Tier Saunders, RD

Clinical RD. Interests in nutrition & physiology, SDoH, neurodiversity, the complexity of obesity, creating a culture of health, but mostly here to read..

[Ahmed Bennis MD 🫀 @drbennisahmed]

Not all fat is equal — and in HFpEF, the type and location of fat may matter more than total body weight.
New framework from Packer et al. lays out how to actually measure dysfunctional fat — from clinic to imaging to molecular markers 👇
📊 Measuring Dysfunctional Fat in HFpEF:
🔹 Waist-to-height ratio ��� reasonable proxy for visceral adipose tissue mass (bedside)
🔹 DXA, CT or MRI abdominal imaging → estimates excess mesenteric fat depot (imaging)
🔹 Tissue-specific adiposity imaging (cardiac) → quantifies paracardiac fat with paracrine effects on the myocardium (imaging)
🔹 Adipose inflammation / circulating adipokine ratios → quantifies truly dysfunctional fat — not just excess fat (advanced)
💡 Key distinction: dysfunctional fat ≠ excess fat. Inflamed adipose tissue secretes pro-inflammatory adipokines that directly impair cardiac mechanics — even in patients who aren’t severely obese by BMI alone.
📄 Packer M, et al. JACC Heart Fail. 2026;10.1016/j.jchf.2026.103046
#HFpEF #HeartFailure #Cardiology #Obesity #Adipokines #CardioMet

[Frontiers - Endocrinology @FrontEndocrinol]

New Research: Adipose tissue distribution in metabolic disease: depot-specific biology, clinical assessment, and therapeutic remodeling https://t.co/6malpbVWok #FrontiersIn #Endocrinology

[Prof Kamlesh Khunti @kamleshkhunti]

Our paper in print now

🎯 Obesity + Multiple long term conditions (MLTC, multimorbidity): Is weight loss always beneficial?

📊 Study of 618,000+ patients with obesity & ≥2 conditions

⚖️ Key findings:
🟢 Weight loss → ↓ risk of new obesity-related complications

💊 Weight loss → ↓ polypharmacy
🔴 BUT…

⚠️ Both weight loss and weight gain → ↑ mental health conditions
🏥 ↑ hospitalisations
⚰️ ↑ mortality vs stable weight
📉 Effects were modest → not a simple “more weight loss = better outcomes”
🧠 Take-home:
👉 In MLTC, weight loss ≠ universally beneficial
👉 Outcomes are complex, bidirectional, and patient-specific
👉 We need personalised, holistic approaches — not weight alone
#Obesity #Multimorbidity #WeightLoss #ChronicDisease #PrecisionMedicine

with @AbdTahrani et al

https://t.co/edICQaR60S

[Michelle Sholzberg @sholzberg]

Thank you @OntarioHealthOH OLMP, thank you @Dynacare, thank you @LifeLabs, thank you AlphaLabs, thank you @UofT, thank you to all members of ‘Raise the Bar’. This is a big step forward for Ontario and for 🇨🇦 Canada in promoting health equity for ppl with iron deficiency. 💥

[Unity Health Toronto @UnityHealthTO]

Ontario's iron deficiency guidelines are changing; the baseline of what's considered a normal amount of iron is increasing. Dr. Michelle @sholzberg, hematologist & scientist at St. Michael's Hospital, has been advocating for this change for years.
https://t.co/RNtESY1YIf 1/3

[Tier Saunders, RD @tierneyRD]

This! Also, let’s see more acknowledgement of #timepoverty in discussion of health behaviours. Like other #SDoH, under-recognized in policy + public health initiatives yet a pervasive barrier/contributor to health status!
#cultureofhealth #obesity #weightstigma

[Ted Kyle @ConscienHealth]

Everywhere we turn the presumption that obesity is all about #PoorDiets smacks us in the face. But the truth is more complex. To focus only on food is to ignore most of what is at work, promoting ever more #obesity. #DiscomfortOfThought
https://t.co/m0AWKqBs0E

[Tier Saunders, RD @tierneyRD]

Dominant narratives of #autism remain stigmatizing and above all, unhelpful.
Understanding #monotropism can provide scaffolding to build non-deficit based insight on autism - Fergus Murray,
Scottish Autism Research Group Conference
2023

https://t.co/BXjCCFoMZj

[Kelly Mahler @kmahlerkmahler]

This site was put together by Fergus Murray, with support from Wenn Lawson & Panda Mery. It is designed as a resource for anyone interested in learning about #monotropism, which should include everyone who wants to understand autistic people: https://t.co/5jqNayPmLH

[Holland Bloorview @HBKidsHospital]

When you become a parent, how do you nurture a positive body image in your child? At Holland Bloorview, we have developed a guide to help parents feel better prepared to talk to their child about body image and weight. Read more with @AmyCMcpherson, here: https://t.co/Lxsz5uUIpE

[Food & Mood Centre @foodmoodcentre]

The first ever international clinical guidelines for lifestyle-based mental health care for major depressive disorder are out today! Developed by our @wfsbp_congress & @ASLMLifeMedGlobal Taskforce. (1/19)

[PROOF @proofcanada]

Higher rates of #FoodInsecurity among working-age adults & children + fact that relying on any public income support, besides old-age pensions, means ⬆️ risk, highlights need to support working-age Cdns at the bottom end of the income spectrum.

🧵 on policy priorities (1/6)

[Neil Pasricha @NeilPasricha]

[NEW PODCAST ALERT!]

Please help me welcome the deeply wise and introspective Dr. Vivek Murthy @vivek_murthy, 19th Surgeon General, bestselling author of TOGETHER, and Co-Chair of
@joebiden's COVID Task Force onto my podcast 3 Books.

Listen here:

https://t.co/XWga3siWQO

[Tier Saunders, RD @tierneyRD]

Sound interpretation of Canada’s new obesity CPG and the question of weight loss.
https://t.co/x4z6TG4MCB

[Dr Angela Meadows (she/her) @DrAMeadows]

Holy crap! Phenomenal piece by @MattMcGorry "My Journey Toward Radical Body Positivity" Long but totally worth it. #systemicoppression #intersectionality #privilege #fatphobia #patriarchy #racism #ableism #transphobia It's all in there. https://t.co/GFDj6fdQI0 @humanparts #haes

[Tier Saunders, RD @tierneyRD]

So uplifting 👏🏼🎶👇🏼
https://t.co/ywMc6Yazbd

[Rachel HB Mitchell @DrRachelHBM]

On the eve of Passover, Easter and soon Ramadan Toronto Physicians sing “We Rise Again”. We all need this message of hope!

Thx Voices Rock Medicine, Voices Rock Canada & Anthony Bastianon

#ThanksHealthHeroes
#WeAreInThisTogether
https://t.co/zA9X0hHgkI

[Ted Kyle @ConscienHealth]

Q2: A little more complex than that.
#RootsOfObesityChat #WorldObesityDay

[Tier Saunders, RD @tierneyRD]

Time to change the narrative & end #weightbias #obesitystigma

@ObesityCan

https://t.co/V2y1n64QTS

[Tier Saunders, RD @tierneyRD]

@Emily_J_RD @KCKlatt ERAS pathway,including CHO bev 2hrs pre-op,reduces post-op infections as well..agree w/ observation of pts not doing ERAS & eating little in days post-op can be hyperglycemic. Seems like the focus should be on post-op protocols for glycemic management.

https://t.co/iNKEKZ3zK4

[Michelle Cardel, PhD, MS, RD @MichelleCardel]

In our new manuscript, we propose acceptance-based therapy, which integrates techniques from acceptance and commitment therapy, as a potential novel treatment option for diabetes management.
Coauthors @LeahWhigham @DrKathrynRoss @DonahooWm @JacksonRDillard
https://t.co/em2elFxpEe

[Tier Saunders, RD @tierneyRD]

How important is exercise in weight loss? Reframe that question: how important is it for health (independent of wt loss)?

#exercise for health & quality of life!
#bustthebias #CultureofHealth #obesity #obesityiscomplex

[Obesity Canada @ObesityCan]

How important is #exercise for #weightloss? Watch now to find out!
https://t.co/O2qMVAXnCO