsQLTM and anthropometry (BMI z-score). The data will be extracted and stored in the online REDCapTM database.Relevance: This evaluation will assist with understanding the success of dieti-tian-led interventions in achieving lifestyle behaviour change for children referred for pediatric weight management, and identify areas for future improvement. P4.24Children and Youth Nutrition Survey: Monitoring Dietary Patterns During Weight Management CounsellingTesia Bennett, Lorian Taylor, Susan Buhler, Kim Brunet WoodAlberta Health Services, Edmonton, AB, Canada

Purpose: Accurate methods for collecting food intake and eating behaviors are needed for children participating in weight management interventions. The primary aim of this study was to develop, pilot and evaluate the Children and Youth Nutrition Survey (CYNS).Methods: The CYNS is adapted from three previously published surveys with acceptable psychometric properties. The CYNS includes foods and eating behaviors both recommended and discouraged for a healthy lifestyle. The survey contains four sections: fruit and vegetables, beverages (sugar-sweetened and healthier choices), fat, and eating behaviors. To ensure relevance to Canadian children, the survey was developed with expert review, and piloted to assess internal consistency and identify evaluation cut-points. Participants were parents of children aged 3-17, who were attending dietitian counselling sessions for weight management.Results: A convenience sample of 48 surveys was completed. The fruit and vege-tables questions demonstrated acceptable internal consistency (Cronbach’s alpha = 0.83). The beverages, fat and eating behavior questions showed low internal consistency when examining them as subscales (Cronbach’s alpha = 0.51, 0.48, and 0.46 respectively). Upon examination of the beverage and eating behavior questions, it was identified tracking individual items over time and using cut-points was preferable to using a total subscale score. More items were added to the fat questions to improve internal consistency.Conclusions: The CYNS shows promise for assessing food intake and eating behaviors in children receiving weight management interventions. Further research is underway to retest the adaptation identified in this pilot study. P4.25Differential Health Burden and Clinical Risks Associated with Types of Obesity in Patients with Obesity and Knee OsteoarthritisKristine Godziuk, Carla Prado, Linda Woodhouse, Mary ForhanUniversity of Alberta, Edmonton, AB, Canada

Knee osteoarthritis (OA) can lead to severe pain and disability that necessitates surgical joint replacement. The demand for total knee arthroplasty (TKA) in Canada has risen along with rates of obesity, resulting in long wait times for surgery. Screening for TKA eligibility is routinely based on clinical evaluation and obesity classification using body mass index (BMI). Individuals with moderate to severe obesity (BMI ≥35 kg/m2) are often considered ineligible for surgery unless they lose weight, without clear evidence that weight loss improves surgical outcomes. Long term results after TKA appear similar for individuals with and without obesity, although post-surgical infection rates and recovery times are elevated in those with obesity. Reliance on BMI to screen for TKA discounts the influence of body composition on outcomes. Sarcopenic obesity (SO), a condition of high adiposity and low skeletal mass and function, has been linked to increased infection rates after cardiac surgery. SO could be influencing TKA outcomes, and further investigation is essential. Our research program aims to identify the prevalence of sarcopenic and

non-sarcopenic types of obesity in OA, and examine the relationship between body com-position, physical function, quality of life, and surgical outcomes in this population. A two phase prospective study protocol was developed based on a systematic literature review and focused meetings with stakeholder organizations. Research results will expand knowledge on the impact and identification of sarcopenic obesity in knee osteoarthritis. P4.26Personalizing Obesity Assessment and Care Planning in Primary Care: Patient Experience and Self-management OutcomesThea Luig1, Robin Anderson2, Arya M. Sharma4, Denise L. Campbell-Scherer1, 3

1. University of Alberta, Edmonton, AB, Canada, 2. Edmonton Southside Primary Care Network, Edmonton, AB, Canada, 3. Grey Nuns Family Medicine Centre, Edmonton, AB, Canada, 4. Alberta Diabetes Institute, Edmonton, AB, Canada

Purpose: This project aims to improve primary care obesity management by examining how personalized root cause assessments and action plans can support patients in improving their health. Root causes include comorbid diseases and psychosocial factors. Personalized strategies are crucial to helping patients navigate their set of drivers and barriers to self-management. Despite available resources, clinicians feel ill-equipped to counsel on weight and patients’ needs are not adequately addressed. There is a pressing need for an effective intervention that de-livers personalized obesity care. We integrated the 5As of obesity management with the collaborative deliberation model for patient-centred communication to develop an intervention. We examined how patients experience the intervention and make changes to improve health as a result.Methods: Purposeful sampling of 20 patients to record consultations, conduct semi-structured patient and provider interviews, and document patients’ self-man-agement through diaries and two follow-up interviews. Inductive, thematic analysis in NVIVO11.Results: Preliminary results reveal interpersonal processes that prove decisive for supporting patients’ everyday self-management: (1) validating patients - listening to stories of weight gain and exploring root causes; (2) supporting self-efficacy - labeling patients’ strengths and exploring preferences; (3) optimizing care - prioritizing root causes and directing patients to interdisciplinary clinicians.Conclusion: Personalized consultations using the 5As and collaborative deliberation appear to support patient self-efficacy and coordinate clinical care and self-management to addressing root causes of weight gain and improving health. Results will be used to refine an intervention and identify outcome measures for testing in a future trial. P4.27Effect of Yellow Pea Fiber on Fecal Short-chain Fatty Acids and Bile Acids in Adults with Overweight/Obesity: a 12-week Randomized Controlled TrialShyamchand Mayengbam1, Jennifer E. Lambert1, Jill A. Parnell2, Jasmine M. Tunni-cliffe1, Jay Han3, Troy Sturzenegger3, Hans J. Vogel4, 5, Jane Shearer1, Raylene Reimer1, 5

1. Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada, 2. Physical Edu-cation and Recreation Studies, Mount Royal University, Calgary, AB, Canada, 3. Food Processing Development Centre, Alberta Agriculture and Rural Development, Leduc, AB, Canada, 4. Department of Biological Sciences, University of Calgary, Calgary, AB, Canada, 5. Department of Biochemistry & Molecular Biology,Cumming School of Medicine, University of Calgary, Calgary, AB, Canada

Obesity is a major risk factor for several metabolic diseases. It is also associated with dysbiosis of gut microbiota and alteration in microbial metabolites, especially short chain fatty acids (SCFAs) and bile acids (BAs) in humans. The role of dietary fiber in regulating SCFAs and BAs metabolism as one the mechanisms in the prevention of metabolic disease is well recognized. The current study aimed to investigate the effect of yellow pea fiber on SCFAs and BAs metabolism in adults with overweight/obesity. A total of 53 adults (BMI>25.0) were randomly assigned to either a pea


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fiber (PF, n=29) or placebo (PL, n=24) group for 12 weeks. The PF group received wa-fers containing 5g/serving of yellow pea fiber thrice a day, while the PL group received an isocaloric amount of control wafers with no fiber. Fecal samples were collected at baseline and at the end of the study. Fecal SCFAs and BAs were analysed by the use of GC-MS and HPLC-DAD methods respectively. There was no significant change in fecal SCFAs or BAs in the PL group. However, we found a significant increase in fecal acetate (P=0.039) and significant decrease in fecal isovalerate (P=0.015) concentrations in PF group compared to baseline. In case of BAs, cholic acid (P=0.011), deoxycholic acid (P=0.014) and total BAs (P=0.042) content were significantly reduced. Thus, the current study provides important data on the effect of yellow pea fiber on fecal SCFAs and BAs metabolism in adults with overweight/obesity. P4.28Impact of Computer-Based Cognitive Training on Outcomes During a Weight Loss Intervention in an Obese PopulationRyan M. Stallard2, Vic Sahai1, Duncan Day2

1. Hotel Dieu Research Institute, Kingston, ON, Canada, 2. Hotel Dieu Hospital, Kingston, ON, Canada

Objective: Elucidate the impact of computer-based cognitive training on eating behaviours and weight loss in an obese population.Methodology: We will recruit treatment seeking obese adults to participate in a double-blind, randomized, controlled trial. This trial will include 3 phases; a weight loss intervention phase, a weight maintenance phase, and a no-contact phase. Eligible participants will be randomized to 1 of 2 groups: standard care or computer-based cognitive training. All participants will attend a 12 week lifestyle-based weight loss in-tervention. Weekly sessions are designed to educate participants on evidenced-based lifestyle change strategies that support weight management. Participants in both groups will complete online cognitive training tasks; the control group will be provid-ed tasks that have no known impact on ingestive behaviours while the experimental group will receive tasks shown to improve response inhibition and emotion regulation. They will be asked to complete these tasks on 5 separate days each week during the course of the treatment phase and 1 time per week during the maintenance phase.Relevance to practice: An ability to detect an effect of computer-based cognitive training on eating behaviours and weight loss will expand our current understanding of the role that known neural networks play on the management of ingestive behaviours that has not been accomplished by existing laboratory studies. Improving our understanding in this field can provide new insights into novel therapeutic strategies for this complex disease P4.29Benefits of a Multi-Agency Obese Treatment ProgramRyan M. Stallard1, Allison Little2, Kaitlyn Bresee3

1. Hotel Dieu Hospital, Kingston, ON, Canada, 2. Queen’s Family Health Team, Kingston, ON, Canada, 3. Kingston General Hospital, Kingston, ON, CanadaGoal: Assess the benefits of a multi-agency community-Bariatric Centre of Excellence collab-orative obesity program on weight and quality of life in obese adults living in the Kingston, Ontario region.

Background: Obesity is a primary risk factor for multiple chronic diseases including type 2 diabetes, heart disease, sleep apnea, and several cancers. Sustained weight loss, while chal-lenging, is possible and is related to significant improvements in patient health and quality of life. While barriers to successful treatment are multifactorial one common challenge that faces many people living with obesity is access to appropriate resources. Health care systems are also challenged by obesity given limitations in budget and difficulty creating expertise in all relevant domains. These challenges may be overcome by offering inter-connected pro-grams that are shared between agencies alleviating the barriers faced by both patients and health care teams. The Kingston region has a collection of obesity programs, however there appears to be little or no collaboration between agencies resulting in duplication of efforts.

Methods: 15 patient charts will be retrospectively reviewed from a multi-agency obesity program. Classes take place at the Queen’s Family Health team with excursions to the local grocery store for grocery shopping education and cooking classes. At each weekly visit participants are seen by a registered nurse for blood pressure and review of health status, and a registered dietitian for weight measurement and lifestyle assessment. At treatment completion participants will be provided additional resources for ongoing support. P4.30Differences in Short and Long-term Mortality Associated with Body Mass Index Following Coronary RevascularizationTasuku Terada, Jeffrey A. Johnson, Colleen M. Norris, Weiyu Qiu, Raj Padwal, Arya M. Sharma, Jayan Nagendran, Mary ForhanUniversity of Alberta, Edmonton, AB, Canada

Background: Few studies have investigated the mortality associated with obesity following cardiac revascularization while accounting for coronary anatomy risks and diabetes status.Objective: This study examined the associations of body mass index (BMI: kg/m2) with short-, intermediate-, and long-term mortality following coronary artery bypass graft surgery (CABG) and percutaneous coronary intervention (PCI) in patients with different coronary anatomy risks and diabetes status. Methods: Data from the Alberta Provincial Project for Outcomes Assessment in Coro-nary Heart Disease (APPROACH) registry were analyzed. Using normal BMI (18.5–24.9) as a reference, multivariable-adjusted hazard ratios (HRs) for all-cause mortality within six months, one year, five years, and 10 years were individually calculated for CABG and PCI with a Cox proportional hazards regression model for four prespecified BMI categories: overweight (25.0–29.9), obesity class I (30.0-34.9), obesity class II (35.0–39.9), and obesity class III (≥ 40.0). The analyses were repeated after stratifying for coronary risks and diabetes status.Results: The cohorts included 7560 and 30258 patients for CABG and PCI, respective-ly. Following PCI, overall mortality was lower in overweight and obese class I compared to normal BMI, irrespective of follow-up duration; however, five-year (adjusted HR 1.38 95%CI 1.01–1.88) and 10-year (adjusted HR 1.34 95%CI 1.00–1.79) mortality rates were significantly higher in obesity class III with high-risk coronary anatomy. Following CABG, obesity was not associated with higher mortality compared to normal BMI.Conclusion: Obesity was not associated with elevated mortality following CABG. Greater long-term mortality in patients with obese class III and high-risk coronary anatomy warrants further investigation. P4.31Non-invasive Brain Stimulation (NIBS) of the Prefrontal Cortex: a System-atic Review of Multi-session Treatment Studies Examining Eating-related OutcomesCorita M. Vincent1, Peter A. Hall2

1. University of Toronto, Toronto, ON, Canada, 2. University of Waterloo, Waterloo, ON, Canada

Objective: Previous studies have demonstrated that single session NIBS of the PFC results in significant reduction of food cravings that may extend to changes in food consumption. However, findings from multi-session treatment studies have been mixed. The current systematic review summarizes multi-session and long-term follow up studies of NIBS on food behaviours and suggests possible explanations for disparities in findings.Methods: PubMed, Scopus, Web of Science, PsychoInfo and EMBASE databases were used to identify studies examining multi-session effects of NIBS of the PFC on food behaviour. Studies with more than 1 session of NIBS, sham comparison group, and outcome measures related to food behaviours (consumption, craving, binge/purge) were included.


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Results: Eight articles were included in the systematic review: two studies involved healthy adults, 3 studies involved individuals with obesity, and 3 studies involved individuals with bulimia nervosa. Of studies involving healthy or obese populations 2 of 2 studies demonstrated significantly reduced food cravings in participants randomized to NIBS compared to sham, 1 of 2 studies observed significant weight loss, 1 of 2 studies observed decreased caloric intake. Among studies examining individuals with bulimia nervosa 2 of 3 studies observed no effect on binges and purges and 1 study observed a decrease in the number of purges.Conclusion: The findings of this systematic review indicate a potential role for NIBS in altering food behaviours in the longer term among healthy populations and those with obesity; however further research is needed to clarify the long-term effects on food consumption and weight loss. P4.32Reasons for Attrition in a Publicly Funded Weight Management ProgramSean Wharton1, 2, Rebecca A. Christensen1, Dishay Jiandani2, Kristin J. Serodio1, Jennifer L. Kuk2

1. The Wharton Medical Clinic, Toronto, ON, Canada, 2. Department of Kinesiology and Health Science, York University, Toronto, ON, Canada

Objective: To explore why patients stop attending clinical weight management and to determine whether these attrition factors relate to weight loss (WL) attained.Methods: The Wharton Medical Clinics (WMC) are weight and diabetes man-agement clinics with locations across Southern Ontario. Semi-structured phone interviews were conducted with 52 former patients to determine why they stopped attending WMC. Reasons cited by patients were categorized as personal, or relating to the program, facility or staff.Results: Personal issues (55.8%) were the most common reason for attrition, followed by issues related to the program (40.4%), facility (28.9%), and staff (26.9%). Regardless of the reason(s) given for attrition, there were no differences in WL at their last visit (P>0.05) or at follow-up (P>0.05). Individuals reporting issue(s) with staff had greater personal WL goals (36.0±16.4% versus 24.3±13.5%, P<0.05) and attended for significantly less time (P<0.05), but were not different in their intentions to return to WMC as compared to those reporting no issues with staff (P>0.05).Conclusion: As longer treatment time is one of the strongest correlates of greater WL, determining factors that contribute to attrition is crucial. Greater patient WL goals may be associated with greater likelihood of perceived issues with weight manage-ment staff and shorter treatment time. While the program, staff, and facilities may influence patient attrition, personal factors outside of the clinic appear to be the most common contributing factor. However, the reasons for attrition do not appear to result in differences in weight loss achieved during the program or after leaving. P4.33Effectiveness of a Multidisciplinary Lifestyle-Based Weight Management Program on Improving the Metabolic Health of Adults with ObesityBenyamin HakakzargarSimon Fraser University, Burnaby, BC, Canada

Objective: Assessing the effectiveness of a publicly funded medical weight man-agement program Methods: Medical records of 1418 patients who had attended the multidisci-plinary weight management program at Medical Weight Management Centre (Coquitlam, BC) between Jan 2011 – Oct 2016 were checked. Patients between 18 – 90 years of age who had attended the clinic for at least 6 months were included. Patients with missing data or bariatric surgery before their initial visit were excluded. Data collected were waist circumference, BMI, blood glucose, cholesterol and blood pressure. Smokers and past smokers were put in the smokers’ category for sample size purposes. The data was compared at the initial versus latest visit.

Results: Out of 473 patients, 81.4% (N=385) who were metabolically abnormal at baseline 67.8% (N=321) reduced their weight by ≥ 5%, while 41.8% (N= 198) at-tained a weight loss of ≥ 10%. The mean (SD) initial waist circumference was 125.3 (18.3) cm and average initial BMI was 44.3 (8.85). At baseline, 146 patients (30.8%) were diagnosed with type 2 diabetes (41.1%) with A1c >7%. After a minimum of six months participation in the program, 51.6% (N=31) of patients had an A1c <7%, and 40.0% (N=24) achieved an A1C <6.5%. Conclusion: Gathered data supports the effectiveness of this publicly funded weight management program. P4.34Computer Apps to Assist with Weight Loss: Limited Value in the Present and Opportunities for the FutureBradley Tanner1, 2, Mary Metcalf1, 2, Brian C. Tanner2

1. Clinical Tools Inc, Chapel Hill, NC, USA, 2. University of North Carolina, Chapel Hill, Chapel Hill, NC, USA

Computer apps and wearable enabled devices tied to apps are common and ubiquitous; yet there is little evidence they offer much value to a health community interested in the prevention or treatment of obesity. Even the cardiovascular benefits are doubtful. The talk reviews existing app and device based solutions by first categorizing them and then summarizing research findings related to their success and failure. Example lessons that can learned from work include the value of social connectedness. Going forward software and solutions will evolve. The talk reviews the potential role of Virtual Reality especially VR delivered with state of the art head mounted displays such as Facebook Oculus, Google Daydream, HTC Vive, and Playstation VR. Strengths and weakness for each solution vary because of complexi-ty, computer hardware requirements, and the availability or lack of support for hand controllers which are essential to manipulate objects in the VR environment. Further options also include entertainment quality role playing games to practice lifestyle change as seen in so called “first-person thinker” games, mystery games, find-and-seek (e.g., Pokeman Go) games, and exploratory simulations. In such games players make choices, healthy or unhealthy, and receive feedback on the outcome. Elements of the typical game challenge players to maximize metrics such a health, strength, and mobility, develop and test skills, advance to higher levels, and work with other players in the game. The collaboration potential of games allows them to offer peer support and coaching, further enhancing motivation for lifestyle change. P4.35Health Markers Improvement While Meeting the Physical Activity Guide-lines Only doing Resistance Training in People considered ObeseDanielle R. Bouchard, Andrea Mayo, Martin SénéchalUniversity of New Brunswick, Fredericton, NB, Canada

Background: Very few people considered obese in Canada reaches the national physical activity guideline (PAG) including a minimum of 150 minutes of aerobic exer-cises and a minimum of two sessions of resistance training every week. The objective of this study was to explore a new way of encouraging people living with obesity to reach the PAG by targeting a major barrier to regular exercise; lack of time.Methods: A total of people with a minimum body mass index (BMI) of 30 kg/m2, considered inactive were recruited for a 12-week exercise program. One group did the traditional PAG while the other group did only 150 minutes of resistance train-ing at moderate to vigorous intensity reducing considerably in the weekly required time. Health outcomes included anthropometric measures, body composition, cardiorespiratory fitness, blood pressure, fasting glucose, and lipids profiles.Results: At baseline, the average age and BMI were of the sample were 46.4 ± 11.3 years old and 35.7 ± 4.9 kg/m2 respectively. The proportion of men participat-ing in the study was 36.7 %. The traditional group increased cardiorespiratory fitness


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compared to the non-traditional group median (25-75th) [6.1% (4.3-15.0) vs. + 3.5% (2.9-4.7); p=.02], while no such difference was observed on health markers were observed between the groups when analyzing pre-post values.Conclusion: This pilot study suggests that a person considered obese could replace some aerobic time for resistance training activities and still achieve health outcomes. A study with an appropriate sample size of longer duration is needed to confirm these findings. P4.36Increasing BMI in Primary Hip and Knee Arthroplasty; Influencing Length of Stay, Complications and Adverse Events. A Retrospective ReviewRichdeep Gill, Irfan Abdulla, Rajrishi SharmaUniversity of Calgary, Calgary, AB, Canada

Purpose: Total Hip Arthroplasty (THA) and Total Knee Arthroplasty (TKA) are reliable surgical options to treat pain and disability secondary to degenerative arthritis. The purpose of this study is to retrospectively compare length of stay, complications and adverse events in patients undergoing joint arthroplasty with increased BMI to those with normal BMI. Methods: We retrospectively reviewed the data in the ABJHI (Alberta Bone and Joint Health Institute) between March 2010 and July 2016. 10, 902 THA patients and 16,485 TKA patients were included in the study. Results: In THA, Class II and III obesity were more likely to have 2 or more surgical risk factors, while in TKA only Class III had similar findings. In THA patients, class II and III had higher 30-day re-admission rates while there was no difference in the TKA group. All classes in TKA had increased post-operative medical events. No association was found in the THA cohort. In THA, all classes were more likely to have a deep infection while in TKA, patients with Class III Obesity had similar results. In THA, Class II and III obesity had longer length of acute hospital stay while BMI did not affect TKA length of stay. In both THA and TKA, class II and III obesity patients were less likely to be discharged home.Conclusion: We offer insight on the effects of BMI on THA and TKA patients. The current data can be used to better detail the risks associated with this particular patient population. P4.37Impacts of Exercise Training on Quality of Life, Body Image, Anxiety, and Depression in Individuals with Obesity: A Systematic Literature ReviewStephanie Saunders1, Jennifer Brunet1, 2, Ahmed J. Romain3, Paquito Bernard4, 5, Aurélie Baillot2, 6

1. University of Ottawa, Ottawa, ON, Canada, 2. Institut de recherche de l’Hôpital Montfort, Ottawa, ON, Canada, 3. University of Montreal Hospital Research Centre, Montreal, QC, Canada, 4. Université du Québec à Montréal, Montreal, QC, Canada, 5. Institut Universitaire en Santé Mentale de Montréal, Montreal, QC, Canada, 6. Université du Québec en Outaouais, Gatineau, QC, Canada

Objective: The negative health consequences of obesity are multi-faceted and complex. Reviews show that exercise (EX) reduces many obesity-related physical health problems. However, it is unclear whether those benefits extend to psychosocial out-comes. We undertook a systematic review of the literature to evaluate the effects of EX on quality of life (QoL), body image (BI), anxiety, and depression in adults with obesity.Methods: Searches were performed in 7 databases (Pubmed, Cochrane, EMBASE, Proquest, CINAHL, Psycharticle, SportDiscus). Two reviewers screened records using the following selection criteria: 1) peer-reviewed empirical study, 2) sample of obese adults (BMI ≥30kg/m2), 3) randomized controlled trial (RCT), experimental, or quasi-experimental studies with isolated EX, and 4) assessment(s) of QoL, BI, anxiety, and/or depression.Results: Of the 1,084 studies identified during the search, 20 met inclusion criteria. Studies were published recently (≥2010; n=17, 85%) and most were RCTs

(n=12, 60%). Ten studies were with samples mostly comprised of women (75% of the sample) and 13 studies were with adults who had type-2-diabetes, arthritis, hypertension, and/or cardiovascular diseases. Interventions averaged 23±19 weeks, 55±17 minutes/session, and were mostly aerobic (n=13). Significant changes in global QoL (n=6/8), depression (n=4/5), and BI (n=1/1) were reported post-EX. No significant changes were found for anxiety (n=0/2). Conclusion: EX appears to improve QoL and BI, and reduce depression in adults with obesity. Due to heterogeneity across studies and poor rigorous reporting in the studies reviewed, additional studies are needed to strengthen evidence regarding the effects of EX on psychosocial outcomes in adults with obesity. P4.38Maternal Antibiotic Consumption Alters Expression of Neurotransmitters Associated with Reward-Seeking Behavior in RatsNicole Cho, Teja Klancic, Raylene ReimerUniversity of Calgary, Calgary, AB, Canada

Background: Healthy gut microbiota is essential for the maturation and maintenance of the immune and nervous system. Gut microbiota are especially important in early life (during pregnancy and/or in the first years of life). Since the gut communicates with the brain via the gut-brain axis, antibiotics may indirectly perturb neurotransmitters and inflammatory markers in the brain. Therefore, early life antibiotic exposure could have detrimental effects later in life. Our objective was to alter microbiota through low dose penicillin (LDP) in pregnant Sprague-Dawley rats and examine changes in the hippocampus of the dams and their offspring. Methods: Pregnant 10 week old female Sprague-Dawley rats (n=10) were randomized to: 1)control (water+AIN-93G diet) or 2)antibiotic (LDP+AIN-93G diet). Mothers received LDP via drinking water through the third week of pregnancy and lactation. Offspring were kept until 10 days post-weaning. The expression of various neurotransmitters and inflammatory markers was measured using real-time PCR.Results: LDP increased mRNA levels of dopamine receptors Drd1 (p=0.033) and Drd2 (p=0.025) compared to control. Expression of μ-opioid receptor was also in-creased in LDP dams (p=0.01) as well as TLR4 (p=0.021). Female offspring showed a trend towards higher levels of TNF-α in LDP groups. There were no significant changes in gene expression of Drd1, Drd2, or μ-opioid receptors in the offspring.Conclusion: Administration of LDP during pregnancy and lactation increases expression of neurotransmitters associated with reward-motivated behavior such as seeking out palatable food in dams. Implications for behavior, obesity, and neuro-psychiatric disorders in offspring warrant further investigation. P4.40ENHANCE: A Preliminary Examination of Physiological Outcome Data Following a 12-week Well-being InterventionStefanie Ciszewski1, Lesley Lutes1, Kostadin Kushlev2, Samantha J. Heintzelman2, Jaque-line May Kanippayoor1, Damian Leitner1, Derrick Wirtz1, Shigehiro Oishi2, Ed Diener2

1. University of British Columbia - Okanagan, Kelowna, BC, Canada, 2. University of Virginia, Charlottesville, VA, USA

Subjective well-being (SWB), which refers to an individual’s evaluation of their life and emotional experiences, is associated with health and longevity. It has been sug-gested that individuals who report higher levels of SWB are more likely to engage in healthy behaviours (e.g., exercise). However little is known about physiological adaptations following an intervention targeted at improving SWB. ENHANCE (Enduring Happiness and Continued Self-Enhancement) is 12-week intervention with the primary aim of improving SWB. The purpose of the present poster is to examine the physiological outcomes following completion of the ENHANCE program. Participants included men and women community members who were randomly assigned to either the ENHANCE intervention condition (n = 27, Mweight = 179.38) or a wait-list


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control condition (n = 26, Mweight = 159.78). Participants assigned to the intervention condition participated in a 3-month group-based intervention program. Weight, height, blood pressure, and resting heart rate were recorded at baseline and immediately following the intervention. Participants in the intervention condition lost a mean weight of -4.87(t = -.530, NS) and participants in the control group lost a mean weight of -2.73(t = -.530, NS). Furthermore, systolic, diastolic, and resting heart rate was not found to be significantly different following the completion of the program for either condition. While non-significant, the theoretical potential for a well-being intervention to produce beneficial physiological changes remains. Implications and recommendations for future studies, particularly integrating health components into treatment, will be discussed. P4.41Identifying Patient Attributes that Contribute to High Engagement and Long Term Weight LossChristine Ferguson, Jeanette MayLeverage Global, Jamestown, RI, USA

Obesity rates are on the rise in the US and globally with over 641 million individuals with obesity, a major risk factor for many chronic diseases. The American Board of Obesity Medicine has certified 1,590 Diplomats, but there continues to be a lack of obesity specialists available to patients causing most patients to turn to their primary care provider for help. Unfortunately, due to new information and treatment options constantly being developed, primary care physicians have difficulty understanding all of the obesity treatment options available and the role a patient’s individual attributes and weight loss history plays in successful treatment. There is a need for solutions that bridge the knowledge gap for both patients and providers as well as enabling patient engagement and driving outcomes in obesity care. H20- Health to Outcomes, a Patient-Provider Solution for Obesity, is being developed by a team of cross-sector pro-fessionals that includes obesity specialists, doctors, clinicians, consumer groups, data scientists, information experts and technology specialists. The core of the solution is a predictive engine that utilizes retrospective patient information and current evidence to predict potential obesity treatment options that are individualized to each patient. The goal of H20 is to provide each patient with an individual plan using insights about individual patients and a comprehensive set of treatment approaches from lifestyle and behavior to surgical interventions. It will match patients with the treatment options most likely to be effective given their health status, cultural context, insurance coverage, demographics, lifestyle attributes and treatment intricacies. P4.42Applying Shared Decision Making Models in Clinical Practice to Increase Exercise AdherenceAndrew Hanna, Kenneth KirkwoodThe University of Western Ontario, London, ON, Canada

Background: The benefits of incorporating exercise as a method to treat obesity has been well documented; however, clinical practice fails to utilize both the preventative and treatment benefits of exercise on various chronic diseases. Shared decision models between physicians and patients have been gaining recognition recently as a method to increase exercise adherence when prescribed in practice. To date, no shared decision-making model exists that incorporates both pharmaceuti-cals and exercise interventions to treat chronic diseases. Objective: The aim of this study is to develop and pilot a shared decision-making tool target-ing the treatment of obesity, with an emphasis on exercise prescription as first-line treatment. Methods: a search of the literature will be executed to identify shared deci-sion-making tools that have been implemented successfully in other areas of clinical practice. The findings of this search will be used to inform the development of a similar tool targeting the treatment of obesity. This tool will be piloted among 30 physician-patient pairs and a mixed methods paper survey will be administered to

assess patient acceptance, satisfaction and feedback. Anticipated Implications of Study Results and Conclusion: the findings will increase collaboration in clinical practice by empowering patients and physicians alike to participate actively in shared decision making when treating obesity. The findings will help make patients aware of the interventions that exist and highlight the benefits of exercise as a first treatment method over traditional pharmacotherapy. P4.43CHANGE Adventure Camp: Obesity Prevention and Health promotion for Children and FamiliesDoug Klein, Serena HumphriesUniversity of Alberta, Edmonton, AB, Canada

Objective: The CHANGE Adventure Camp is a new program to prevent and mange obesity by targeting the family unit. The camp aims to reconnect families and children with healthy, active lifestyles through a series of educational programs. The camp facilitates the exploration of nature and teaches participants key principles of physical activity, land use, growing food and meal preparation.Methods: The physician led camp content was developed in collaboration with community stakeholders, with each activity having specific educational messages relating to physical activity, nutrition and/or nature. The camp was piloted through two weeklong nature experiences for children aged 9–12 focusing on discovery, exploration and health. The CHANGE Adventure Camps were evaluated using a multi-method approach, including participant observation, facilitator reflections, and surveys of participants, parents and facilitators.Results: The weeklong camp included experiential activities related to 1) encourag-ing physical activity without a gym; 2) improving nutritional awareness and cooking skills; and 3) connecting with nature. Participants scored the meals on a 5-point scale with average scores ranging from 3.15-5.0. Participants also reported whether meals included first-time foods with some meals introducing new foods to 100% of the participants. Feedback from parents and participants was positive.Conclusion: The CHANGE Adventure Camp promotes healthy lifestyles in children and families by building life skills while engaging with nature. Future programing is planned to include family camps and children expanded age ranges. P4.44An Online Training System to Improve the Health of University Students: Rationale and DescriptionGillian E. Mandich, Linda MillerWestern University, London, ON, Canada

Background: It has been suggested that obesity may have a negative effect on the subjective well-being and happiness of individuals. Research has shown that hap-piness skills can be taught, and that these skills can have positive implications for emotional, physical and spiritual well-being. Given that physical and mental health are becoming an increasing concern on university campuses, innovative and flexible solutions such as online learning offer promising opportunities for this population. Methods: This study includes a descriptive research design involving pre/post self-report questionnaires used to assess happiness, physical well-being, and mental health. Data will be collected via questionnaires at baseline and post-intervention. Participants will be full-time, undergraduate student aged 17–24. The intervention is a series of 10-30-minute online video modules that teach happiness skills and are available to participants (1 per week for 4 weeks). The impact of the module on outcomes such as subjective well-being, happiness literacy, expressions of gratitude, and life satisfaction will be evaluated. The main outcome measure is self-reported happiness, and secondary outcomes include lifestyle information (body image and goal setting), health behaviours (exercise habits, stress, tobacco use, drug use,


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alcohol use), social information (social issues and friendships), and gratitude. Discussion: Given that physical and mental health are becoming an increasing concern on university campuses, this project explores a fresh approach to enhance happiness; improve quality of life, well-being and health; and motivate health behaviour change. Conclusion: It is anticipated that the modules will have a positive effect on health indicators among university students. P4.45Standards for a Bariatric Friendly Care Hospital - Translating Research into PracticePetra O’Connell1, Linda Iwasiw1, Vince DiNinno1, Mary Forhan2, Arya Sharma1, 2

1. Alberta Health Services, Calgary, AB, Canada, 2. University of Alberta, Calgary, AB, Canada

Thirty-five percent of patients admitted to an acute care setting in Canada had a body mass index classified as obesity and that obesity was associated with a two-fold increase in the length of time a person spent in hospital. Factors within the hospital care environment were found to contribute to costly increased time spent in hospital due to issues associated with respectful and responsive care that meets the needs of patients with obesity, access to appropriate and timely care, a lack of evidence for guiding practice in acute settings for patients with obesity, a lack of knowledge of health care practitioners about obesity and it’s impact on acute care and issues re-garding patient and provider safety. In response to this evidence, a university based research group, in collaboration with a provincial health authority, practitioners and patients at a regional hospital are leading a project to be the first hospital in Canada to methodically and strategically develop standards that contribute to the development of an acute care setting that sustains safe, high quality healthcare for patients with obesity who require acute care services. This presentation will describe the process and strategies used to change practice environments and behaviours in a hospital setting that will improve quality care and reduce time spent in acute care settings for patients living with obesity. P4.46The Hockey Fans in Training Weight Loss and Healthy Lifestyle Program Can Attract and Retain Overweight and Obese MenDawn P. Gill1, Wendy Blunt1, Ashleigh De Cruz1, Brendan Riggin1, Kate Hunt2, Sally Wyke2, Cindy M. Gray2, Christopher Bunn2, Roseanne Pulford1, Cassandra Bartol1, Karen Danylchuk1, Robert J. Petrella1

1. Western University, London, ON, Canada, 2. University of Glasgow, Glasgow, United Kingdom

Objective: To examine the feasibility of recruiting and retaining overweight/obese men into a gender-sensitized weight loss and healthy lifestyle program using the power of sport affiliation. Methods: Hockey Fans in Training (Hockey FIT) includes a 12-week active (group coaching) phase and a 40-week maintenance (self-directed) phase. We conducted a pilot pragmatic randomized controlled trial with an integrated process evaluation. Male hockey fans (aged 35-65 years; BMI ≥28 kg/m2) of 2 Ontario Hockey League teams were recruited. Eligible and consenting men were randomized to interven-tion (Hockey FIT) or comparator (Wait-list Control). Coaches monitored attendance weekly; men allocated to intervention, who attended <50% of sessions (including none in the final 6 weeks), were classified as ‘program non-completers’. Results: Email blasts from hockey teams (35%) and word of mouth (25%) were the most successful methods for recruiting participants. In <6 weeks, 105 men heard about the study; 24 men were excluded [did not meet eligibility criteria (n=17); unavailable on scheduled day/time slot for program (n=7)] and 1 eligible individual did not enroll. The remaining 80 men were randomized and enrolled. In total, 10/40

(25%) of men in the intervention group were ‘program non-completers’. Of ‘program completers’, the mean (SD) percentage of sessions attended was 81.7 (13.7)%. Conclusions: It was feasible to recruit and retain overweight/obese men to Hockey FIT. Recruitment methods were easy to implement and had no added costs. The majority of men were ‘program completers’ with high average attendance over 12 weeks; nonetheless, program optimization is warranted to further improve retention. P4.47Effect of Regular Physical Activity on Cardiovascular Risk Factors in Mid-dle-aged Active and Non-active IndividualsAlireza Ramezani1, Morad Hosaini2

1. Department of Exercise Physiology, Shahid Rajaee Teacher Training University, Tehran, Iran, 2. Sport Cardiovascular and Respiratory Physiology, Shahid Rajaee Teacher Training University, Tehran, Iran

Objective: lifestyles of Iranians can affect their susceptibility to cardiovascular diseases. This study is aimed at surveying the Effect of Regular Physical Activity on Cardiovascular Risk Factors in Middle-Aged Active and Non-Active Individuals.Methods: Subjects included 26 Teaching Staff and 55 administrative staff. The age range of test subjects was 26–58 years. Fasting blood glucose was measured by test strips of code free made in Pars Azmoon Co, Iran, serum TC, TG, LDL and HDL choles-terol levels were measured by test strips SD Lipid care made in Biosensor Co, South Korea. To determine Peripheral Arterial Disease (PAD) used Ankle-Brachial Index (ABI). Individuals had physical activity three sessions per week at least included as active persons. To assess variables was used one sample t-test, Pearson Correlation test, and independent t-test by use SPSS software, version 20.Results: Results showed that total measured variables located in normal range except administrative staff serum TG level that place in risk area (P=0.05). Total variables were not significantly different between faculty and administrative staff groups (P=0.05). There was a significant positive correlation between TC (r=0.204, P=0.031) and TG (r=0.277, P<0.012) levels with age. TC, LDL-C, and TG significantly correlated with BMI.Conclusions: Authors concluded that Faculty and not- the academic staff of University have health lifestyles, of course, it needs to encourage performing regular exercise training and health nutrition regime. P4.48Dental Professionals Perceptions of Sugar Consumption and Obesity Advice in the Dental PracticeJeanie Suvan, Petya Karadobreva, Bob Blizard, Albert LeungUCL Eastman Dental Institute, London, United Kingdom

Objectives: The WHO has challenged all health care providers to contribute to efforts targeting increased awareness of healthy weight dietary choices amongst patients. The study aim was to explore dental professionals’ perceptions of extend-ing advice to patients on sugar consumption and oral health to include overweight/obesity information.Methods: This study was a cross-sectional international questionnaire survey of dental professionals working in practice. The questionnaire covered the following domains: willingness and confidence, knowledge of the association between obesity/sugar consumption and oral health, self-evaluated abilities on screening and giving advice in regards to sugar consumption, obesity, and potential barriers to providing advice.Results: 245 dental professionals consisting of 79.6% females and 20.4% males completed the survey. Results showed the majority of dental professionals (75.3%) would be willing to give advice on obesity/overweight if a relationship between obesity /overweight and oral health was found. Significant misconceptions in their


Abstract Details

knowledge about obesity as a disease and its relationships to oral health were evident. Although 88.3 % of dental professionals are already providing counselling over other oral and/or general health matters, only less than 30% would start a conversation with their patients addressing sugar consumption and obesity. The lack of training and understanding of obesity as a disease was highlighted as a potential barrier to providing advice.Conclusions: Although dental professionals showed willingness to expand sugar consumption counseling beyond oralhealth messages, confidence is lacking. Fur-ther training is indicated to understand the association between sugarconsumption, overweight/obesity and/or their association with oral or general health. P4.49Impact of a Bariatric Support Garment to Manage Excess Skin on Activi-ties of Daily LivingKatelyn Teske, Chelsea Wong, Seyoung Kim, Mary ForhanUniversity of Alberta, Edmonton, AB, Canada

Objective: The purpose of this study was to investigate the impact of custom made bariatric support garments on patient engagement and participation in activities of daily living (ADL) (i.e. functional mobility, self-care, work and leisure).Method: Participants in treatment for obesity and who had lost significant amounts of weight were included in the study and were fit with a custom-made support garment. While wearing the garment for a minimum of seven days, participants completed a garment wearing log and participated in individual interviews. Partic-ipants were asked to describe their experiences participating in ADL while wearing their garment. Data was analyzed using thematic analysis.Results: Participants reported that they found it easier and more comfortable to move around as they participated in ADL including walking indoors and out, sitting, standing and running. These activities were completed in the context of work, self-care, recreation and physical activity. Participants also perceived improvements in their posture, ability to bend over, sit and stand with ease and bodily control during movements with less strain on their lower back. A second theme identified in the study, was increased self-confidence when participating in activities of daily living.Conclusion: Wearing the bariatric support garment provided participants the feeling of postural stability and control while mobilizing that translated into feeling more confident while engaging in ADL at home and in public places. Participation in life events provide opportunities for skill development, physical activity and social support that contribute to health and well-being.


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