Authors: Kaitlyn Gilham, Qianqian Gu, Trevor JB Dummer, John J Spinelli, Rachel A Murphy  Abstract An understanding of relationships between different constructs of the neighbourhood environment and diet quality is needed to inform public health interventions. This study investigated associations between material deprivation, social deprivation and population density with diet quality in a cohort of 19,973 Canadian adults aged 35 to 69 years within the Atlantic PATH cohort study. Diet quality, a metric of how well diet conforms to recommendations was determined from a 24-item food frequency questionnaire. Neighbourhood environment data were derived from dissemination area level Census data. Two deprivation indices were evaluated: material and social deprivation, which reflect access to goods and amenities and social relationships. Multi-level models were used to estimate relationships (mean differences and 95% CI) between neighbourhood environment and diet quality, adjusting for covariates. Mean diet quality was lower in the most socially deprived neighbourhoods compared to the least socially deprived: −0.56, 95% CI (−0.88, −0.25). Relationships between diet quality and population density differed between urban and rural areas (p-interaction < 0.0001). In rural areas, diet quality was higher in intermediate-density neighbourhoods: 0.54, 95% CI (0.05, 1.03). In urban areas, diet quality was lower in intermediate-density and the most-dense neighbourhoods: −0.84, 95% CI (−1.28, −0.40) and −0.72, 95% CI (−1.20, −0.25). Our findings suggest socially deprived and high-density neighbourhoods are associated with lower diet quality and possible urban-rural differences in neighbourhood environment-diet quality relationships. Additional studies are needed to determine the temporal nature of relationships and whether differences in diet quality are meaningful. Doi: https://doi.org/10.3390/nu12103217  

Authors: Jacob Nearing, Vanessa DeClercq, Johan Van Limbergen, Morgan Langille   ABSTRACT More than 1,000 different species of microbes have been found to live within the human oral cavity, where they play important roles in maintaining both oral and systemic health. Several studies have identified the core members of this microbial community; however, the factors that determine oral microbiome composition are not well understood. In this study, we exam the salivary oral microbiome of 1,049 Atlantic Canadians using 16S rRNA gene sequencing to determine which dietary, lifestyle, and anthropometric features play a role in shaping microbial community composition. Features that were identified as being significantly associated with overall composition then were additionally examined for genera, amplicon sequence variants, and predicted pathway abundances that were associated with these features. Several associations were replicated in an additional secondary validation data set. Overall, we found that several anthropometric measurements, including waist-hip ratio (WHR), height, and fat-free mass, as well as age and sex, were associated with overall oral microbiome structure in both our exploratory and validation data sets. We were unable to validate any dietary impacts on overall taxonomic oral microbiome composition but did find evidence to suggest potential contributions from factors such as the number of vegetable and refined grain servings an individual consumes. Interestingly, each one of these factors on its own was associated with only minor shifts in the overall taxonomic composition of the oral microbiome, suggesting that future biomarker identification for several diseases associated with the oral microbiome can be undertaken without the worry of confounding factors obscuring biological signals.   Doi: 10.1128/mSphere.00451-20

Authors: Hall, R., Tusevliak, N., Wu, C.F., Ibrahim, Q., Schulze, K., Khan, A., Desai, D., Awadalla, P., Broet, P., Dummer, T.J.B., Hicks, J., Tardif, J-C., Teo, K., Vena, J., Lee, D., Friedrich, M., Anand, S., Tu, J. Background The intent of the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort is to understand the early determinants of subclinical cardiac and vascular disease and progression in adults selected from existing cohorts; the Canadian Partnership for Tomorrow Project (CPTP), the Prospective Urban and Rural Evaluation (PURE) cohort and, the Montreal Heart Institute Biobank. We evaluated how well the CAHHM-Health Services Research (CAHHM-HSR) sub-cohort reflects the Canadian population. Methods Cross-sectional design among prospective cohort of community-dwelling adults 35-69 years of age who met the CAHHM inclusion criteria and, a cohort of adults 35-69 years of age who responded to the 2015 Canadian Community Health Survey-Rapid Response (CCHS-RR) module. The INTERHEART risk score was calculated at the individual level with means and proportions reported at the overall and provincial level. Results There are modest differences between CAHHM-HSR study participants and the CCHS- RR respondents in age (56.3 vs 51.7 mean years), proportion of males (44.9% vs 49.3%), and mean INTERHEART risk score (9.7 vs 10.1). Larger differences were observed in post-secondary education (86.8% vs 70.2%), Chinese ethnicity (11.0 % vs 3.3%), obesity (23.2% vs 29.3%), current smokers (6.1% vs 18.4%) and having no cardiac testing (30.4% vs 55.9%). Conclusions CAHHM-HSR participants are older, of higher socioeconomic status, and their mean INTERHEART risk score is similar. Differing sampling strategies and missing data, may explain some differences between the CAHHM-HSR cohort and Canadian community dwelling adults and should be considered when using the CAHHM-HSR for scientific research.   Link: https://doi.org/10.1016/j.cjco.2020.07.013

Authors: Vanessa DeClercq, Todd Duhamel, Olga Theou, Scott Kehler Purpose The aim of this study was to identify lifestyle factors in males and females that are associated with a greater degree of frailty in a Canadian cohort. Methods Cross-sectional data analysis from participants aged 30−74 yrs of the Atlantic PATH cohort. Inclusion criteria included completion of mental health questionnaires and ≥1 vital measure (n = 9133, 70% female, mean age 55 yrs). A frailty index was created based on 38 items with higher values indicating increasing frailty. The association between lifestyle factors and frailty was assessed by logistic regression. Results 805 participants had a high level of frailty (frailty index ≥0.30). There was a significant interaction among sex, age, and lifestyle factors such as smoking status (P < 0.001), alcohol consumption (P < 0.001), physical activity level (P = 0.005), time spent sitting (P < 0.001) and sleeping (P < 0.001) on frailty. Smoking was harmful whereas sleep was protective for both males and females (<60 yrs). Females (<60yrs) that sat for ≥4 h/day were more likely to be highly frail whereas females (all ages) that consumed alcohol at least occasionally were less likely to be highly frail. Males, but not females, that engaged in a high level of physical activity were less likely to have a high level of frailty. Conclusions Higher frailty is more prevalent among participants with unhealthy lifestyle behaviors related to smoking, alcohol consumption, sedentary and physical activity level, diet, and sleep. Differences in lifestyle behaviors of males and females of specific ages should be considered for managing frailty levels. Link: https://doi.org/10.1016/j.archger.2020.104207

Authors: Gabriela Ilie, Robert Rutledge, Ellen Sweeney Abstract Objective: Prostate cancer (PCa) is the most prevalent form of cancer among men and has one of the most favorable survival rates among all cancers. Here we examine the association between depression and anxiety symptoms in a population‐based sample of men. Methods: A cross‐sectional analysis was conducted on a subsample of 6 585 male participants aged 49‐69 from 2009 to 2015 survey cycle of the Atlantic PATH. Mild, moderate or severe depression or anxiety indicators were primary outcomes and were assessed using the Generalized Anxiety Disorder (GAD‐7) scale and the Patient Health Questionnaire (PHQ‐9). The presence of a lifetime history of PCa, other forms of cancer (except PCa) or absence of either was the main predictor variable. Results: An estimated 3.9% of men self‐identified as having had a history of PCa diagnosis, 11.3% of men identified as having had a history of other forms of cancer and 84.9% reported never having had a diagnosis of cancer in their lifetime, respectively. Survivors of PCa had 2.45 or 2.05 statistically significantly higher odds of screening positive for current anxiety or depressive symptoms, respectively, compared with those who identified as without a lifetime history of any form of cancer in controlled analyses (including survivorship time). Conclusions: Increased rates of anxiety and depression among men with a history of PCa highlight the need for mental health screening among PCa survivors. The findings highlight the importance of a multidisciplinary effort to prioritize and deliver comprehensive mental health support to PCa survivors. Link: https://onlinelibrary.wiley.com/doi/full/10.1002/pon.5244

Authors: Yunsong Cui, Ellen Sweeney, Cynthia Forbes, Vanessa DeClercq, Scott Grandy, Melanie Keats, Louise Parker, Zhijiie Michael Yu, Trevor JB Dummer Abstract The population of Atlantic Canada is aging rapidly and has among the highest rates of chronic disease in the country. This cross-sectional study drew data from the Atlantic Partnership for Tomorrow’s Health (Atlantic PATH) study to investigate the association between physical activity and self-rated health among adults in this population. The results suggest that physical activity is associated with and may help to improve perceived health status of individuals with one or more chronic conditions. The findings support literature suggesting that physical activity can be beneficial for adults as they age with chronic disease. Link: https://www.tandfonline.com/doi/abs/10.1080/08952841.2020.1735286?journalCode=wjwa20

Authors: Melanie Keats, Yunsong Cui, Vanessa DeClercq, Scott Grandy, Ellen Sweeney, Trevor JB Dummer Abstract: Purpose: Individuals living with cancer have been shown to have a higher burden of comorbid disease and multimorbidity in comparison to their cancer-free counterparts consequently, leaving them at risk of polypharmacy (i.e., ≥ 5 medications) and its potential negative effects. The primary aim of the current study was to examine the self-reported prevalence of and association between multimorbidity and prescription medication use in a population-based sample of adult cancer survivors (CS). Methods: This retrospective, nested case–control study drew participant data from the Atlantic Partnership for Tomorrow’s Health cohort. CS (n = 1708) were matched to 4 non-cancer controls (n = 6832) by age and sex. Prevalence of polypharmacy by number of chronic conditions and age was estimated with 95% CI. Logistic regression was used to examine the association between multimorbidity and polypharmacy while adjusting for sociodemographic and lifestyle factors. The comorbidity–polypharmacy score was also calculated as an estimate of disease burden. Results: Multimorbidity was common in both CS (53%) and non-cancer controls (43%); however, a significantly higher percentage of CS reported multimorbidity (p < 0.001). Prescription medication use was also found to be significantly higher among CS (2.3 ± 2.6) compared to non-cancer controls (1.8 ± 2.3; p < 0.0001). Exploratory comorbidity–polypharmacy score analyses indicated that CS had a significantly higher overall disease burden than the age/sex-matched non-cancer controls. Conclusions: As CS appear to be at a higher risk of multimorbidity and polypharmacy and by extension, increased healthcare burden, ongoing education on the prevention of medication-related harm, and interventions to reduce the occurrence of both co-morbid disease and unnecessary medications are warranted. Link: https://link.springer.com/article/10.1007/s00520-020-05529-3

Authors: David Fleming, Samantha Crook, Colby Evans, Michael Nader, Manuel Atia, Jason Hicks, Ellen Sweeney, Christopher McFarlane, Jong Sung Kim, Erin Keltie, Anil Adisesh Abstract: Zinc is an essential trace element in humans. Zinc deficiency can result in a range of serious medical conditions which include effects on growth and development, the immune system, the central nervous system, and the gastrointestinal system. Diagnosis of zinc deficiency is often precluded by the lack of a noninvasive and reliable biomarker. Zinc concentration in nail is considered an emerging biomarker of zinc status in humans. Whether zinc in nail accurately reflects zinc status is beyond the scope of the current study, but is an important research question. The development of a portable method to quickly assess zinc concentration from a single nail clipping could be a useful advance. In this study, single toenail clippings from 60 individuals living in Atlantic Canada were measured for zinc using a portable X-ray fluorescence (XRF) technique. These samples were obtained from the Atlantic PATH cohort, part of the largest chronic disease study ever performed in Canada. Each toenail clipping was measured using three 300 s trials with a mono-energetic portable XRF system. Results were then assessed using two different approaches to the XRF analysis: (1) factory-calibrated zinc concentrations were output from each trial, and (2) energy spectra were analyzed for the characteristic X-rays resulting from zinc. Following the measurement of zinc using the non-destructive portable XRF method, the same clippings were measured for zinc concentration using the “gold standard” technique of inductively coupled plasma-mass spectrometry (ICP-MS). A linear equation of best fit was determined for the relationship between average XRF output zinc concentration and ICP-MS zinc concentration, with a correlation coefficient r = 0.60. Similarly, a linear equation of best fit was found for the relationship between a normalized XRF energy spectrum zinc signal and ICP-MS zinc concentration, with a correlation coefficient r = 0.68. Individual ICP-MS zinc concentrations ranged from 32 μg/g to 140 μg/g, with a population average of 85 μg/g. The results of this study indicate that portable XRF is a sensitive method for the measurement of zinc in a single nail clipping, and provides a reasonable estimation of zinc concentration. Further method development is required before portable XRF be considered a routine alternative to ICP-MS for the assessment of zinc in nail clippings. Link: https://www.sciencedirect.com/science/article/pii/S0946672X20301681