Differences in Adiposity and Diet quality among individuals with Inflammatory bowel disease in Eastern Canada

Authors: DeClercq, V., Limbergen, J.V., Langille, M.G.I. Abstract The objective of the current study was to characterize the relationship between diet quality and body composition in participants living with IBD, specifically Crohn’s disease (CD) or ulcerative colitis (UC), in Atlantic Canada. Participants from the Atlantic Partnership for Tomorrow’s Health (PATH) study are residents of one of the four Atlantic Canada provinces. Participants who completed the dietary questionnaire and had body composition measured were included in the study (n = 12,462 without IBD, n = 111 CD, n = 119 UC). A greater number of participants with IBD reported having multiple chronic conditions compared to those without IBD. Those with UC had statistically higher body weight and body mass index (BMI) compared to those without IBD. Overall, significant positive correlations were observed between adiposity and servings of refined grains, and meats and alternatives such as eggs and fish, whereas negative correlations were observed with servings of vegetables, fruit, whole grains, and alternatives such as tofu, and nuts/seeds. Participants with IBD (both CD and UC) consumed more refined grains than those without IBD. Using logistic regression analysis, participants consuming more servings of vegetables and whole grains were less likely to have CD where as those consuming more serving of fruit and bean/legumes were less likely to have UC. In the Atlantic PATH cohort, which includes a region of the world with a high incidence of IBD, distinct differences in adiposity and diet quality were observed in individuals with specific types of IBD compared to those without. There is a need for collaborative efforts to address weight management and diet quality issues in those living with IBD in the Atlantic Canadian region. Link: https://doi.org/10.1371/journal.pone.0200580

Fruit and Vegetable Intake and Body Adiposity among Populations in Eastern Canada: The Atlantic Partnership for Tomorrow’s Health Study

Authors: Yu, Z.M., DeClercq, V., Cui, Y., Forbes, C., Grandy, S., Keats, M., Parker, L., Sweeney, E., Dummer, T.J.B. (2018). Abstract Objectives: The prevalence of obesity among populations in the Atlantic provinces is the highest in Canada. Some studies suggest that adequate fruit and vegetable consumption may help body weight management. We assessed the associations between fruit and vegetable intake with body adiposity among individuals who participated in the baseline survey of the Atlantic Partnership for Tomorrow’s Health (Atlantic PATH) cohort study. Methods: We carried out a cross-sectional analysis among 26 340 individuals (7979 men and 18 361 women) aged 35–69 years who were recruited in the baseline survey of the Atlantic PATH study. Data on fruit and vegetable intake, sociodemographic and behavioural factors, chronic disease, anthropometric measurements and body composition were included in the analysis. Results: In the multivariable regression analyses, 1 SD increment of total fruit and vegetable intake was inversely associated with body mass index (−0.12 kg/m2; 95% CI −0.19 to –0.05), waist circumference (−0.40 cm; 95% CI −0.58 to –0.23), percentage fat mass (−0.30%; 95% CI −0.44 to –0.17) and fat mass index (−0.14 kg/m2; 95% CI −0.19 to –0.08). Fruit intake, but not vegetable intake, was consistently inversely associated with anthropometric indices, fat mass, obesity and abdominal obesity. Conclusions: Fruit and vegetable consumption was inversely associated with body adiposity among the participant population in Atlantic Canada. This association was primarily attributable to fruit intake. Longitudinal studies and randomised trials are warranted to confirm these observations and investigate the underlying mechanisms. Link: http://bmjopen.bmj.com/content/8/4/e018060.full?ijkey=s8Si2uDe3SHk33b&keytype=ref

Environments Associated with Moderate-to-Vigorous Physical Activity and Sedentary Behavior of Colorectal Cancer Survivors

Authors: Lawrence LM, Stone MR, Rainham DG, Keats MR      Journal: Int J Behav Med. 2016 Jun 30 Abstract Purpose Physical activity (PA) is an effective intervention for improving the quality of life of colorectal cancer survivors (CRC) and may reduce the risk of cancer recurrence and cancer specific and all-cause mortality. However, most CRC survivors are not sufficiently active to receive these benefits. Sedentary behavior (SB) has also been linked to morbidity and mortality risk independent of activity level, thereby presenting an additional opportunity to improve health outcomes of CRC survivors. The built environment is known to influence PA and SB; however, little is known about where CRC survivors engage in PA and SB. The objective of this exploratory study was to objectively identify locations where CRC survivors engage in PA and SB in order to inform health promoting interventions. Method Activity and location of CRC survivors (n = 31) was monitored for 1 week between January 2014 and April 2015 in Nova Scotia, Canada. Bouts of PA and SB were time-matched with GPS data to attribute bouts to specific geographic locations. Results Participants’ home environment was the main location for both time spent in PA bouts (73.7 %) and time spent in SB bouts (90.5 %). Conclusion This study is the first to objectively identify environments where CRC survivors are active and sedentary. These findings highlight the importance of considering the home environment when developing intervention strategies to increase PA and reduce SB in CRC survivors. Keywords Behavioral medicine; Built environment; Cancer survivorship; Colorectal cancer; GPS; Physical activity; Sedentary behavior https://link.springer.com/article/10.1007%2Fs12529-016-9575-6

Understanding Healthy Eating Behaviour Within the Context of the Modern Food Environment

Date: 2013 | Authors: Tarra L Penney The prevention of chronic disease requires understanding and intervention related to both individual and environmental level determinants. However, traditional approaches to chronic disease prevention and management have primarily been focused at the individual level, with limited attention toward environmental level influences on health behaviour. This lack of comprehensiveness is partially due to a paucity of complex theoretical frameworks for clarifying the influences of personal cognitive, and broader environmental, variables on a range of health behaviours. Therefore, the purpose of this research was to expand and test a popular health behaviour theory, Social Cognitive Theory (SCT), to include influences of the perceived food environment on healthy eating behaviour. This study involved two phases. Phase 1 expanded SCT to include a perceived food environment construct through review of the food environment literature. Phase 2 conducted a cross-sectional study of 201 adults (age 35 to 69 years) using an online survey to test the expanded SCT informed by phase 1. Data analysis included descriptive statistics and structural equation modeling (SEM) to compare the traditional and expanded SCT model. Results demonstrated no significant model fit, with no improvement in oveall fit with the inclusion of the perceived food environment. However, the expansion of SCT to include perceived food environment attributes altered the pathways of influence within the social cognitive model, suggesting that the presence of perceived environment measures is important for understanding how perceived environments might mediate the effect of personal cognitive influences on eating behaviour. These findings have implications for food environment research, the development of ecological theories, the field of health promotion and the prevention of chronic disease.   http://dalspace.library.dal.ca/handle/10222/35463

Relationship between drinking Water and Toenail arsenic concentrations among a cohort of Nova Scotians

Authors: Zhijie M Yu, Trevor J.B. Dummer, Aimee Adams, John D Murimboh and Louise Parker Journal: Journal of Exposure Science and Environmental Epidemiology | Volume: 24 | Pages: 135-44 |Date: 2014 | Abstract: Consumption of arsenic-contaminated drinking water is associated with increased cancer risk. The relationship between arsenic body burden, such as concentrations in human toenails, and arsenic in drinking water is not fully understood. We evaluated the relationship between arsenic concentrations in drinking water and toenail clippings among a cohort of Nova Scotians. A total of 960 men and women aged 35 to 69 years provided home drinking water and toenail clipping samples. Information on water source and treatment use and covariables was collected through questionnaires. Arsenic concentrations in drinking water and toenail clippings and anthropometric indices were measured. Private drilled water wells had higher arsenic concentrations compared with other dug wells and municipal drinking water sources (P<0.001). Among participants with drinking water arsenic levels ≥1 μg/l, there was a significant relationship between drinking water and toenail arsenic concentrations (r=0.46, P<0.0001). Given similar levels of arsenic exposure from drinking water, obese individuals had significantly lower concentrations of arsenic in toenails compared with those with a normal weight. Private drilled water wells were an important source of arsenic exposure in the study population. Body weight modifies the relationship between drinking water arsenic exposure and toenail arsenic concentrations.   https://www.nature.com/jes/journal/v24/n2/pdf/jes201388a.pdf

Understanding the Translation of Scientific Knowledge about Arsenic Risk Exposure among private well water users in Nova Scotia

Authors: Heather Chappells, Norma Campbell, John Drage, Conrad V. Fernandez, Louise Parker, Trevor J.B. Dummer Journal: Science of The Total Environment | Volume: 505 | Pages: 1259-1273 |Date: February 2015 | Arsenic is a class I human carcinogen that has been identified as the second most important global health concern in groundwater supplies after contamination by pathogenic organisms. Hydrogeological assessments have shown naturally occurring arsenic to be widespread in groundwater across the northeastern United States and eastern Canada. Knowledge of arsenic risk exposure among private well users in these arsenic endemic areas has not yet been fully explored but research on water quality perceptions indicates a consistent misalignment between public and scientific assessments of environmental risk. This paper evaluates knowledge of arsenic risk exposure among a demographic cross-section of well users residing in 5 areas of Nova Scotia assessed to be at variable risk (high-low) of arsenic occurrence in groundwater based on water sample analysis. An integrated knowledge-to-action (KTA) methodological approach is utilized to comprehensively assess the personal, social and local factors shaping perception of well water contaminant risks and the translation of knowledge into routine water testing behaviors. Analysis of well user survey data (n = 420) reveals a high level of confidence in well water quality that is unrelated to the relative risk of arsenic exposure or homeowner adherence to government testing recommendations. Further analysis from the survey and in-depth well user interviews (n = 32) finds that well users’ assessments of risk are influenced by personal experience, local knowledge, social networks and convenience of infrastructure rather than by formal information channels, which are largely failing to reach their target audiences. Insights from interviews with stakeholders representing government health and environment agencies (n = 15) are used to reflect on the institutional barriers that mediate the translation of scientific knowledge into public awareness and stewardship behaviors. The utilization of local knowledge brokers, community-based networks and regulatory incentives to improve risk knowledge and support routine testing among private well users is discussed. http://www.sciencedirect.com/science/article/pii/S0048969713015982

What is the role of Obesity in the Aetiology of Arsenic-related Disease?

Authors: Zhijie M. Yu, Bryan Fung, John D. Murimboh, Louise Parker, Trevor J.B. Dummer Journal: Environment International | Volume: 66 | Pages: 115-123 |Date: May 2014 | Consumption of arsenic contaminated drinking water causes a large variety of adverse health outcomes. Body mass index (BMI), which is linked to diet, is positively associated with arsenic methylation capacity. We investigated the association between an obesity-related diet and arsenic body burden from exposure to naturally contaminated drinking water among Nova Scotia residents. We collected home drinking water and toenail clipping samples among 960 men and women aged 35 to 69 years in Nova Scotia, Canada from 2009 through 2010. We measured body composition and arsenic concentrations in drinking water and toenails clipping samples and collected socio-demographic, behavioural, and dietary information via standardized questionnaires. We derived an obesity-related dietary pattern score using reduced rank regression. Across quartiles of the obesity-related dietary pattern score there were no significant differences in drinking water arsenic concentrations, but there was an inverse trend in arsenic concentrations in toenails across the dietary pattern score (P = 0.01). Compared with individuals in the first quartile of the dietary pattern score, those in the second through fourth quartiles had decreased likelihoods of high toenail arsenic (≥ 85 percentile). The corresponding odds ratios (95% confidence intervals [CI]) were 0.81 (95% CI, 0.49, 1.36), 0.57 (95% CI, 0.33, 0.99), and 0.55 (95% CI, 0.31, 0.98), respectively (P for trend = 0.02). We conclude that given similar levels of naturally occurring arsenic exposure via drinking water, an obesity-related dietary pattern was associated with significantly lower arsenic concentrations in toenails. Further studies to investigate the underlining mechanisms are warranted. http://www.sciencedirect.com/science/article/pii/S0160412014000403

The Future of Prevention is Almost Here

The Future of Prevention is Almost Here Researchers are conducting experiments to observe if diseases can be prevented before developing through exercise, diet, or changing your environment. Imagine knowing years in advance that you are likely to develop a serious disease and then discovering the lifestyle changes you can make to lower the chances of that happening. The Canadian Partnership for Tomorrow’s Health (CanPath) is aiming to create a future where links between the onset of disease and factors related to lifestyle, genetics, and the environment are much clearer. As the largest health research platform in Canadian history, CanPath includes more than 300,000 participants between the ages of 30 and 74 who were recruited through five regional cohorts representing eight provinces (BC Generations Project, Alberta’s Tomorrow Project, Ontario Health Study, CARTaGENE, and Atlantic PATH). Over the next 25 years, some participants will develop cancer or other diseases and the accumulation of CanPath data and biosamples will allow researchers to conduct important population-health studies. They will determine links between the onset of illness and risk factors — including those that can be modified like diet and exercise, those that can’t be modified due to genetics, and those that are largely based on environmental exposure. “The data can touch every aspect of future health research because it gives you a time capsule to go back and see what people were doing before they developed certain diseases,” says Dr. Craig Earle, Vice President of Cancer Control at the Canadian Partnership Against Cancer. The organization is a critical investor in, and the founder of, CanPath. CanPath building ‘world-class’ health resource CanPath data and biosamples were used in a study that determined that air pollution can alter DNA. Dr. Philip Awadalla, National Scientific Director of CanPath, notes that gene expression signatures largely follow where you live, rather than your ancestry. Dr Awadalla is with the Ontario Institute for Cancer Research and the University of Toronto — the university recently became the national scientific home of CPTP. “By tracking the health of participants over an extended period of time, we will be acquiring knowledge that could help with disease prevention down the road,” he says. Dr. Awadalla envisions that CanPath will enable a future where doctors will be armed with new genetic tools or biomarkers in order to advise patients on the steps they can take to prevent the onset of various diseases in the same way they now advise patients to stop smoking to avoid lung cancer. “CanPath is a great example of pan-Canadian cooperation to build a resource for health research that is world-class and unique for medicine,” says Dr. Earle. “It is going to be yielding benefits for decades to come.”

U of T to Lead Canada’s Largest Living Population Laboratory

U of T to Lead Canada’s Largest “Living Population Laboratory” (Original Post at University of Toronto) The University of Toronto has been selected to serve as the national scientific partner of the Canadian Partnership for Tomorrow’s Health (CanPath), Canada’s largest population research platform that is unlocking the answers to why some people develop cancer and chronic diseases while others do not. Through a national competition by the Canadian Partnership Against Cancer, Professors Philip Awadalla, in the Faculty of Medicine, and John McLaughlin, in the Dalla Lana School of Public Health, were chosen to lead CanPath into its next phase as Canada’s premier health research initiative. This announcement coincides with a recent publication led by Professor Awadalla that received widespread media attention, including in the Globe and Mail, in which analyses of CanPath data from Quebec revealed how air pollution and other environmental factors influence gene expression and disease. “CanPath enables precision health research because it’s a living population laboratory,” said Philip Awadalla, who is a Professor of Population and Medical Genetics in the Faculty of Medicine’s Department of Molecular Genetics, and will now serve as National Scientific Director for CanPath. The Canadian Partnership for Tomorrow’s Health has more than 300,000 participants, aged 30-74, who have voluntarily provided health and biological information, which can be used by researchers to conduct long-term population health studies. As participants age, some will develop a range of conditions, which allows researchers to search for factors linked to disease onset and progression. These types of studies can detect health links with genetic, environment, behaviour and societal factors. “We are honoured and grateful for the opportunity to lead this major program at U of T in partnership with many contributors across Canada,” said John McLaughlin, who is a Professor of Epidemiology at the Dalla Lana School of Public Health, and will now serve as CanPath’s Executive Director. “While benefiting from the University’s massive research capacity and range of expertise, we will work collaboratively with our many partners to heighten scientific outputs and impacts, enrich the platform with new data linkages, and work with researchers across campus and across Canada who share our vision of how health and health systems can be improved nationally,” said McLaughlin, who is also Chief Science Officer at Public Health Ontario. “By deeply characterizing and following the health of Canadians, we will be able to develop and optimize tools that slow or prevent disease evolution in an individual. The future of this program is reliant on research and discovery by the research community and the continued participation of Canadians to unlock the genetic and environmental factors associated with the development of disease,” said Awadalla who is also Director of a Genome Canada genomics platform, at the Ontario Institute for Cancer Research, a strategic partner for the project. U of T is the natural home for the second phase of the CanPath because of its strong track record of world class population health, biomedical, and health services research and education, combined with its impressive faculty with extensive experience leading large-scale studies and research networks. “We aim to attract more national and international researchers who can use the platform to further their own research as well as actively engage with CanPath leadership and expand its future direction,” said France Gagnon, Associate Dean of Research at the Dalla Lana School of Public Health.

Ambitious new study is a powerful tool in the fight against cancer and chronic disease

Ambitious new study is a powerful tool in the fight against cancer and chronic disease (Originally Published on National Post) A new and powerful resource is now available in Canada to help researchers in the fight against cancer and other chronic diseases. The Canadian Partnership for Tomorrow Project (CPTP) is the first national database designed to both document and follow the health of hundreds of thousands of Canadians for decades to come. CPTP seeks to better understand the complex pathways of disease, and is aimed at improving health outcomes for the next generations. CPTP is the largest research database ever built in Canada, comprising harmonized information from five regional population health studies. Participants were recruited from British Columbia, Alberta, Ontario, Quebec and the Atlantic provinces. Dr. Catherine Boileau is the Director of Epidemiology at CARTaGENE, CPTP’s Quebec partner. She says the database offers researchers an opportunity to focus on analyzing data rather than starting from scratch to set up studies and recruit participants. Researchers have access to a wealth of biological and health data through a simple online request process. “Collecting information, collecting biological material and physical measurements costs a lot of money,” Dr. Boileau notes. “Gaining access to this resource saves money and time. Instead of having to collect data, recruit people and process biological material, researchers can now access the high-quality biological material they need [through CPTP].” Study participants are between the ages of 30 and 74, and have volunteered to provide updated health information over the course of their lives. They come from varying socio-economic backgrounds, and live in both large urban centres and remote rural towns. All have volunteered to fill out a baseline survey that includes detailed questions on their medical history, diet and lifestyle. They have also agreed to link their questionnaires and any bio-specimens with information from electronic health records. Nearly half of CPTP participants have provided blood samples that can be used for biochemical research. There are also 100,000 urine samples, as well as 45,000 blood spots and saliva samples that are additional sources of DNA. CPTP bio-samples also include more than 30,000 toenail clippings that can be tested for environmental exposure to toxins. “Researchers now have at their fingertips a valuable resource they can use,” says Dr. Trevor Dummer, co-leader of the West Coast’s regional population study, the BC Generations Project.  He notes the national sample size represents about one in 50 Canadians within the CPTP’s age group. “We have gathered a lot of information on a large proportion of Canadians. Now that the infrastructure has been created, it is going to accelerate the speed at which we can do research studies.” Accelerated research into the risk factors for cancer is of particular urgency. Despite important advances made in recent decades, cancer remains a formidable adversary for those looking for new prevention strategies and treatments. The disease is complex, unpredictable, and the leading cause of death in this country. As Canada’s population ages, cancers are expected to become even more prevalent, and are forecast to rise by about 40 per cent by the year 2030. CPTP offers a unique window into the genetic make-up and health of people from across the country. It has significant statistical power to explore how genetic predispositions and environment can influence cancer risks. The database gives researchers a new opportunity to scale up their work to include more data from Canadians from diverse geographic regions. “You can test out whether a particular hypothesis in one province may hold true in other populations,” Dr. Dummer says. He points to a research project he and his colleagues are pursuing in B.C., on how urban development can impact people’s health in Metropolitan Vancouver. With CPTP, there is potential to expand the study to include people from other regions of the country. “You can see whether health outcomes in British Columbia hold true for the Prairies. It effectively enables us to do a number of cutting-edge projects.” CPTP is still considered a young population health research study. Its greatest value, according to Dr. Boileau and other researchers, may well be found in the years and decades to come. As the regional population health studies return to their participants for updates, the new information gathered might help shed light on why some people develop cancer and other chronic diseases while others don’t. “We are just beginning. We plan to follow participants for many years, and the study will become more valuable with time,” says Dr. Boileau. “We will be able to compare people who were exposed to different risk factors, and at what rate they develop these diseases.” Dr. Boileau adds that as researchers return the findings of their studies to the cohorts, they will enhance the quality of the data. The more researchers use the database, the more questions CPTP might be able to help answer. The door is now open for independent investigators to use this new national resource – one that holds great potential for scientific discovery.