o here it is, Spring 'Well' 2004, 5 years old and counting. T.S. Eliot told us that, "April is the cruelest month" but not through my eyes. I prefer the words of Susan Bissonette who said, "An optimist is the human personification of spring." Dr. Atkins gives a compelling summary of The Atkins Diet in 'Weapons of Mass Reduction'. We admired the initiative, but were disappointed in the Special K pedometer. There's the joy of 'Kapiolani Park' and the sadness of the 'Last Supper'. Don't miss the utterly remarkable photos of the work of plastic surgeon Bill Magee in 'My Favorite Things'. Dr. Magee literally is helping a damaged world to smile. 'Walking the Talk' reminds us in many different ways that Mark Knopfler was right when he sang, "Do the walk, do the walk of life." 'Well' would not exist were it not for the artistry, input and presentation skills of Ron Nye, the insight, editing and photography of Bev Mason, and the sense of humor they both possess. There's much more, so move your mouse to enjoy our vision of wellness

	look at the latest in low-carb marketing and research and some very persuasive last words from the mouth of Dr. Atkins.
(If you want to understand why the Atkins diet works, read the section 'Dr. Atkins, in his own words' at the end of this article.)

In the past months, it's been hard to open a magazine or newspaper without being confronted with an Atkins related article. The post mortem Atkins seems to be bigger than he was in life, almost literally and metaphorically. Fahrenheit 2004 is the temperature at which truth burns and with so much money at stake and so many special interests and spin-doctors at work, the controversy has been hot and truth has been hard to pin down.

I suspect we'll never be sure of the answers to some of the following questions. Did Dr. Atkins slip and fall on the ice and hit his head, leading to a coma and death, or did he have another heart attack, which caused the fall? (He was known to have suffered a cardiac arrest in 2002). Was his cardiac condition the result of a viral infection, as the Atkins group asserts, or could it have been partly a result of his diet and lifestyle? Did the good doctor actually gain over 60 lbs. during the 8 days he was admitted to hospital and his death, thus elevating his weight classification from merely overweight to obese? We'll probably never know the answers to these questions because, somewhat surprisingly, no autopsy was performed. Of course, none of this would matter were it not for the fact that there is a potential 25 billion dollar business in low carb living, and the untimely death of its figurehead from cardio-vascular complications would not be what the spin doctor ordered.

These are not mean-spirited and petty observations but rather they are illustrations of how hard it is to find the simple truth where big bucks are involved and how easy it is to become cynical.

Diets and their followers

Diets can be like cults, and cults often rise and fall with the publicity about the life and death of their leader or guru. The anti-cancer diets of Nathan Pritikin and Adelle Davis lost some credibility when Ms. Davis died of cancer and Dr. Pritikin committed suicide after being diagnosed with cancer. The low carb/high protein diet of Dr. Irwin Stillman 'The Doctor's Quick Weight Loss Diet' went out of fashion when Dr. Stillman died of a heart attack. This book was actually ghost written by Samm Sinclair Baker, who also co-wrote 'The Scarsdale Diet' with Dr. Herman Tarnover, who was shot to death by his headmistress mistress. (Although we can't blame this on the diet). Sales of Suzanne Somers ThighMaster and diet books were not helped when she was pictured leaving a liposuction clinic. So it's understandable that the low-carb industry does not want us associating Dr. Atkin's death with a heart condition.

I've noted previously in 'Well' that most people really haven't read the 500 plus pictureless pages of 'Dr. Atkins New Diet Revolution', so that much of what is talked and written about Atkins does not come from a clear understanding of his diet. To prove my point, I created an informal Atkins quiz, which I gave to 10 people who had either been on the diet or who felt they were familiar with it.

Quiz

1. "If you're not eating vegetables, you're not on the Atkins diet' True or False?
   Answer: True
   Responses: 4 T     6 F
   
2. Dr. Atkins said that if you followed his diet you didn't need vitamin supplements and he did not recommend them.
   Answer: False
   Responses: 5 T     5 F
   
3. How many phases in the complete Atkins Diet?
   Answer: 4
   Responses: 1 Don't know     3 Two stages     2 Three stages     4 Four stages
   
4. Name as many phases (or levels) as you can in the Atkins Diet.
   Answer: 1. Induction
   2. OWL (Ongoing Weight Loss)
   3. Pre-maintenance
   4. Lifetime Maintenance
   Responses: Only one person could name the 4 correctly.
   
5. Are you likely to go into ketosis if you follow the Atkins diet?
   Answer: Yes, particularly in the induction phase.
   Responses: 7 Yes     2 Don't know     1 No
   
6. Dr. Atkins says, "If you are not exercising you are not on the Atkins Diet." True or False
   Answer: True
   Responses: 4 True     6 False
   
7. What artificial sweetener does Dr. Atkins recommend?
   Answer: Sucralose marketed as Splenda
   Responses: 1 Splenda     7 incorrect or "don't know'     2 "He doesn't believe in artificial sweeteners".
   
8. What is the "metabolic advantage" that Atkins claims for his diet?
   Answer: Atkins simple answer is that burning fat takes more calories than burning carbohydrates and that the 'calorie is a calorie' thinking is wrong.
   Responses: 6/7 people were on the right track in answering this one.

Overall, as I suspected, half the people didn't really know what they were talking about.

The 'Metabolic Advantage" Question

When you set aside all the do's and don'ts and packaging and presentation, the 25 billion dollar question remains, 'Does the Atkins Diet, or ones just like it, confer a 'metabolic advantage' over the many low fat diets?' Atkins has always maintained that this is the case, basing his original thinking on two modest studies by Kekwick and Pawan reported in the Lancet July 28, 1956. (I reviewed those studies in detail in the Fall 2002 edition of 'Well' in 'The Great Diet Debate') However, much to the discomfort of many of the nutrition establishment, most recent research seems to suggest that Dr. Atkins has a strong case. Last year, a Harvard School of Public Health study was released in which the scientists worked with the chefs at the Ristorante Marino in Cambridge, Mass. to provide some meticulously crafted menus, which included dinner, a snack, breakfast and lunch. Reporting on the study Ann Brocklehurst writes,

"The 21 participants were divided into a low-fat group, whose members lost 17 lb. on average, a low-carb group that ate the same number of calories and lost 23 lb., and a third group on a low-carb plan that got 300 more calories than everyone else and lost 20 lb. The counterintuitive results contradict the idea that the best way to lose pounds is to eat fewer calories, and support Atkins' metabolic-advantage theory and the idea that it takes more energy to digest certain foods.

Matching Caloric Intake			Extra 300 Calories
	Low Fat	Low Carb	Low Carb
Weight Loss	17 lbs.	23 lbs.	20 lbs.

The Harvard study, designed as a pilot for a much larger study still to come, was too small to be statistically conclusive. It was led by the new guard in the diet wars, researchers with reputations to make, and was attacked, using familiar criticisms, by the old guard, who not only have reputations to lose, but an entire belief system. First off, the critics accused the poorer-performing dieters of cheating, a standard charge that's easy to make since diet studies rely on the honour system, and it's impossible to prove that some dieters aren't secretly scoffing down Snickers bars. The critics also accused the Harvard participants of violating the first law of thermodynamics, which states that energy -- in this case calories -- can neither be created nor destroyed. But the obvious alternative explanation is simply that the conventional wisdom about nutrition is wrong.

Although a very small minority of nutritionists concede that the calorie theory needs refining, the majority can't give up their faith in low fat. They point to numerous peer-reviewed scientific studies that demonstrate people who follow low-fat diets lose weight. But what remains to be proven is whether low-fat diets work better or worse than low-carb alternatives. With definitive diet studies still to come, however, the public has chosen not to wait around and get fatter. It's ignoring the dire warnings of nutritionists and opting for low carb."

Two studies were published last year in the New England Journal of Medicine and both showed that participants lost more weight on the Atkins Diet than a matched group on a low fat diet. Not only did the Atkins followers lose more weight but, to the surprise of the researchers, improved key factors associated with coronary artery disease. As previously reported in the Spring 'Well' 2003 (Walking Thoughts - sub-section Dr. Atkins), Dr. Gary Foster, who is clinical director of the Weight and Eating Disorders Program at the University of Pennsylvania, and his co-researchers compared an Atkins diet group to a group on a low-fat/high complex-carb diet. After 3 months the Atkins group lost twice as much weight and some of their major coronary risk factors improved.

	Atkins group	Low Fat Group
LDL (Bad cholesterol)	7 points higher	2 points lower
HDL (Good cholesterol)	12 points higher	unchanged
Triglycerides	22 points lower	unchanged

It would have been better to see the LDL's go down, but the increase in HDL's and big decrease in triglycerides is impressive. Dr. Foster said, "It was very surprising, I went into this skeptical about the claims that the Atkins Diet was safe and now I'm much more open-minded." He has now embarked on a major 5-year low carb study.

In the second study, at the Philadelphia Veterans Affairs Medical Center, subjects started weighing an average of 288 pounds. One group was told to limit carbohydrates to 30 grams a day. The other was told to eat 500 calories a day less than the quantity necessary to maintain their starting weights and to limit fat to 30 percent of calories. After six months, the low-carbohydrate dieters lost an average of 13 pounds. The low-fat dieters lost four. Fifty-three of the 132 people quit before the six-month period.

These results are not definitive and not statistically significant, but they are not what the experts expected to find and go a long way to explaining why the New York Times best sellers list looks the way it does, with the low carb South Beach Diet leading the way in hard cover sales (over 5 million) and Dr. Atkins New Diet Revolution still leading paperback sales after nearly 7 years, and the Atkins Essentials not far behind.

Many physicians who've long preached low fat diets to their overweight patients are now turning to Atkins to deal with their own weight problems. Two leading cardiologists in my home town could both be poster boys for sustained weight loss on Atkins.

High Profits from Low Carbs.

Big business is not waiting for the definitive research study, if indeed such a thing will ever exist. They have jumped on the low carb gravy train (or perhaps non-gravy train) as a way of boosting sales to weight conscious North Americans. Writing in the New York Times, Kate Zernike and Marian Burros reported.

"Last month, representatives of 450 companies, including Kraft, Con-Agra and WalMart, gathered at a two day Low-Carb Summit in Denver to discuss how to take advantage of what analysts predict will be a $25 billion market for everything from low-carb pasta to low-carb European barge cruises and low carb marshmallows to hotel "get a-weighs." In Southern California, two entrepreneurs (and Atkins dieters) last month opened the first two in a chain of low-carb supermarkets called 'Pure Foods', and individual low-carb markets are opening nationwide, while in Canada the 'Low Carb Centers' are doing brisk business. In January, a new magazine called 'LowCarb Living' hit newsstands."

The "Atkins approved" symbol is ubiquitous and is showing up at places we don't always associate with weight loss. Here's a few of the companies I've seen in recent days who are proffering low-carb choices:

McDonalds
Morning Start
Burger King
TGI Fridays
Pure Foods
Kraft

Nestle
Heinz
Weston Bakeries
Panago Pizza

Even the breweries are involved with Molson's selling low-carb Molson Ultra, while Sleeman's offers Clear Beer and Labatt's, Sterling Beer, all to help us lose weight and drink ourselves thin.

Health Canada is already moving to try and bring some consistency and meaning to low carb labeling. One term that's starting to show up is 'net carbs'. Net carbs exclude carbohydrates that come from fiber and sugar alcohols, with the lower tally supposedly reflecting only those carbohydrates that elevate blood sugar. Meanwhile, names like 'Carb Wise', 'Carb Conscious', 'Carb Smart', 'Carbolite' and 'Atkins Friendly' are everywhere on your grocery store shelves.

The old conventional wisdom was that low carb dieters couldn't eat bread, pasta, cake, cookies or candy. But the new improved decarbonated wisdom is that low carb dieters can eat almost any food, as long as they buy higher priced, low carb versions.

Dr. Atkins was astute in designing a diet that is psychologically appealing. The Induction phase of the diet really jump-starts weight loss, reinforcing people's immediate desires. Our taste buds respond to fat and Atkins dieters can indulge in a variety of fatty treats. By cutting out most carbohydrates, he eliminates the food group, which accounts for the largest proportion of our caloric intake.

The Atkins spokespeople such as seminar leader Colette Heimonitz have been quietly preaching moderation and a little revisionism to Atkins followers.

The diet remains high fat but the new word is that more of that fat should be unsaturated, the kind that comes from fish and selected vegetable oils rather than just bacon, cheese, steaks and butter. In the words of Dr. Atkins in 'Atkins for Life', "You should always eat a balance of different types of natural fat."

It's interesting that despite all the low carb publicity and the possibility of a 'metabolic advantage' and the sales of millions of books, the huge majority of people on the National Weight Control Registry lose weight the old fashioned way. The National Weight Control Registry, which follows over 3000 people who have lost at least 30 lbs (average over 71 lbs) and have kept it off for 6 years, has found some commonalities among people who successfully lose weight, and, more importantly, keep it off.

1. Breakfast in the morning. (Don't leave home without it.)
2. Regular exercise
3. Plenty of fruits and vegetables. (complex carbs)
4. Regular weigh-ins. (Don't kid yourself)

For people in search of a nutritional loophole, things like breakfast, regular exercise and fruit and vegetables have very little appeal despite the fact that they can be the foundation of long-term weight control and healthy living.

Meanwhile, the dueling diet doctors pronounce their new theories and denounce opposing points of view and the public gets ever more confused. The recent American College of Preventative Medicine conference is typical. Lisa Sanders, M.D. from the Yale Preventative Medicine Research Center said, "I think Atkins has got something" and went on to say physicians should not summarily dismiss low carb diets. At the same conference, a colleague from the same Research Center at Yale, David Katz, M.D., said that low carb diets such as Atkins are "so utterly wrong as to be insane."

The real insanity of course is people who don't exercise, eat huge quantities of processed food, smoke, live stress-filled lives, and then look for a pharmacological or medical solution for their unsustainable lifestyle.

"There's only one guru can help you win
And she's walking around inside your skin.
You are the trainer, the dietician is you
You're the psychologist, you're the guru."

I enjoyed the following article by Richard Cohen, which brought a little humor into the serious business of losing weight. As Monty Python and Don Ardell never tire of reminding us, "Always look on the bright side of life." When Faith is Toast. by Richard Cohen Near where I live is a marvelous bakery. Sometimes I stand outside the window, like some forlorn figure from Dickens, and watch people eat their bread, lathering it with butter or jelly or -- someone stop me! -- cream cheese on a toasted anything. I love bread more than almost anything in the world, but I will not have it, cannot have it, have not had it -- all on account of Robert Atkins, who died last year at the age of 72, weighing 258 pounds. For years, I've been on his diet. My story is that I've been on something like the Atkins diet for years. I say "something like" since I never actually read his diet book or consulted a doctor of any kind. I simply listened to what my friends were saying and cut out bread and pasta and started eating meat. It worked. I lost weight. [Martin's comment. "This is typical of the way in which many people approach the Atkins diet."] Sure, I missed my bread. Sure, I missed my bagel in the morning. And sure, I missed my pasta, which I enjoyed at least once a day. It was tough to give all that up. But in exchange, I got to eat meat, which meant steak, which is what I was not supposed to eat until Dr. Atkins, blessed be he, came along and repealed all sorts of laws of nature or physics. I loved the guy. I could have bacon. This was Atkins's greatest gift. Not only was bacon suddenly okay and not, as it had been before, the precursor of almost-instant death, but it was actually good for you. Every morning, I had three slices of delicious bacon. What a diet! On weekends, I sometimes had more than three slices, figuring that if three slices were good for me, six were even better, a virtual fountain of youth from which I could drink each morning of a very, very long life. Now, all of that is being brought into question. A group of anti-Atkins guerrilla fighters, the Physicians Committee for Responsible Medicine, which advocates vegetarian diets, got hold of the New York City medical examiner's report on Atkins's death and went to town with it. They raised all sorts of questions: Why the heart condition? Why was he so obese? Did his diet contribute to his heart problems? In other words, could you really eat fat and lose weight at the same time -- and stay healthy? After all, 72 is not that old. For me -- and countless others -- much depends on the answer to that question, and I'm not talking about diet and health. I'm talking instead about gullibility, about wanting to believe something so badly that common sense got shoved aside. (Bacon, indeed!) The Atkins diet made me into a believer. Here I was, all these years, the sort of person who laughed when some homophobe turned out to be gay or some cultural conservative was found in the hay with a 16-year-old. I scoffed at people who were always discovering that college sports were corrupt or that "fan" was just another word for sucker. Me? I floated above it all. I believed fully and without reservation in cynicism. Cynicism will never let you down. And yet every morning, I did my little religious number from the church of Dr. Atkins. I had my bacon. It made no sense -- not to me, anyway -- but it gave me something I wanted, which happened to be the bacon. Later in the day, I could have my steak -- the fattier, the better -- and take solace from the sacrifice I was making by forswearing bread and pasta. Now, I am experiencing a crisis of faith. Atkins is dead and his secret is out. He was fat and sick. I want to move on to a new diet, something with bread and pasta that also satisfies my newly reinforced cynicism. All I need is someone to tell me it works.

One of the goals of 'Well' is to help you look at wellness through 'new eyes' and to sometimes see familiar things in a different light. 'Well' also can bring you some depth, which is not always available in the speed-reading world of computers and popular magazines. Dr. Atkins can no longer respond to his critics, so we have given him the last word and some space to describe his diet and why it works.

Dr. Atkins in his own words

The following is a verbatim transcript of Dr. Atkins' presentation to the Millennium Lecture Series Symposium, "The Great Nutrition Debate", sponsored by the US Department of Agriculture in the year 2000. The presentation was accompanied by slides, most of which are unavailable to me, but I have included the ones I could find. Other presenters included John McDougall and Dean Ornish, who gave some insightful and often humorous responses to Dr. Atkins presentation. Dr. Ornish spoke last and opened with the comment that the "order of presentation was from the most unhealthful (Dr. Atkins) to the most healthful diet (the Ornish Diet)." But as the wheels of science and research grind away, it seems that there are some reasons behind the success of Dr. Atkins' diet.

Okay. I've got a lot to say and not a lot of time to say it, so I'm not going to be very sociable. After analyzing virtually every scientific paper written on the low carbohydrate diet over the last 80 years, beginning with when it was first offered as a treatment for epilepsy, I am convinced that a diet low enough in carbohydrate to automatically convert our stored fat into the body's primary energy fuel is qualified at present to be considered the treatment of choice for obesity and related conditions such as diabetes, hypertension and atherosclerosis.

I know that to gain mainstream acceptance of this proposal I must first demonstrate that the nutritional program, which I believe can put an end to the lion's share of obesity right now, is both safe and effective over both the short and the long term, so in the brief time allotted let me do just that.

Stored fat is, after carbohydrate, the body's backup fuel system. The human body cannot store more than a two-day supply of carbohydrate. In the absence of dietary carbohydrate, fat becomes the primary fuel. It's next on the pecking order.

This metabolic changeover is supported by biochemical catalysts, which facilitate the steady burning of fat, producing more energy, increased well-being and a dramatic loss of appetite.

What are ketones? They are simply the energy fuels derived from our fat stores. Fat delivers energy via ketones, just as carbohydrate delivers energy by way of glucose. Enzymes are present within all our cells, including our brain cells, to convert ketones into useable fuel.

When ketones are used as fuel, the most consistent finding is a decrease in appetite. Insulin is not involved in ketone production. Thus, the consequences of elevated insulin, which are many - there are increases in triglycerides, in blood pressure, in adrenaline, in cortisol; all of these are avoided.

Obese individuals and people who are overweight are keto resistant. Pay attention to this term. What it means is that there will be no accumulation of ketones in the blood.

The best documentation of keto resistance was brought to us by two very important researchers, the department heads of London's Middlesex Hospital, Alan Keckwick and Gaston Pawan.

In their documentation they showed that obese subjects given the ketogenic diet that I'll tell you about momentarily produced a flat level of ketones rising from two milligrams to an average of four milligrams, never more than six, whereas the non-obese subjects had their ketones escalate rapidly.

This is one reason why overweight people will never have problems with ketosis, but ketosis is a negative catchword for many people. The only reason can possibly be that they're confusing it with diabetic ketoacidosis.

Look how diametrically opposed they are. Ketoacidosis occurs in Type I diabetes, meaning it occurs because of an insulin absence or an insulin deficiency. Benign ketosis is achieved in overweight subjects whose metabolism is characterized by the fact that they put out too much insulin.

Ketoacidosis is caused by an increased intake of carbohydrate, benign ketosis by a decreased intake of carbohydrate. There is, of course, acidosis in ketoacidosis, but in benign dietary ketosis the pH is normal. There is no acidosis. In ketoacidosis, patients are extremely symptomatic, and in ketosis the subjects describe an improvement in well-being. Now, that's pretty different. Don't let anybody confuse it ever again.

Much of the success of the low carbohydrate diet is that it is extremely effective for people with large appetites who enjoy eating, and these are the two main reasons why. First, hunger is eliminated. Hunger is not even allowed. Hunger is eliminated because the biochemical changes I will outline momentarily reduce the appetite.

Secondly, and this is something that bears emphasis. More weight is lost on low carbohydrate diets than on balanced diets identical in calories. This benefit is called "metabolic advantage". We're going to look at these two phenomena right now. First we'll look at the hunger aspect.

The guru of fasting as a weight loss system, Dr. Garfield Duncan, back in the 1960s when fasting was in vogue, he described a dramatic decrease in hunger after the second day of a fast. He attributed this to high levels of ketones. In his words, "In every case, there was a relationship between hyperketonemia and loss of appetite."

In 1963, Walter Lyons Bloom and Gordon Azar in Atlanta discovered that the same degree of ketosis could be achieved simply by eating protein and fat containing foods and eliminating carbohydrate. There was no need to fast. Instead of a fast, a meat and salad diet would do the trick. Therefore, carbohydrate restriction will suppress the appetite.

Bloom and Azar's paper convinced me to go on the only diet I've ever been on. That was 36 years ago, and I'm still counting, and I'm still on it, but here's the second point.

Is a calorie is a calorie is a calorie really true? This axiom that everyone repeats, is it really true? The truly significant breakthrough came from Keckwick and Pawan. After a series of animal experiments, including the discovery that rats on a low carbohydrate diet put out a fat mobilizing substance which, when injected into other animals, caused an automatic weight loss, they directed their attention to obese humans.

Two groundbreaking studies were published in 1956.

First, they studied 1,000 calorie diets, but it was a research study that they had done on rats, and this is what they did. There were diets 90 percent fat, 90 percent protein, 90 percent carbohydrate. They wanted to see the effect.

One thousand calories of 90 percent carbohydrate produced no weight loss. As a matter of fact, there was a slight weight gain. The 90 percent protein diet produced a weight loss between three and a half and four pounds in the week that people followed it. The 90 percent fat diet did even better. Between five and six pounds of weight were lost. That is a dramatic portrayal of how different foods can lead to different amounts of weight loss.

But, of course, there were all 1,000 calorie diets, and they wanted to look at diets with sufficient calories not to provide guaranteed weight loss.

So look at this one. Look at this one. For an average of eight days, six subjects were alternated between a 2,000 calorie balanced diet and a 2,600 low carbohydrate diet.

The 2,000 calorie balanced diet led to a one pound weight gain, as you see on this slide, whereas the 2,600 calorie low carbohydrate diet given to the very same subject -- it was a cross over study -- produced a three pound weight loss in the same amount of time. Keckwick and Pawan did water balanced studies, and it wasn't water.

The mathematics. A half a pound a day more weight loss is 1,750 calories of advantage plus the 600 in the extra food. This provided an edge totaling 2,350 calories per day. That means they demonstrated for the first time a phenomenon called metabolic advantage, a refutation of the calorie theory where diets of different compositions lead to disproportionate weight loss.

Keckwick and Pawan, despite their important academic position, were met with skepticism, but nine years later Dr. Fred Benwa and his colleagues at Oakland Naval Hospital furthered the concept. Their technology allowed them to measure body fat, and this is what they found.

They compared a total fast, which certainly was in vogue in those days, with a 1,000 calorie, ten grams -- very low -- carbohydrate diet for ten days. They found that the fasting took off 21 pounds, but only seven and a half of those pounds were fat. The other 14 were lean body mass.

The low carbohydrate diet, despite the extra 1,000 calories, took over 14 pounds, all but one-half pound of which was fat. Virtually none was lean body mass. Again it met with skepticism, but it was quite logical. In starvation, you will start to use your protein for fuel, but when ample fat and protein are included in the diet there will be no need to do so.

More skepticism and more studies. This time the professor of medical nutrition at Cornell, Dr. Charlotte Young, studied eight obese 23-year-old men, undergraduates at Cornell and graduate students at Cornell. They were all overweight, and she used an 1,800 calorie diet.

An 1,800 calorie diet of differing amounts of carbohydrate. One was 104, moderate low; one was 60, even lower; and the other was 30 grams of carbohydrate a day. She also did body fat estimations.

This is how much body fat they lost. Two pounds a week for the nine weeks on the 104 gram diet, two and a half pounds a week on the 60 gram diet, and 3.6 pounds per week on the 30 gram diet. This means that cutting down from 60 to 30 grams, from low to even lower, without cutting calories led to an increase ten and a half pounds of fat being lost in the nine weeks of the study.

I hope I've proven that the diet is effective, so now let's turn our attention to the safety. Over the years, I've heard myriad concerns, but very little in the way of observed complaints. In fact, in 1973 the AMA requested that its members be on the lookout for adverse effects from my diet and report them to AMA headquarters.

Three years later when we checked, despite the fact that millions had been on my diet, no examples of adverse reactions were in their files. None. Some complaints, by the way, that organs such as the kidneys or the liver are damaged by the diet must be dismissed immediately as being total inventions. Not a single case of kidney or liver damage was ever reported, even as an isolated case history.

The major issue then seems to be the speculation that it would be bad for the heart. I hope you agree that it's not the cholesterol and fat in the diet that leads to heart disease, but rather the cholesterol and fat in the blood. If so, we can review the changes in the lipid profile on low carbohydrate diets. They fall into a common pattern.

The total cholesterol usually drops a bit, and there is usually a tendency for the HDL to rise and the LDL to fall, much as a recent study out of Wilmington, Delaware on a modified low carbohydrate diet shows.

In this particular study, all the lipid variables moved in the right direction. You will notice that these people lost a lot of weight, and the first group that I'm about to show you the changes were fairly dramatic.

Another group was done with more people who lost very little weight, but they had a major effect on their blood sugar. They were diabetics. However, again every single one of the parameters, the cholesterol, the triglycerides and the LDL, all went down, and the HDL went up.

Okay. Now, most of the other studies throughout the years, and I've reviewed the literature, and it goes back to the 1950s and 1960s -- there are about ten of them -- report a striking improvement in triglycerides particularly.

I want to talk about triglycerides because this is much more important than you might imagine. It's logical, by the way, that it should be beneficial in controlling triglycerides because body fat biochemically is triglyceride, and we know that the diet causes a loss of body fat.

The first demonstration of this was done at Harvard by P.K. Ressel and his colleagues. The subjects had very high triglycerides in Ressel's study. Their triglycerides ranged from 500 and up, and a typical fall was from 1,300 down to 300.

There were many, many other studies, which I don't have time to show, but you can be sure that high triglycerides are corrected by a low carbohydrate diet.

The impact of high triglycerides cannot be underestimated. Let's look at another Harvard study, this one very recent, published in Circulation, October, 1997. Gaziano was the senior author.

He took 340 patients who survived a myocardial infarction and got out of the hospital. They were compared with age and sex matched controls. Of all the lipids studied, and they studied every lipid there was, they were most fascinated by the elevation of triglycerides combined with a low level of the good cholesterol, the HDL.

This is what the study showed. They divided them into quartiles of this ratio, triglyceride to HDL. The lowest quartile or the most ideal number, so to speak, was given a factor of one. They were assigned that number. Then 4.1 times more of that group in the second quartile were in the heart attack group, 5.8 times in the third quartile, but in the fourth quartile, the upper 25 percent, there was 16 times more likelihood of being in the heart attack group if you had triglycerides combined with low HDL. This is the most powerful risk factor for heart disease ever described.

If you look at what cholesterol does, it's maybe two to one. If you look at what homocystine does maybe five to one, but 16 to one? This is what you must be looking for if you want to reverse heart disease.

The importance of high triglycerides then is that they are perhaps the most important cardio risk factor at all, but they are a known surrogate marker for hyperinsulinism. Now, we haven't talked about hyperinsulinism, but a lot of people have. High triglycerides and low HDL are surrogates for this phenomenon.

You do see, by the way, the same incidence of high heart attack rates when you study insulin levels as well. Even more important is that triglycerides are a known responder to carbohydrate restriction.

We've done a retrospective study on 319 subjects at the Atkins Center we're going to really skip most of. We don't have time. I just want to point out that in the group of 85 people who had triglycerides of over 150, the value one year later was less than 50 percent of what it was at the beginning of the study.

To dismiss the complaint that the Atkins diet skimps on fruits and vegetables, I would like to point out that it is nutritionally naive to lump fruits and vegetables together. There is a wide variance in their phytochemical content.

In my latest book, Age Defying, I deal with this issue. Carbohydrates per se are not nutritionally essential, only the phytochemicals that they contain. Future dieters will be instructed to select foods with a high antioxidant to carbohydrate ratio. The best phytochemicals act as antioxidants.

There is a very good study. By the way, it was done out of Tufts, and I wonder if it was done from the USDA. I hope it was because this work is very, very valuable.

These are the fruits and vegetables that have the highest ratio of antioxidants, done by the Tufts study, per gram of carbohydrate.

You see that at the top of the list are foods like garlic, kale, onions, leafy greens, spinach. These are the foods with the highest ratios. The only fruits on the list were berries.

If we now turn to the next list, you're going to see the bottom of the list.

You're going see that things like apples and pears and bananas have a reading of 0.2, and yet kale a reading of 6.5, so that if you pick the right green vegetables you will do 30 times better than if you pick the wrong fruits.

One leaf of lettuce has double the antioxidant power as an entire banana, so let's no longer lump fruits and vegetables together. Let's learn to be selective and pick the vegetables that work.

Now we have to deal with the accusation that the Atkins diet is low in vitamin and mineral content. Here's an example of a 2,000 calorie version of my strictest diet from the standpoint of carbohydrate. It only has 20 grams. It starts with a three egg omelette of avocado and cheese and tomato and two strips of bacon and so on. You can read the rest. I hope you can. I can't from here, but maybe you can.

All right. I want to show you it measures up to the RDI, which stands for the recommended daily intake, of 12 different vitamins.

Do you see that black line? That's 100 percent. These are 12 vitamins. Nine of the vitamins go way over that line, two of them are virtually at the line, and only one, pantothenic acid, is at the 50 percent mark, and it's a question of whether we can do better.

Now, I personally believe in nutritional supplements for everyone. I believe that people on the food pyramid diet need nutritional supplements a lot more than people on the Atkins diet, and so if I tell people to take nutritional supplements it's not because my diet is inadequate. It's because they were on an inadequate diet before they started my diet.

Okay. Now the main question about the long-term studies. No one has one. There are no long-term studies showing that any diet for weight reduction is both effective and safe. Mostly it's not hard to show that they're safe, by the way, but none have been shown to be effective. To be effective, they must be followed. They must be easy and pleasant enough to follow.

The recidivism rate of most diets falls into the 95 percent range, which indicates that very few people want to follow them. I predict that my diet will be the first diet to achieve the long-term effectiveness award, and the reason is that it is easy to follow. It's easy to comply with. You're never hungry. You have a metabolic advantage. You can take in more calories than you can on other diets and still lose weight. You can go to restaurants, order from the best of the main courses. You can eat in luxuriously, and you will correct an awful lot of other health problems.

It will correct diabetes, hypertension, most of the risk factors for heart disease, gastritis, esophageal reflux disorder, headaches and a variety of other problems, and for all of these reasons I hope -- the reason I'm here, by the way, is to help the people of our nation and of other nations, and I hope to correct the misinformation that people have to deal with saying that a low carbohydrate diet is scientifically unsupported

I hope that some government official will decide okay, it's pretty clear that long-term studies are going to have to be studied by the government and that they will do that. When they do, they will begin to get some of the exiting results.

Thank you.

Listening to my local FM rock station (93.6 The Zone), I was surprised to hear the morning DJ talking about pedometers. He was delighted by the generosity of his Special K pedometer, which was crediting him with 10,000 steps for, as he put it, "a few trips to the coffee machine". He'd discovered an almost exercise-free fitness program. Unfortunately, the steps were not originating from Paul Brown, the DJ, but were an artifact of the often erratic plastic giveaway from his Special K box.

This may have been a little DJ hyperbole, but was symptomatic of the problems that many people who contacted me encountered with their give-away pedometers from Kellogg's.

I've spent much of my adult life encouraging people to be physically active. At times, I felt like a voice crying in the wilderness as people became more and more sedentary. Not surprisingly I was excited by the announcement that Kellogg's Canada was going to partner with the Canadian Institute of Health Research and some other agencies to distribute 800,000 free pedometers to Canadians. The cereal boxes would include a reference to the www.canadaonthemove.ca web site where people could provide their own demographic data and record their daily step-count. This was to be the marriage we are always looking for, of government and industry with the general public being the major beneficiary.

Conceptually, the idea is excellent and is the product of some very good minds. The Canada On The Move website designed and built by Blue Spark contains some good features and will be of on-going value to Canadians. I like the single month display, which is like an advent calendar into which you enter your steps each day. The total number of steps accumulated by Canadians makes an impressive looking number when you log on.

However, the linchpin of the enterprise, the Kellogg pedometer (step counter), has not lived up to the grand design of the program. The very last thing I want to do is to be critical of an initiative to get people walking, (any jackass can kick down a barn door) but based on the enquiries I made I believe the malfunctions of the Kellogg step-counter and possibly the inexperience of people unfamiliar with pedometers have left a lot of people disillusioned and frustrated.

When the Special K pedometers were released in January, myself and fellow step-counting enthusiasts quickly tracked down the supermarkets where they were available and purchased a few boxes. The price was right, $5.99 for a 475 gram box of Special K, which included the pedometer with an "approximate retail value $15". We thought they might be great for schools and other organizations looking for affordable, effective pedometers.

I tested my new Special K pedometer in the time-tested way, by going for a walk. All was well on my first walk, which normally takes about 5100 steps (a chocolate bar walk), the Special K pedometer read 4135, but I figured my steps were longer than the one-step-fits-all on the Kellogg step counter. I wore the same one the next day and it quit, never to work again. I tried wearing 2 Special K pedometers simultaneously and got wildly different results, although one of them seemed reasonably accurate.

I thought perhaps I was wearing them incorrectly and looked carefully at the instructions. These must have been translated from an oriental language and clearly not proofread for Canadian consumption, although they are unintentionally very funny in a Python-esque way.

The paces are detected by a movement of waist. [I'm glad the spelling was correct.] Attach the step counter securely to your waistband or belt, close to the center of your body. False mounting will possibly arouse inaccurate result!!! [It was ever thus].

Two former colleagues at the University of Victoria had similar problems relating to unreliability of the Special K pedometers, the most common being the apparently spontaneous re-setting of the step counter back to zero while it was being worn. I thought that perhaps my colleagues and I had been unlucky and had maybe got a poor batch of pedometers, so I wrote the following letter to my local newspaper, The Victoria Times-Colonist. As you can see there is nothing in the tone of the letter suggesting that there might be a problem with the pedometers.

Researcher needs pedometer input I am researching the use of pedometers as given away in Special K cereal boxes over the last few weeks. This was a joint promotion by Kellogg's and the Canadian Institute of Health Research. I am writing an article for my online newsletter, "Well" (www.speakwell.com) and would welcome feedback from any readers who have been using these pedometers to count their steps. I would like to know how well the pedometer performed for them. Has it encouraged them to walk more and have they logged on to the Web site for "Canada On The Move" to donate their steps? They may call me at 721-6997 or email me at mcollis@speakwell.com. Martin Collis, Victoria.

The replies saddened me because they confirmed my original impression that we were dealing with an instrument that did not seem suitable for research, or for guiding an individual on their daily step count. So far I have received individual reports on 36 Special K pedometers by email, phone call and personal interviews, only three could be interpreted as being really positive. Below I list some of the typical comments I received. I have limited these to email responses in order to quote the respondents precisely.

The idea is great, too bad for me the pedometer never worked. I wore it all day at work as well as took it for a 3km walk on my lunch hour and it told me I took 7 steps. More junk plastic for my recycling.

Another writer echoed this ecological concern.

My take on the Special K pedometer is that it is an environmental concern. The packaging and the fact that these plastic units, being sold in cereal boxes across our country - that don't work - will now end up in the landfill.

In early January (or was it late December?), I bought a box of Special K (which I never eat) for the "free" pedometer. I guess you get what you pay for. I immediately spent $29 on one (Life-Gear at Canadian Tire) which is accurate!

I tried to use the Special K pedometer, and it never worked once. I gave it several tries over several days, and the readings were silly, after a whole day I was getting numbers like 285, or even less. Sometimes it would be quite high and then the next time I looked it was way down again. I consider the whole thing to be a waste of time, and just a gimmick to get suckers like me to buy Special K. $15 value, indeed! I hope you publish your research results, I cannot believe I am the only one who was disappointed. I did not log on to the web site.

I purchased my two boxes of cereal and received a pedometer in each box. I tried them together and they were very different one was about double the other.

I saw your letter in the paper this morning. We bought several boxes of Special K cereal thinking this would be a good thing for our family. We threw away the cereal and found out the pedometers were junk. None of them worked. I still think this is a good idea and I will probably buy a good one.

Interesting to read your letter in TC. I have long wondered what a pedometer was, how it measured walking. After using one for almost 3 weeks now, I do see that something happens - how is another matter. This morning, for example, getting washed, shaved and preparing breakfast took me 993? Yesterday I walked 3 measured miles to town indicating about 9000, and later walk and activity totaled 12746.

My father, who is 92 today, gave me the pedometer from his box of Special K cereal - being handicapped he won't be using it. It came without instructions so I'm not sure how it should be worn. I fastened it on my slacks at my waist by my right hip before going for my daily walk. I recorded the paces measured on my return home. The next day I did the same but went for a longer walk - it recorded fewer paces.

My husband, who golf's as much as the weather will allow, thought he would get the Kellogg's pedometer just to see how many steps he takes while walking the golf course. Unfortunately, the Kellogg promotion is a piece of junk! It just does not work and the cereal went in the garbage too. Now I'll have to buy him a real one!

I read your letter in the Times-Colonist this morning with more than casual interest. My Kellogg's pedometer came in a box of Special K about five weeks ago. The cereal, as usual, was good. The pedometer, however, is bad
I can't get the damned thing to ped, although it's had several outings while clipped on my belt, over my hip bone.

And from a writer in a major health agency.

I noticed your letter while in Victoria on business. I purchased a box of the Special K a few weeks ago so I could try out the pedometer because I had heard about it from some colleagues who work in the health field and were encouraging clients to use them.

I run for exercise, but didn't find that the pedometer was accurate enough to be reliable. It recorded a step at the slightest movement. I did not log onto the website as I wasn't aware of it (likely because I didn't read through the promotional materials very thoroughly).

In theory it is a good concept. In practice it is not reliable enough to base any kind of research on....in my opinion...I would be afraid that people would gain a false sense of security thinking that they are doing all this walking, when in fact, they may not be.

The following letter sadly seems to sum up the sense of disillusion and being conned that is inevitable when high hopes are dashed.

I am a 50 year-old over-weight female. I thought the pedometer would be a good thing to own even though I am not a cereal aficionado.
I was surprised at the poor quality of the pedometer itself. I know the value was only $15 but even so, it looked like something one could purchase in a Dollar Store for $1. I also don't think it is anywhere near accurate as I get different readings for going the same distance, and even when I put it on preparatory to leaving--while sitting perfectly still--it can show up to 10 steps taken.
Over all I was hoping it would encourage me to go out more. It has not, although I do take it with me when I remember to (I have no car, so I walk and take the bus). I think that a better quality pedometer might be of more benefit because at least I would have confidence in its calculations and probably would go out more often, as I tend to keep track of various things.
Your letter in the paper was the first I had heard of 'donating' steps on a web site.
I doubt this has been of much use to you but, as I rarely read the paper, the fact that I even came across it seems like some sort of minor fate. I trust that my name will not be used, although you are welcome to use my particulars if they are applicable.

The above reflect the general tone of the responses I received. The 3 major concerns seem to be:
I. Ongoing unreliability and inconsistent numbers, which seem to bear no relation to steps taken or distance walked.
II. Spontaneous resetting of the step counter back to zero. It is unclear whether this happens because of the pedometer itself, or whether the wearers accidentally hit the unprotected reset button.
III. A minor concern. The clip could be better designed. I lost one of mine somewhere on a trip to Toronto. Other responses mentioned this. The writer below clearly felt positive about the stimulus to walk provided by the pedometer and indeed about Special K cereal with the clip being her only concern.

Hi. My pedometer made me more conscious of the days I wasn't walking as much and those nights I would go for an extra walk. The problem was that it kept falling off because I am in and out of the car a lot of times during the day. So although I quit wearing it (started again today when you jogged my memory.) I continue to eat the Special K for breakfast and am continuing to lose weight for the last couple of months, eating more healthy food. It did make me more aware of the exercise and nutrition.

The next response is similar, mentioning that pedometers in general seem to motivate people (in this case her colleagues) to walk. Again the clip was a concern.

Hi, I did buy a box of specially marked Special K as it offered the pedometer.
I find wearing a pedometer is a concrete way of keeping tabs of my steps - and it gives me personal satisfaction to do so.
I'm not so sure of the quality of the Special K freebie - but know it is ticking off something - each step, or jolt I give it. I seem to put it on daily and record my total at the end of the day and do no more than that. The pedometer clip isn't as tight as it might be and does tend to fall off my waistband fairly easily - so imagine each time it falls it jolts the digital recorder to mark a few extra steps The pedometer hasn't encouraged me to walk more, but I have noticed a number of acquaintances who are wearing pedometers - commercial ones - not Special K ones and are becoming aware of the number of steps they take.

Yet another response began, The Kellogg's device had a vital weakness - the belt attachment was too small - it fell off and is gone.

On the positive side I had a great phone call from a couple in their 50's, both of whom were using the Special K pedometers, both of whom had lost weight and felt fitter and more energetic than they had in years. The man was averaging over 15,000 steps a day.

There is a general feeling that pedometers really do provide a good motivational stimulus to get people walking, even from some people who were not happy with the accuracy of the Special K pedometer. Someone who purchased another pedometer wrote:

Since January, I have averaged at least 10,000 steps/day 5 days out of every seven (except when I was ill). I have gone down one size, lost a bit of weight and definitely toned. I feel more energetic, and enjoy finding ways to walk the extra steps. My strategies have included parking further from where I work or shop, walking around my building at work when I go to the washroom, walking my dog longer, and getting out for that lunch-time walk, even when I don't really feel like it.

I know I walk much more than average - so find the pedometer affirms my exercise.

It was fun to play around with, though. Maybe that was enough to raise awareness.

T.S. Eliot said, Between the idea and the reality falls the shadow and in this case I think the shadow was the Special K pedometer, which has probably diminished a potentially terrific project. In the early stages of this article I spoke with Dr. Marco Buono at Kellogg's who was helpful and informed me that, like many pedometers, the Special K was spring loaded and that they had tested a number of thousand on a 'linear shaker table'.

There's an old saying that, "You only have one chance to make a good first impression", and for a lot of people their first impression of a pedometer is the one distributed by Kellogg's. None of the people who responded to my enquiries had accessed the CIHR web site (www.canadaonthemove.ca). This was due in part to their disillusion with the pedometer and also to the fact that it is mentioned in relatively small print at the bottom of the back panel of the cereal box.

In summary, I was quite taken aback by the negative nature of the responses to my letter in the newspaper. I suspect that some people might not have used the pedometers properly, and I feel more information and better instructions would have helped. Part of successful marketing is to raise awareness and then deliver a usable product and this didn't seem to happen. People look at a pedometer in the same way they would a bathroom scale, if their weights vary from day to day and are different from a standardized scale in a medical office, they will soon lose interest in their house scale.

"The numbers on my Kellogg's step-counter seemed about as reliable as the Victoria flower count."

Canada On The Move Web Site

The name is similar to the America on the Move, National and State web sites, but the layout and content are different. The Canadian version is designed to collect data and to reinforce walking. There is a short quiz titled 'Tell Us About Your Pedometer', which asks questions such as, 'Where did you get it?' and 'How long have you been using your pedometer?' and includes a 20 step accuracy test, but strangely enough omits the obvious question 'What brand and model of pedometer do you own?' (Could there be a legal reason for this?). I'd like to have seen Canada on the Move borrow a few features from their American namesake including the BMI calculator, caloric calculator and a goal setting section.

There is a 'glass half full' or a 'glass half empty' perspective to looking at the 120 million plus steps that Canadians have 'donated' to the web site.

The half full approach would be that it is an impressive number that is growing day by day and that many Canadians are contributing data to a research platform. The glass half empty approach looks at the numbers differently. At the time of writing this article (March 25, 04) the grand total has been increasing by just about 1 million steps a day. (107,566,000 at 10 am March 19 to 114,762,838 at 10 am March 25). With Kellogg's distributing 800,000 pedometers and if people averaged 10,000 steps a day then this means that about 100 people a day are contributing to the daily total, which is 0.0125% of the people who got a Kellogg's pedometer. (Presumably some of those donating their daily steps will be people involved in designing the project.) Of course, the site is not just for Kellogg's pedometers and there is a direct link from Canada on the Move to the catalogue of the Canadian subsidiary of New Lifestyles featuring the highly rated Digi-Walker pedometers. In fact, New Lifestyles are listed as one of the 6 contributors to the Canada on the Move Step One project. Even if people are averaging 5000 steps a day it's fair to say only a tiny percentage of pedometer owners are contributing to the step total and an almost infinitesimal percentage of the 32 million Canadians. However, the site is now established and, like any web site, can be developed and modified to meet the needs of the users and, in this case, the researchers.

People have asked me why Special K, with a glycemic index rating similar to Fruit Loops, was the chosen vehicle for this initiative. The answer I suspect is that they have superb access to the marketplace, and it should be noted that one of the triumphs of this program was successful distribution.

The Silver Lining

I was looking for a good news story to complete this article and I found one. Our enquiries led me to Luther Court Society and Housing Foundation. At Luther Court, the staff of about 80 have the challenging job of looking after people in the latter years of their life. The challenge for the staff is to bring some joy to the residents and to maintain enthusiasm and zest for life themselves.

In response to the Special K promotion they had a great idea. The residents ate Special K, so the organizers made a bulk purchase of the cereal that provided pedometers for the 48 staff who decided to participate in a cumulative walking program titled 'Walk to Puerto Vallarta'. With the cereal purchase, there was a reserve of pedometers to replace those that malfunctioned. These staff divided themselves into 3 groups (The Tijuana's, Hot Tamales and Baja Chicks) and recorded their steps each day. At the end of the week, the team with the most steps was announced and given a small prize.

My Executive Assistant, Bev, visited Luther Court and said that maybe we could learn a lot from the attitude of the participants. They were not hung up on the precision of the pedometers and if the pedometers wouldn't stay on their waistbands they attached them to their shoes or ever their bras.

All the teams have reached their goal of walking to Puerto Vallarta. Later this month they're having a celebration Mexican Lunch with many prizes, and they're hoping Kellogg's, with whom they're in contact, will provide a grand prize of two airfares to Puerto Vallarta.

Winning Team : Baja Chicks

With the unorthodox way in which some pedometers are worn and the variability of the instruments there might be a bit of a lottery in terms of actual totals but nobody seems concerned. The good thing is that the promotion got 48 women walking, socializing and having fun. If this has been happening across the country, then my earlier concerns are not important and it doesn't matter how many steps are recorded on a National web site.

It should be noted that in September 2004, the staff of Luther Court are planning a 'Walk to France' event. The prize will be a week's stay in a house near Montpellier and with the pressure of competition mounting, they have some concerns about pedometer accuracy and they will be using a more reliable step counter so that they feel the competition is less of a lottery and more a reflection of their daily walking.

A lot of money, time and professional expertise was used to create this project. The following information appears in the FAQ's on the web site.

Who was involved in developing this project? A Request for Participation was sent to an international community of researchers and stakeholders with experience in areas relevant to this type of initiative. Of the applications we received, members were selected to form a SWATeam (Strategic Working Alliance Team). From the start, an advisory board was also established comprised of leading researchers and experts from various fields of relevance to this project. These individuals helped shape the project in its infancy and continue to offer guidance and support as we move forward.

Maybe there was a rush to get the program launched in January 2004, but somewhere, somehow I feel there was a lack of due diligence on the key item, the Special K pedometer. (You can now get one for about a dollar on Ebay). I believe the project would have had a much more positive impact if, instead of 800,000 Special K pedometers ("approximate retail value $15.00"), they had distributed 200.000 of the New Lifestyle Digi-Walker SW200 ($38.99 each) or other accurate step counter.

Looking on the bright side, we have a National web site, we've learned some lessons and the word 'pedometer' is a much more familiar part of everyday Canadian vocabulary.

Addendum

I emailed Kelloggs saying I would be interested to find out:

1. If the pedometer was field tested, other than the testing on the linear shaker table that Marco told me about, and if so, who did the testing?
2. Who manufactured the Special K pedometer?
3. Have you received any feedback about the performance of the pedometers?
4. Do you have some success stories you could share with me?
   In response to my enquiries, I just received the following letter from the Kellogg's Public Relations Department.

Hello Dr. Collis,
Thank you for your e-mail.  In the interest of time, I thought I would forward answers to the questions outlined in your original e-mail with consumer feedback to follow in the next day or two. 

They are as follows:

1. Testing of pedometers -- The Special K Step Counter is manufactured with a mechanism modeled after some of the most accurate step counters available.  The Special K Step Counter has been thoroughly tested for functionality, accuracy, quality and safety by independent appraisers. 
2. Who manufacturerd the Special K pedometer?  For competitive reasons, we do not disclose this information.
3. Have you received any feedback about the performance of the pedometers? Overall, we have received very positive feedback from our consumers with many consumers looking for additional packages.  A very small percentage of the step counters may not have functioned properly (e.g. inaccurate readings, physical damage) but they were of a small minority and were replaced by our Consumer Pulse Centre.  
4. Do you have some success stories you could share with me? To be forwarded.

Hope this helps.

Sincerely, Lores Tome

Lores forwarded the following 10 examples of positive customer feedback.

1. This is wonderful and I wanted to say thank you.
2. Your company should be very proud of itself for inspiring young and old alike to increase their fitness level.
3. I think this is a great idea.
4. You have really inspired many people thanks.
5. Excellent idea keep up the good work.
6. It's a great service that you are doing to the public.
7. I am getting one for my wife on Valentines.
8. Cape Breton loved it will you bring this back?
9. The best promotion ever.
10. It was a really good idea maybe something you should do again.

So there you have it. Kelloggs are happy and I'm not because I'd much rather have written an upbeat article about this fitness related promotion.

I suspect a number of people might have done better if they had been provided with clearer instructions and possibly one or two trouble shooting stratagies. What the project did show is that it is possible to get information and a product out to millions of Canadians. If we are going to achieve lifestyle change on a grand scale, this might be a template for future initiatives.

Photo of John Kellogg
creator of the original Corn Flake



Kellogg's story was featured
in the movie 'Road to Wellville'.

A little controversy can go a long way and filmmaker Morgan Spurlock serves it up with relish in his documentary, 'Super Size Me'. The concept of the film is simple, and merely chronicles what happened when you took a healthy man and fed him super sized McDonald's food for 30 days. The man in question was the film's director, Spurlock, who had pre and post medicals to accurately document the impact of a month's worth of McDonalds. Like Michael Moore, Spurlock likes to push reality to extremes to make his point and prior to making this movie honed his film-shock skills on MTV's 'I Bet You Will'. But 'Super Size Me' works well and won Spurlock the Best Director Award at the Sundance Film Festival this year, and was one of the hottest tickets at the festival.

The fast food industry and McDonalds itself has grown so bloated that straight factual information seems unbelievable.

• In 1972 we spent 3 billion on fast food -- today we spend 110 billion.
• In the U.S. people eat more than a million animals an hour.
• Almost 2/3's of all Americans are either overweight or obese.
• The average child sees 10,000 TV ads per year, many of them for fast food.
• Before most children can speak they can recognize McDonalds.
• McDonalds distributes more toys per year that Toys-R-Us.
• 40% of American meals are eaten outside the home.

  Morgan Spurlock, against his doctor's advice, ate exclusively at McDonalds for a month and accepted any and every offer to super size his meals. In 30 days his weight ballooned 25 lbs., his total cholesterol rose and there were measurable negative changes in liver function. He seemed like a man taking a short cut to diabetes. In the movie, people are able to watch Spurlock pack on the weight and ride out some wild mood swings interspersed with segments about obesity and processed food in North America.

  

  There have been no McLibel suits from McDonalds but on March 1, 2004 McDonalds announced that it is officially "phasing out" their Super Size options for fries and drinks. Not content with downsizing some portions, McDonalds are planning the national launch of the "Go Active" (Adult Happy Meal) which includes a salad, bottle of water, a pedometer!!!!! and a diet and activity log designed by Oprah's nutrition guru Bob Greene. As part of our market research we asked a young McDonalds-using friend to request supersizing his fries. No problem. I guess the head office edict hasn't made it to the West Coast of Canada.

  Maybe Morgan Spurlock touched a nerve..

  'Super Size Me' is scheduled for a May release in theatres and has been picked up by A&E for showing towards the end of 2004.

  The purveyor's of fast food are safe from lawyers for a while. In what some are calling the McDonald's amendment, the House of Representatives voted to bar customers from suing fast food franchises on the grounds that burgers, fried chicken and fries are making them obese and sick.

   

  
  

  Cats do it, dogs do it,
  Netherlanders in their clogs do it.
  Let's do it, lets take a walk.

  Some bike it, but don't like it.
  They would rather wear their boots and hike it.
  Let's do it, let's take a walk.

  Dickens did it, Ghandi did it,
  Thomas Jefferson, too.
  Hippocrates in ancient Greece did it
  And now it's time for you.

  Put on your ped and do it, get off your bed and do it.
  Don't turn on the tube and say, 'Oh screw it'.
  Let's do it. Let's just take a walk.

          With apologies to Noel Coward

  

  
  
  
  Walking is the most natural and accessible exercise we have. Ever since we've been researching the benefits of physical activity, study after study has proven the health benefits of walking. Jobs that involve walking have always proved to be healthier than sedentary jobs. But in an era where communities are designed for wheels rather than shoes, and where houses, worksites, shopping malls and entertainment venues are as efficient and step-free as possible, we are developing a society that is overweight and unfit because they're starving for steps.

  Everywhere's in walking distance, if you have the time. ~Steven Wright

  The Amish Way

  Dr. David Bassett put pedometers on 98 adults in an Amish community. The men averaged 18,425 steps a day and the women just over 14,000. Despite the fact that the men consume about 3,500 calories a day, only 25% of the men were overweight, and none was obese, among the women 27% were overweight with 9% obese. The fact that the Amish eat 33% more than a typical North American but show much less than half the incidence of overweight and obesity is testimony to the importance of walking and physical activity. The study was published recently in the Journal of Medicine and Science.

  

  The sovereign invigorator of the body is exercise and of all the exercises walking is the best. Thomas Jefferson

  

  Walking and Weight Control Around the World

  The editors of Self Magazine were intrigued to read a quote by Dr. John Puchar of Rutgers University that, "roughly 25% of Americans are obese, while only 7% of Europeans are." Puchar felt the reason was that, on average, Europeans walk three times as much as Americans. Puchar noted the following:
  Holland - 45% of daily travel on foot or by bicycle.
  Sweden - 33% of daily travel on foot, 10% by bicycle.
  France and Italy - More than 25% of their daily travel is on foot.
  USA - Roughly 5% of people's comings and goings are on foot.

  

  Dr. Andrea Dunn of the Cooper Institute says, "Today the average US woman burns 700 to 800 fewer calories a day than she did 25 years ago, and it's largely because we don't walk anywhere, anymore." [Martin's Note: The 700 to 800 calorie number seems high to me, I would have thought something closer to 300 calories.]

  Dana Sullivan picked out representative women in various countries and had them wear a Sportbrain pedometer, the findings speak for themselves.

  	STEPS
  Mia Petree, 33, Arlington, Virginia (Garden work, shopping)	4.138
  Florence Labedays, 59, Paris (Train to and from work, shopping, errands, evening out. Does not use a car)	13,522
  Maria Kostaki, 27, Athens (Walk to and from metro, errands, 8 hours bar tending/waitressing)	28,879
  Kristen Harris, 30, Hong Kong (Lives on an island where no cars are allowed, walks to and from the ferry)	10.599
  Ramatu Ahmed, 22, Aiban, Niger (visited a friend by walking to the next village; about a 2 hour walk)	14,099

  The above are not scientific, but are fairly typical; without significant walking as part of your daily commute and without setting aside time for purposeful walking, it is not easy to get more than 5000 steps in our energy saving North American culture.

  Walking is the best medicine. ~ Hippocrates (460 BC - 377 BC)

  

  There Must be 50 Ways to Lose Your Blubber

  Just get off the bus Gus,
  Put on some new shoes Suze,
  Pick up the pace, Ace.
  Your body's a disgrace.
  There must be 50 ways to lose your blubber.

  Go on a hike, Mike.
  Cut out the carbs, Barb.
  10,000 a day, Ray.
  You know what I say,
  There must be 50 ways to lose your blubber.

        With apologies to Paul Simon

  

  Here are a few thoughts on how to get more steps into your life. Readers of 'Well' are asked for more suggestions to get us up to 50.

  1. Use the stairs instead of the elevator.
  2. Walk as many errands as you can.
  3. Walk between flights at airports.
  4. Park your car in the far corner of parking lots.
  5. Walk your dog.
  6. Walk around the room during every commercial break on TV.
  7. Take extra trips to load shopping into your car, or put out the recycling bins.
  8. Walk with your children.
  9. Walk your kids to school.
  10. Get a home treadmill.
  11. Walk around your house or apartment and make one improvement on each walk.
  12. Have walking meetings at work instead of sitting in an office.
  13. Walk to work, or part of the way to work.
  14. Use public transport so that you have to walk to and from the bus or train.
  15. Give yourself a walking reward on the completion of a task.
  16. Take a walk after dinner. (This used to be called a post prandial stroll)
  17. Arrange a social walk with a friend.
  18. Plan a vacation that includes walking or hiking.
  19. Volunteer to walk dogs at the local pound.
  20. Buy a pedometer and monitor your steps.
  21. Treat yourself to a good pair of shoes.

  Good shoes are important. If you find a shoe you like and that works for you, buy 2 or 3 pairs because styles change so fast.

  

  I like Nike,
  I really like their style.
  Put some Nikes on your feet
  Make your ankles smile.
  

  [click the guitar to hear an mp3 file of Martin singing this verse of the Nike song]

  

  The Omron Healthcare Diabetes in Control, 10,000 Step Study

  

  
  
  Patients were given an Omron pedometer and encouraged to walk 10,000 steps a day for 3 months. Forty-four diabetic patients completed the study with some very positive results.

  THE RESULTS:
  Out of the patients who started, 44 patients completed the 3-month study with startling results. Not only did their blood glucose and A1C (a marker of diabetes) improve, but they also improved their lipids, lowered their blood pressure and lost some weight. They also had more energy, had less general pain, had more flexibility and all 44 patients plan to continue using the pedometer after the study.

  

  E.W. Gregg, PhD of the Division of Diabetes, US Centers for Disease Control and Prevention, and his colleagues investigated the association between walking and the risk of all causes of death, and death due to cardio-vascular disease among people with diabetes.

  "Walking was associated with lower mortality [death rates] across a diverse spectrum of adults with diabetes," wrote the authors. "One death per year may be preventable for every 61 people who could be persuaded to walk at least 2 hours per week."

  In an accompanying editorial, Frank B. Hu, MD, PhD, of Harvard School of Public Health, said, "Persuasive evidence from epidemiologic studies and clinical trials demonstrates substantial benefits of exercise, especially walking, in the prevention and treatment of type 2 diabetes mellitus. Because walking is accessible, is relatively safe, and can easily be incorporated into a daily routine, it is a form of exercise that is practical and suitable for most individuals, including women, diabetic patients, and the elderly.

  To read the complete article, go to www.diabetesincontrol.com/studies/step.shtml

  

  

  
  
  
  Walking and Working

  

  I always feel a bit envious of people whose job helps keep them in shape.

  We put a pedometer on our letter carrier, Mike, who, on a slightly shortened route, did 18,598 steps in about 2 hours and 40 mins. The Omron pedometer registered 695 calories, but it would be more than that as he's toting a heavy bag of mail.

  Mike said the only downside to his job is that when he takes a vacation and stops walking he puts on a few pounds.

  My gardener, Cheryl, logs over 20,000 steps a day, plus plenty of upper body work.

  She is going back to a reunion at the high school from which she graduated 22 years ago. I said to her, "I bet you look about the same as when you graduated." Her reply was, "No, I've lost about 20 lbs." Not something that most of her former classmates will be able to say. Cheryl recently got I.D'd at a bar and she is more than 20 years over the BC drinking age.

  We do so well when we're active and struggle so much when we're sedentary.

  Upcoming Attraction

  We are working on making the Speakwell site more interactive. In the coming months, you will be able to record your step-count, check your BMI and record your comments about the effectiveness of various brands and models of pedometers.

  A Package Deal on Walking

  The American Diabetes Association sells a boxed package with the theme, "Small Steps, Big Rewards". It's good to see the D.O.G.S. (Disease and Organ Groups. e.g. Diabetes Assn., Heart and Stroke, Cancer Society etc.) really get behind prevention initiatives. For many years, a huge percentage of their budgets has gone to fund the creation of procedures and pharmaceuticals, which will 'cure' or 'control' an illness or condition. There is now a growing recognition that the real 'cure' is in a healthy, active lifestyle, and that there is a much bigger pay-off to keeping people healthy, rather than trying to fix the sick.

  

  The A.D.A. box contains a step-counter, reminding you to do "10,000 steps per day". I've just had the one package, so I can't generalize about the accuracy of the step counters. However, the one that came in my box consistently showed about half the number of steps I actually did. The consistency suggests that the mechanism is fine, but there is no way to adjust it to reflect my actual number of steps.

  I like the fact that a spare battery is included.

  The box also contains a common sense booklet written by Sherrye Landrum. The cover of the booklet says, "Expert Advice and Scientific Research". In order to be easy to read, the scientific research is understandably not mentioned, but I'd like to have seen references to some major walking and exercise studies, so that interested readers could look them up.

  The booklet is published by Small Steps press (no web site yet), which is a publishing arm of the A.D.A., initially printing books on lifestyle and the prevention of diabetes. These books are targeted for the general public, not for diabetics or people with metabolic syndrome. It took me a while to figure this out and I was wondering why there was nothing about monitoring blood sugar or other information relevant to diabetes and exercise.

  Looked at as a walking and exercise stimulus for the general public, the booklet generally does a good job with common sense ideas and references to some useful websites and resources.

  Minor criticisms include:

  1. Uninspired illustrations, which make it look like a government publication. e.g. The picture of the pedometer bears absolutely no resemblance to the pedometer in the box. (Although the generalized instructions can be applied to the Small Steps/Big Rewards pedometer.)
     
  2. To avoid confusion the opening paragraphs should emphasize that this booklet is designed for the prevention of diabetes and not specially for people with diabetes. (Most people don't read the small print.)
     
  3. In the Resources section along with yoga and stretching, it would have been helpful to include a book or video on the use of the exercise ball, which is one of the most versatile pieces of fitness equipment.
     
  4. Out of the box at $7.95 US, I think the booklet is overpriced. (Five dollars would have been more realistic).

  The box (including pedometer, booklet and spare battery) can be ordered from the American Diabetes Association. Order code 5012-01. Information can be obtained from Lee Romano Sequeira Tel: (703) 299-2046. I had a hard time finding ordering information on the ADA web site, but eventually found it at store.diabetes.org. As noted, the cost is $19.95 US, which I feel is acceptable, especially if any profit goes into supporting positive lifestyle programs and diabetes research. However, I think putting the money towards a really good pedometer might be a better investment, although before committing myself to that I'd like to check out a few more of the "Small Steps, Big Rewards" pedometers.

  Stairway to Health
  By Stephen Grundy
  www.healthcanada.ca/stairwaytohealth

  Stairway to Health is a newly launched web-based resource developed to increase physical activity in the workplace through stair climbing.

  Activities like stair climbing can significantly contribute to the 30 minutes of physical activity we all need... everyday, plus...

  • Stair climbing is easy to do in most workplaces. It requires no special equipment to participate.
  • Moderate intensity lifestyle activities like taking the stairs may be more successfully promoted than structured vigorous intensity exercise.
  • Two flights of stairs climbed per day can lead to 2.7 kg weight loss over one year and using the stairs burns twice as many calories as walking.
  • Taking the stairs is often faster than waiting for the elevator and a great way to re-energize throughout the day.

  Registering is easy and free!
  Visit the Stairway to Health website to:

  • Climb virtual mountains and famous buildings
  • Download point of choice posters to encourage stair use
  • Select challenges, create newsletters and manage your participant data
  • View stair climbing success stories from other workplaces
  • Get information on planning events, increasing stair use, design considerations, safety, hiring students, posting signage and much, much more.

  Visit the website today at: www.healthcanada.ca/stairwaytohealth

  Stairway to Health is a partnership between Health Canada, and the Canadian Council for Health and Active Living at Work (CCHALW).

  

   

  

  

  
  ike hundreds of thousands of other people, I come to Hawaii for its almost perfect weather. The temperature always seems to be just under or just over 80^o, the trade winds provide natural air conditioning and the water temperature is a Goldilocks-approved not too warm and not too cool, but just right. Unlike most of my friends, I don't have an ABH (anywhere but Honolulu) fetish and don't feel the need to leap frog over Oahu for the travel supplement charms of other islands. In fact, those days my dictum in NEBH (nowhere else but Honolulu). But it's a very specific part of Oahu that keeps me coming back, the same part where Hawaiians have played for 2000 years, where Robert Louis Stevenson came to recuperate from sickness and where Hawaiian royalty built their palaces.

  I come back year after year to Kapiolani Park, which takes its name from Queen Kapiolani, whose statue is featured prominently.

  On the base of the statue it says she, "was a woman of commanding presence, of easy manner and quiet disposition, ever kind, ever thoughtful of others she dedicated her life to the well-being of her people." This is not the usual brass plate hyperbole, for the good Queen Kapiolani was responsible for founding the Kapiolani Maternity Home, the Kapiolani Home for Girls and the Kapiolani Medical Center for Women and Children.

  

  The current Kapiolani Park is a triangle bordered on one side by the Pacific Ocean and on the other by the crouching presence of Diamond Head. The hypotenuse is made up of the Waikiki Bowl, a parking lot, which doubles as a market for local produce, and an open bandstand for cultural and musical events. The Honolulu Zoo acts as a buffer between the hotel row of Waikiki and the park. I'm not a big fan of zoos but appreciate the green screen of vegetation.

  

  At weekends, the chain link fence around the zoo becomes a place for local artists and photographers to display their work.

  Kapiolani Park is a place of energy, activity, art, music and life. As Bob Dylan reminded us, "It's life and life only."

  Each morning I'd join the endless stream of runners and walkers.

  There's a necklace of walkers and runners
  Moving from dawn until dark
  As shoe upon shoe taps a heartbeat tattoo
  On the path that encircles the park.

  

  At 7 o'clock in the morning I counted a thousand people an hour lapping the 2 mile (approx. 3 k) perimeter, which means that more than 10,000 people a day are getting an exercise fix and burning off 200 calories a lap. In one corner of the park there's a statue of one of the world's most famous walkers.

  

  The park is a patchwork quilt of games and activity from formal to informal, from major to minor and from high levels of skill to cheerful incompetence. (Remembering that GK Chesterton said, "If a thing's worth doing, it's worth doing badly.") Soccer, baseball and softball are the big three, but there's a whole lot more.

  

  From 'a' to 'y' - archery to yoga. If there was a 'z' sport, I didn't see it, unless it was the Zen of tennis or a zone defense in basketball. In this East meets West interface there are games and exercise regimens from every culture, Kendo coexists with cricket, ultimate Frisbee is alongside volleyball and old Japanese men play a game that looks like a cross between croquet and mini-golf. Tai Chi is much in evidence. Plato said, "all life should be lived as play", which would make him right at home in Kapiolani Park.

  

  Across the road grass turns to sand and water sports rule. Nothing is more Hawaiian than the surfer and the sepia silhouettes of surfers at sunset...

  

  ...are enough to make you quit the working world and go in search of the perfect wave.

  

  The surfers are not alone and share the ocean with sea-skis, sailboats, kayaks and outrigger canoes.

  The Outrigger Canoe Club is an institution and boasts one of the fittest memberships and most beautiful oceanside restaurants anywhere.

  

  The park is more than fun and games and each day as I jogged its circumference I became aware of the little old ladies (LOL's). One paints Diamond Head again and again rather like Monet with his haystacks. Another takes photographs of flowers and trees, which she sells in the arts and crafts fair on weekends.

  

  

  There is one who operates a personal garbage patrol and is out each day with her rubber gloves, tongs and plastic bags. Some tend their own gardens in a corner of the park...

  

  ...while others bring their folding chairs and sit in the shade of the Banyan or Ironwood trees and read. As I jogged by one of the readers, I must have looked too serious or self-involved because she raised her head and said, "Don't forget to look up at the rainbow."

  My accountant, Jim McAvoy, has a unique tool to measure the stress in his life. After work each day he walks along an esplanade by the ocean. On days of stress and problems he can get to the end of the beach and never been aware of the sky, sea and confetti of sail boats. He realizes he hasn't let nature in to give its healing perspective to the problems of his world.

  

  In addition to LOL's, there are many people who clearly march to their own drummers, and there are drummers pounding our Polynesian rhythms that have been going on for centuries.
  
  There's Sam; shuffling, dancing, arm circling like a marionette. I talked to Sam who is 82 and who has devised his own exercise routine and diet. "Jogging's too hard on my knees so I do it different, I do almost everything different!"

  As well as its array of interesting individuals, the park, like most parks, is a haven for couples and lovers, who range from informal blanket dancing to formal wedding regalia.

  

  Alcoholics Anonymous meets morning and evening in the park. I like the sunset group, which congregate around a Banyan tree every day and go by the name of Happy Hour.

  

  I'd often stop and listen to the stories and was struck by one told by a man approaching his first anniversary of sobriety. It was a simple story of a friend in trouble calling him for some help. He said, "Can you imagine someone asking me to help them?" One of the common themes is the gratitude people feel for each day, for friendship and for the freedom they feel to make choices that don't involve getting drunk. Their messages are simple, but universal, and you don't have to be an alcoholic to benefit from listening in.

  

  Music is part of the park. People banished from their apartments for disturbing the peace, play their saxophones and trumpets. An Hawaiian choir practices twice a week and the public bandshell provides a stage for everything from ukulele festivals to classic Korean singing, from the ululating Hawaiian vocals and slack string guitars to the blues.

  The Waikiki Bandshell is a great music venue and the site of some legendary concerts, ranging from Bob Dylan to Miles Davis (Both of whom are featured in the 'Quotes' section of this issue.). On consecutive nights I was able to get tickets to hear Bonnie Raitt and then Jimmy Buffett.

  

  The 'shell' seemed like the perfect venue for Jimmy Buffett with his dedicated following of 'Parrotheads'. This is a man who's made a great living singing the same songs for 30 years and his audience wouldn't have it any other way.

  

  He's also one of only two writers to have written a number one best seller in both the New York Times Fiction and Non-Fiction categories. After 'Wasting Away in Margaritaville' and 'Cheeseburgers in Paradise' (A whole new perspective on wellness), he pointed up at Diamond Head and sang a great version of 'Volcano'. Just another piece of perfection in the park.

  

  As far as I'm concerned, when the sun sets on my life you can scatter my ashes on Kapiolani Park, where they can mingle with the ancient volcanic ash of Diamond Head and be trampled into the ground by the feet of people at play.

  

   

  

  

  
  Celia A. Shapiro reconstructed the final meals requested by prisoners condemned to die, 7 of which are shown here. The meals themselves perhaps tell us more about the people we choose to execute than detailed profiles and crime statistics.

  
  
  
  
  
  
  
  
  
  
  
  
  
  

   

  

  

  
  eborah is an accomplished speaker who is in demand nationally and internationally to deliver her clear and passionate message on the real meaning of a healthy organization.

  Her topics include:

  • Building Healthy Work Cultures
  • Achieving Work-Life Balance
  • Building Strategies That Last (Organizational Health)
  • Stress Smart Workstyles
  • Get Well! Putting Wellness On Your Agenda

  Deb has addressed audiences in the USA and recently took her message to South America. In Canada, she has worked with a number of municipalities, universities and provincial conferences, and addressed other groups including the National Quality Institute, Department of Indian Affairs and Health Canada. The name of Deborah Jones on a conference agenda guarantees a cutting edge presentation and gives your conference the credibility that is a magnet to potential delegates.

  More About Deb

  For those struggling to 'keep up with the Jones', it's difficult to keep pace with this one! Meet Deborah Jones - workplace wellness expert, entrepreneur, yoga enthusiast and speaker! Deb has created her life's work around her passion - energizing organizations to be healthier. She began to realize her dream in 1991 when she founded Vancouver-based Well-Advised Consulting Inc., a practice that provides companies with the thinking and tools to improve employee and organizational well-being. Translation: there is a link between happy, healthy employees and the health and wealth of organizations.

  To Deb, the concept is straightforward. Get senior people in organizations investing in their people and the return on their investment will be paid back in spades.
  

  
  

  Deb believes passionately that long-term business success is built upon the foundation of a healthy organization where mutual respect, fairness, and employee wellness-mental, physical, emotional, spiritual and social-is valued.

  "Organizational health is an often misunderstood concept," says Jones. "What I mean by this is that companies that offer lunch n' learn seminars on personal health might claim to have a 'wellness program' in place but in fact, may be very unhealthy."

  Deb Jones has spent the last twelve years of her professional career helping people understand what makes up organizational health and why it's integral to companies large and small.

  A few years into her consultancy Deb realized there was no network in Canada for others like her - working in the organizational health business. She began looking at ways to bring like-minded professionals together to discuss workplace issues and challenges, and ultimately created a think-tank to propel the organizational health agenda towards a greater general understanding of its value.

  

  In 1997 Deb founded the Health, Work and Wellness Conference [www.healthworkandwellness.com]. First staged in Vancouver, BC and initially supported by Vancouver Hospital & Health Sciences Centre and some key sponsors, over 500 professionals from across the country gathered for this three-day conference. Since that inaugural event, Deb hasn't looked back and has never felt so encouraged by the progress being made in Canadian organizations. Entering its eight year, and under Deb's leadership as conference chair, the Health, Work & Wellness Conference has been held at various cities across Canada and has become the largest national annual gathering in the country focusing on strategies for improving workplace health and productivity.

  In 2001 Deb headed the group that developed "Canada's Healthy Workplace Week" [www.healthyworkplaceweek.ca], a national week dedicated to the importance of organizational health and its effect on productivity and the bottom line.

  "Forging new ground in an emerging field is not easy," admits Jones. "So, when a colleague of mine described my passion to this cause as 'annoyingly persistent' I took it as a compliment!"

  Determined to have companies 'get it' and to see more senior executives in Canada 'walking the talk', Deb's crusade continues to create positive change in the workplace and to help organizations create environments where their employees flourish!

  Deb created her company, "Well Advised", to act as a link between innovative, healthy, talented people and effective organizations. We see our work as being a catalyst in helping organizations create work cultures where people thrive, thereby improving recruitment, retention and work-life balance.

  On a personal note, Deb's major interests include travel, music and yoga. She continues to search for calm and peacefulness in a world that often manifests little of either.

   

  

  

  
  n this issue, the 'things' are people and they are dedicated doctors, teachers and nurses. These are people who make a difference and I've been reminded of that in a number of ways in the past couple of months.

  Three Great Physicians

  

  
  
  
  
  
  
  1. Mountains Beyond Mountains
  By Tracy Kidder

  This is the story of Paul Farmer, who is testament to the fact that one person can make a difference. It's the story of a young doctor who established a hospital and general health care center in rural Haiti. Working with minimal resources he takes on AIDS, TB and a myriad of problems, many of them associated with poverty and poor education. He is so successful, that his containment of AIDS is better than that in most Western countries. His work with TB has become a model for much of the rest of the world. It's an utterly compelling read. Recent events in Haiti with the democratically elected Aristide being deposed, might well mean the end of Farmer's work, as the old order of the followers of the Duvaliers and the Ton-Ton Macoute try to claw their way back into power.

  

  2. Another doctor making a difference is Bill Magee, who created an organization called Operation Smile [www.operationsmile.org]. He spoke immediately before me at the World Critical Illness Insurance Conference.
  
  Given the title of his organization I thought he might be humorous and perhaps a tough act to follow. But Bill Magee is a plastic surgeon who has dedicated his life to physically making it possible for people to smile by rebuilding their mouths and faces. He has created a dedicated task force of surgeons, nurses, health professionals and other support staff who volunteer their time to go to 3rd world countries and do their miraculous work. Two of the statements he made still stay in my mind.

  "Knowledge alone is not enough, it has no heart."

  "Any child shackled by deformity is a tragedy. If you ignore those children, you are the tragedy."

  

  3. Before Dr. Magee spoke there was a presentation by another extraordinary physician, Dr, Marius Bernard. One remarkable accomplishment would satisfy most people, but Dr. Bernard has three.