Authors: DeClercq, V., Cui, Y., Forbes, C., Grandy, S., Keats, M., Parker, L., Sweeney, E., Yu, Z.M., Dummer, T.J.B. (2017) Journal: Mediators of Inflammation, 2017. doi: https://doi.org/10.1155/2017/4302412 Abstract: The objective of this study was to examine the relationship between adipokines and adiposity in individuals with rheumatoid and osteoarthritis in the Atlantic PATH cohort. Using a nested case-control analysis, participants in the Atlantic PATH cohort with rheumatoid or osteoarthritis were matched for measures of adiposity with participants without a history of arthritis. Both measured and self-reported data were used to examine disease status, adiposity, and lifestyle factors. Immunoassays were used to measure plasma markers. BMI was positively correlated with percentage body fat, fat mass index (FMI), and a change in BMI from 18 years of age in all 3 groups. There were no statistical differences between levels of plasma adipokines; adiponectin levels were 6.6, 7.9, and 8.2 μg/ml, leptin levels were 10.3, 13.7, and 11.5 ng/ml, and resistin levels were 10.0, 12.1, and 10.8 ng/ml in participants without arthritis, with rheumatoid arthritis, and with osteoarthritis, respectively. Those with higher levels of adiponectin were more likely to have osteoarthritis (but not rheumatoid arthritis). No association was found between arthritis types and leptin or resistin. This study demonstrates differences in measures of adiposity and adipokines in specific types of arthritis and highlights the need for more research targeting specific adipokines during arthritic disease progression. Link: https://www.hindawi.com/journals/mi/2017/4302412/

Authors: Keats, M., Cui, Y., DeClercq, V., Dummer, T.J.B., Forbes, C., Grandy, S., Hicks, J., Sweeney, E., Yu, Z.M., Parker, L. (2017). Journal: Preventive Medicine, 105. Abstract: Owing to an aging population and medical advances, the anticipated growth and prevalence of multimorbidity has been recognized as a significant challenge and priority in health care settings. Although physical activity has been shown to play a vital role in the primary and secondary prevention of chronic disease, much less is known about the relationship between physical activity and multimorbidity. The objective of the present study was to examine the relationship between physical activity levels and multimorbidity in male and female adults after adjusting for key demographic, geographical, and lifestyle factors. The study drew data from a prospective cohort in Atlantic Canada (2009-2015). The sample included 18,709 participants between the ages of 35-69. Eighteen chronic diseases were identified. Physical activity levels were estimated based on the long form of the International Physical Activity Questionnaire. Using logistic regression analysis, we found that multimorbid individuals were significantly more likely to be physically inactive (OR=1.26; 95% CI 1.10, 1.44) after adjusting for key sociodemographic and lifestyle characteristics. Additional stratified analyses suggest that the magnitude of the effect between multimorbidity and physical activity was stronger for men (OR=1.41; 95% CI 1.12, 1.79) than women (OR=1.18; CI 1.00, 1.39) and those living in rural (OR=1.43; CI 1.10, 1.85) versus urban (OR=1.20; CI 1.02, 141) areas. Given the generally low levels of physical activity across populations and a growing prevalence of multimorbidity, there is a need for a prospective study to explore causal associations between physical activity, multimorbidity, and health outcomes. Link: doi: https://doi.org/10.1016/j.ypmed.2017.10.013

Cohort Profile: The Atlantic Partnership for Tomorrow’s Health (Atlantic PATH) Study. Authors : Sweeney, E., Cui, Y., DeClercq, V., Devichand, P., Forbes, C., Grandy, S., Hicks, J., Keats, M., Parker, L., Thompson, D., Volodarsky, M., Yu, Z.M., and Dummer, T. (2017). Journal: International Journal of Epidemiology, dyx124. doi: https://doi.org/10.1093/ije/dyx124. Abstract: Cohort purpose: The Atlantic Partnership for Tomorrow’s Health (Atlantic PATH) study is a regional cohort of a federated prospective cohort study, the Canadian Partnership for Tomorrow Project (CPTP). The Atlantic PATH study was established in 2009 to recruit participants from the general population across Atlantic Canada (Nova Scotia, New Brunswick, Prince Edward Island, and Newfoundland and Labrador). The study collected health measures and biological samples in order to examine the genetic, environmental and lifestyle factors that interact to influence the development of cancer and chronic diseases. Link: https://academic.oup.com/ije/article/doi/10.1093/ije/dyx124/4093155/Cohort-Profile-The-Atlantic-Partnership-for?guestAccessKey=e2e3e4e4-785f-479f-87e1-1f45ca4ae39a

Associations of Coffee, Diet Drinks, and Non-Nutritive Sweetener Use with Depression among Populations in Eastern Canada Authors: Yu, Z.M., Parker, L., and Dummer, T. (2017). Journal:  Scientific Reports, 7. doi:10.1038/s41598-017-06529-w. Abstract: Consumption of coffee and diet drinks and the use of non-nutritive sweeteners is commonplace worldwide. We conducted a cross-sectional analysis to investigate the associations between coffee consumption and non-nutritive sweetener use and depression among populations in Atlantic Canada. During 2009 to 2013, we recruited 18838 participants aged 35–69 years (5854 men and 12984 women) for the baseline survey of the Atlantic Partnership for Tomorrow’s Health cohort study. Coffee consumption, sweetener use, and major depression were assessed using a set of standardized questionnaires. We utilized multiple logistic regression models to assess the associations of coffee drinking and non-nutritive sweetener use with major depression. Compared with non-coffee drinkers, female participants who drank coffee ≥4 cups/day had an odds ratio of 1.38 (95% confidence interval, 1.15–1.64) for major depression with adjustment for sociodemographic and behavioral factors, chronic disease status, and body mass index. We found a significant association between depression and consumption of sweeteners and diet drinks, which was more apparent among women than men. We conclude that heavy coffee drinking and non-nutritive sweetener use were associated with depression among populations in Atlantic Canada. Further studies are warranted to investigate the underlying biological mechanisms. Link: https://www.nature.com/articles/s41598-017-06529-w

Atopic dermatitis and risk of hypertension, type-2 diabetes, myocardial infarction and stroke in a cross-sectional analysis from the Canadian Partnership for Tomorrow Project. Authors: Drucker, A.M., Qureshi, A.A., Dummer, T.J.B., Parker, L., Li, W.Q. (2017). Journal:  British Journal of Dermatology. Doi: 10.1111/bjd.15727. Abstract: Atopic dermatitis (AD) has been associated with cardiovascular risk factors and diseases, but epidemiologic studies to date have found conflicting results. Objectives: We aimed to determine the associations of AD with hypertension, type-2 diabetes (T2D), myocardial infarction (MI) and stroke. Methods: We conducted a cross-sectional analysis of baseline data from the Canadian Partnership for Tomorrow Project which includes Canadian residents aged 30-74 living in British Columbia, Alberta, Ontario, Quebec and the Atlantic Provinces. We excluded participants with incomplete data on AD, hypertension, T2D, MI or stroke, who had type-1 or gestational diabetes or who developed any of the outcomes at an age prior to a diagnosis of AD, leaving 259,119 participants in our analysis. We used logistic regression to calculate age and sex- and multivariable-adjusted odds ratios (OR) and 95% confidence intervals (CI) between AD and subsequent hypertension, T2D, MI and stroke. Results: AD was reported by 21,379 (8.4%) participants. A total of 52,787 cases of hypertension, 12,739 cases of T2D, 4,390 cases of MI and 2,235 cases of stroke were reported by participants at enrollment. In the multivariable-adjusted model, AD was associated with decreased odds (OR, 95% CI) of hypertension (0.87, 0.83-0.90), T2D (0.78, 0.71-0.84), MI (0.87, 0.75-1.00) and stroke (0.79, 0.66-0.95). Conclusions: We did not find evidence of a positive association between AD and subsequent hypertension, T2D, MI or stroke; AD was inversely associated with these outcomes in our study. Given our findings and the conflicting literature, AD is likely not a major risk factor for cardiovascular disease.  

Lead in Drinking Water: A Response from the Atlantic PATH Study Authors: Sweeney, E., Yu, Z.M., Dummer, T., Parker, L. (2017). Journal: Environmental Health Review, 60(1). doi:  https://doi.org/10.5864/d2017-002. Abstract: Exposure to lead through drinking water is an issue of increasing concern, particularly with recent high-profile cases of lead-contaminated water. The maximum acceptable concentration level for drinking water in Canada is 10 µg/L, whereas the current blood intervention level is 10 µg/dL. The health effects related to lead exposure are well established and there is evidence that blood lead levels as low as <5 µg/dL are associated with adverse health effects in both children and adults. We analyzed water and toenail samples for lead concentrations from the Atlantic Partnership for Tomorrow’s Health (Atlantic PATH) project, a cohort of the general population in Nova Scotia. Approximately 46% of Nova Scotia residents use well water as their primary source of drinking water. Water from dug wells had higher lead concentrations compared to drilled wells, and the lowest lead levels were found in water from municipal supplies. Although the majority of the lead levels in the drinking water provided by Atlantic PATH participants were below the Canadian maximum acceptable concentration level, there were outliers, particularly among unregulated private well water sources. Given the health effects that are linked to low-level exposures, any exposure to lead in primary water sources remains a concern. Link: http://pubs.ciphi.ca/doi/abs/10.5864/d2017-002  

Cardiovascular disease and physical activity in adult cancer survivors: a nested, retrospective study from the Atlantic PATH cohort Authors: Keats, M., Cui, Y., Grandy, S., and Parker, L. (2016). Journal: Journal of Cancer Survivorship, 11. doi: 10.1007/s11764-016-0584-x Abstract:  The study aimed to examine the relationship between cardiovascular disease (CVD) and physical activity (PA) levels in cancer survivors (CS). Methods Using a nested, retrospective follow-up design, this study presents the self-reported prevalence of CVD in an Atlantic Canadian population-based cohort of 1526 CS and 6034 age-sex matched, non-cancer controls ranging from 35 to 69 years of age. Univariate and multiple logistic regression models were used to explore the association between CVD and PA. Results Overall, CS were 30% more likely to have ever experienced a CVD event than controls (OR = 1.3; 95% CI 1–1.7, p = .07). Survivors were also significantly more likely to report having hypertension (OR = 1.60; 95% CI 1.03–1.3, p = .02) and diabetes (OR = 1.27; 95% CI 1.03–1.16, p = .02). Compared to controls, CS were significantly less likely to engage in high levels of PA. For survivors, compared to those who were least physically active, the odds of having a CVD risk factor was 35% lower for those who were moderately active (OR = 0.65; 95% CI 0.48–0.88) and 45% lower in the most highly active group (OR = 0.55; 95% CI 0.4–0.73). For controls, the odds of having a CVD risk factor was 25% lower for those in the moderately active group (OR = 0.75; 95% CI 0.64–0.88) and 30% lower for those in the high active group (OR = 0.70; 95% CI 0.6–0.81). Conclusion Low active survivors appear to be at a high risk of CVD-related comorbidity. Implications for cancer survivors PA is associated with lower CVD-related comorbidity in CS, suggesting that interventions directed at increasing PA should be implemented to improve long-term health outcomes.