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Good health isn't just about burning calories to hit weight goals – The Globe and Mail

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New research is showing physical activity is crucial to health, and even plays a role in weight loss – but not in the simple way the numbers suggest.

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When it comes to calories, sometimes the numbers simply don’t add up. Check the tally on your smartwatch or Peloton, keep track for a few months, and then check the bathroom scale. No matter how many calories you’ve torched, the resulting weight loss will be less than you hoped.

That’s the riddle at the heart of a recent review published by Lewis Halsey, who heads the University of Roehampton’s Behaviour and Energetics Lab, in the journal Physiological and Biochemical Zoology. It’s clear from the review’s title, “The Mystery of Energy Compensation,” that final answers aren’t yet forthcoming – but as Halsey explains, a flurry of studies using new techniques to measure calorie burn are overturning some long-cherished tenets of conventional wisdom about the effects of exercise.

The key technology in the debate is “doubly-labelled water,” which is water that contains rare – and easy trackable – isotopes of both hydrogen and oxygen. In the 1950s, a researcher named Nathan Lifson figured out how to accurately measure the total daily calorie burn of mice by having them drink some of this special water and then collecting urine over subsequent days to see how long it took to metabolize. The problem: it would have cost more than $300,000 to run the same experiment on a human.

It’s only in the past few decades that the cost has dropped enough for scientists to use the technique widely, with a current price of about $750 per person. The results have been unexpected, most notably when a team led Herman Pontzer of Hunter College in New York (he’s now at Duke University) tried it with the Hadza, a group of hunter-gatherers who still live a traditional lifestyle in northern Tanzania.

Hunting with bow-and-arrow and foraging with digging sticks, the typical Hadza adult gets more exercise in a day than the average couch-bound Canadian gets in a week. But as Pontzer recounts in Burn, an entertaining book about the new science of metabolism that he published earlier this year, the results defied his and everyone else’s expectations. Once you take into account factors such as age and body size, Hadza adults burn pretty much exactly the same number of calories each day as Canadians – and as everyone else from populations around the world tested with doubly-labelled water.

We know, from the fundamental laws of thermodynamics, that physical activity must burn calories. So the fact that high levels of physical activity don’t lead to greater overall calorie burn means that we must have other ways of saving calories: the “energy compensation” of Halsey’s title.

The first question is how we do it. One theory is that we fidget and move around less after exercise. Another is that we spend less energy on under-the-hood bodily functions like immune response and tissue repair. A third is that our cells become more efficient at converting food into usable energy, squeezing more power out of each calorie we eat. At this point, Halsey says, there’s simply not enough evidence to choose between them.

The second question is what it means for our ongoing societal struggle to lose weight. Another double-labelled water study, published in July, suggests that energy compensation kicks into high gear when you’re losing weight, but is less of a factor when your weight is stable or increasing. That’s consistent with the widespread view that exercise is more useful for preventing weight gain than promoting weight loss.

Even when energy compensation is working against you, it doesn’t erase all your efforts. In one study that’s often cited as evidence of the effect, people training for a half-marathon didn’t burn as many calories as their training predicted – but they still burned about 30 per cent more calories than before they started training, which may be enough to move the needle of the scale.

The broader message, though, is that good health isn’t just about hitting a certain weight. In Burn, Pontzer suggests that some of the health benefits of exercise may be a direct result of energy compensation. If your body foils your weight-loss goals by ramping down immune function, that might reduce chronic low-grade inflammation in response to things like food and allergens, while preserving the ability to respond to real threats. The same is true of the body’s stress response.

Halsey, too, remains convinced that physical activity is crucial to health, and even plays a role in weight loss – but not in the simple way the numbers suggest.

“We need to get over the idea that if we start doing, for example, 300 calories of exercise per day, then we have burned that many more calories per day,” he says. “That appears not to be the case, in the long run.”

Alex Hutchinson is the author of Endure: Mind, Body, and the Curiously Elastic Limits of Human Performance. Follow him on Twitter @sweatscience.

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Health-care announcements expected with two weeks to go in N.B. election race

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New Brunswick‘s Liberal and Green parties are set to make announcements about health care on the campaign trail today as the provincial election race enters its second half.

Liberal leader Susan Holt is scheduled to hold her announcement this morning in Saint John, N.B., followed by lunch at the city’s market.

A spokesperson with the Progressive Conservative party shared few details about the event scheduled for leader Blaine Higgs in Fredericton this morning.

Green Party Leader David Coon will hold a news conference this morning about “local health-care decision-making” alongside deputy leader Megan Mitton in her Sackville, N.B. riding.

On Saturday, Coon said he was proud to put forward a gender-balanced slate among the party’s 46 candidates.

While the Liberals and Progressive Conservatives are running with full slates, the Greens are three candidates short and will not have full representation when the province’s residents go to the polls on Oct. 21.

This report by The Canadian Press was first published Oct. 7, 2024.

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Alberta Health Services’ snag leads to potential delay of patient referrals

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EDMONTON – The Health Quality Council of Alberta is investigating how some medical referrals weren’t properly processed, potentially affecting 14,000 patients over the last five years across the province.

The referrals were made to specialists outside of Alberta Health Services, such as physiotherapists and dietitians.

The health authority’s CEO, Athana Mentzelopoulos, says it does an average 100,000 referrals per year, but in some cases it can’t confirm if patients received referral services.

She says the problem was flagged in late September, and a preliminary estimate suggests 31 patients may have experienced a potential negative outcome due to the delays.

The provincial government requested the investigation, and the quality council is to find out how the snag occurred and how it can be prevented in the future.

The health authority says it has begun notifying patients who may have been affected by the disruption, and the cases could date back to 2019.

This report by The Canadian Press was first published Oct. 4, 2024.

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Don’t fall for fake dentists offering veneers and other dental work on social media

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WASHINGTON (AP) — If you have stained or chipped teeth, you might be considering veneers, customized teeth coverings that can restore a photogenic smile without more extensive dental work.

But dentists warn that these pricey cosmetic enhancements are at the center of a worrisome online trend: unlicensed practitioners without proper training or supervision offering low-cost veneers.

These self-described “veneer techs” often promote themselves on Instagram and TikTok, promising a full set of veneers for less than half of what dentists typically charge. Some also market their own training courses and certifications for people looking to get into the business.

It’s misleading, health professionals warn — and illegal. All states require dental work, including veneers, to be performed under the supervision of a licensed dentist.

On Thursday, Georgia law enforcement officials arrested Brandon Diller, who promoted himself to 158,000 Instagram followers as “Atlanta’s top veneer specialist and trainer.” Diller practiced dentistry without a license and sold “training and certificates, which were worthless” and “provided no legitimate or legal credentials,” according to an arrest warrant from Fulton County’s District Attorney’s office.

Here’s what to know about veneers and how to avoid bogus providers and services:

What are dental veneers?

Veneers are thin, custom-made dental coverings used to hide minor imperfections or to fill in gaps between teeth. Unlike crowns or more invasive dental implants, veneers are almost always considered cosmetic dentistry and generally aren’t covered by insurance.

Dentists usually charge between $1,000 and $2,000 per tooth for veneers, with higher prices for those made from porcelain compared with lower-grade materials.

Placing veneers involves stripping some of the natural enamel from the tooth and bonding the new covering into place. Because of that process, getting veneers is considered an irreversible procedure, according to the American Dental Association. They are not permanent, and can be expected to last between 5 to 15 years before they degrade and need to be replaced.

In recent months the ADA has been stepping up warnings about the risks of veneer procedures done by unlicensed individuals.

“Quality control is lost without the involvement of a licensed dentist,” said Dr. Ada Cooper, a New York-based dentist and ADA spokesperson. “We undergo years of education and training and need to be licensed by various regulatory bodies before we can practice.”

What are the risks of getting veneers from someone who isn’t licensed?

Improper veneer procedures can cause a range of health problems, including severe pain, nerve damage and tooth loss.

Patients need to be anesthetized before the enamel is removed from their teeth.

“It could be incredibly painful if they’re not anesthetized correctly,” said Dr. Zach Truman, who runs an orthodontics practice in Las Vegas. “You can also go too deep into the tooth and penetrate what’s called the pulp chamber, which contains blood vessels and nerves.”

One of the biggest problems Truman sees with unregulated veneer work is that customers aren’t getting screened for existing dental problems, such as gum disease and cavities.

“If you put a veneer on a tooth that has an active cavity, you’re just going to seal it in there and eventually it’s going to progress to tooth loss,” Truman said.

Dental veneers aren’t the only option for improving the appearance of teeth. Over-the-counter whitening kits can help with minor stains and discoloration. And dentists can sometimes use composite materials to reshape chipped or uneven teeth. But Truman says those fillings are prone to crack and won’t last as long as veneers.

How can I spot bogus veneer providers online?

One clue: Many individuals performing unlicensed dental work promote themselves on social media as “veneer technicians.”

Instead of working out of a dental office they often perform treatments at beauty salons, hotel rooms or private homes. Some advertise multi-city tours and encourage clients to message them to book an appointment in advance.

Much of the appeal of the services is in their pricing, with some offering a full set of veneers for a flat fee of $4,000 or $5,000. That’s less than half of what patients can generally expect to pay at a dental office.

Performing dental work without an appropriate license is illegal, the ADA notes.

Dentists and hygienists are licensed by state governments, who also define the work dental assistants can perform. But in all cases, veneers and other dental procedures must be supervised by a licensed dentist.

Earlier this year, Illinois law enforcement officials arrested a woman running a business called the Veneer Experts after she posted videos of herself fitting braces, veneers and other dental products without a license. She was previously arrested in Nevada on similar allegations of practicing dentistry without a license.

What are the best ways to find legitimate dental providers?

The ADA maintains a website detailing the training and licensing requirements for dentists across the U.S. Most states also maintain websites where you can lookup and verify licensure information and find any past disciplinary actions for dentists and other health professionals.

“It’s really critical to understand that dentistry is a regulated health care profession that requires formal educations and licensure,” Cooper said.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

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