Population Profile: Multiple Sclerosis

Population Profile: Multiple Sclerosis Ellen Sweeney Click here to see the full brief Multiple sclerosis (MS) is a progressive chronic disease of the autoimmune system which affects the central nervous system, including the brain, spinal cord and optic nerves. There are a number of different types of MS with varying symptoms and degrees of severity, including clinically isolated syndrome, relapsing remitting MS, primary progressive MS, secondary progressive MS, and progressive-relapsing MS. Symptoms of MS vary between individuals and can include extreme fatigue, as well as difficulties with vision, hearing, balance, and mobility. Prevalence Rates Worldwide, more than 2.3 million people have been diagnosed and are currently living with MS. The global prevalence rate indicates that there are 33 people living with MS per 100,000 people. The highest rates of MS are found in North America (140 per 100,000 people) and Europe (108 per 100,000 people).5,6 Canada has the highest rates in the world with approximately 100,000 Canadians currently living with the disease.

Physical activity levels in Atlantic Canadian cancer survivors

Physical activity levels in Atlantic Canadian cancer survivors Melanie Keats, Cindy Forbes, Scott Grandy, & Yunsong Cui Click here to see the full brief The incidence of cancer within the Canadian population has been slowly increasing since 2009. Currently, it is expected that 2 in 5 Canadians will develop cancer in their lifetime, which equates to a national incidence rate of 515.5 new cancer diagnoses per 100,000 people. In Atlantic Canada, the average incidence rate for Nova Scotia (627.3/100,000), New Brunswick (606.7/100,000), Newfoundland (631.6/100,000) and Prince Edward Island (556.9/100,000) combined is 605.6 new diagnoses per 100,000 people, which is markedly higher than the national incidence rate. Of those diagnosed with cancer, 63% will survive at least 5 years after the initial cancer diagnosis. This means, as the overall number of cancer diagnoses increases, a corresponding increase in cancer survivors can be expected. Although this is good news, it is also concerning as the long–term side effects of treatment and the development of comorbidities, such as heart disease, has become a much larger issue for cancer survivors. One factor that contributes to an increased risk of chronic disease is low levels of physical activity. In fact, the World Health Organization states that physical activity is the fourth leading risk factor for global mortality. Importantly, physical activity can lead to many improvements in physical functioning and quality of life following a cancer diagnosis. These improvements include enhanced aerobic endurance, muscular strength, fatigue, depression, anxiety, self-esteem, functional ability, and overall quality of life. Emerging research has also suggested a potential all-cause and disease-specific survival advantage. Despite these benefits, many cancer survivors do not accumulate the recommended amount of physical activity per week. Numerous international bodies have developed physical activity guidelines to try and reduce the incidence of morbidity and mortality associated with low levels of physical activity. Current guidelines recommend that an individual should complete 150 minutes per week of moderate-to-vigorous physical activity in order to accumulate health benefits and decrease the risk of morbidity and mortality. Previous research among Canadian cancer survivors has found up to 78% can be inactive. Therefore the purpose of this report is to use a population based sample from Atlantic Canada to describe and compare the physical activity levels of individuals with a self-reported history of cancer with those who have never had a cancer diagnosis.

Statin Use in Atlantic Canada

Statin Use in Atlantic Canada Report by Vanessa DeClercq and Scott A. Grandy Click here to see the full brief High levels of low-density lipoprotein (LDL) cholesterol represent a significant risk factor for cardiovascular disease (CVD) [1]. Thus, decreasing LDL cholesterol levels is a key factor in reducing CVD mortality [2]. The drug class statins has proven to be a very effective therapy for reducing LDL-cholesterol levels. Statins also have been shown to reduce inflammation, which plays a prominent role in the development of CVD [2-4]. Based on these therapeutic effects Canadian guidelines now recommend that 1 in 4 Canadians take statins to reduce high LDL cholesterol to reduce the risk of adverse cardiovascular (CV) outcomes [2, 5]. However, a recent report suggests that only 1 in10 Canadians are taking statin drugs [6]. Therefore, the aim of this brief report was to identify the number of Atlantic Canadians with CVD risk factors taking statins and compare this to the Canadian guidelines and the national average for statin usage.

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 Link to full article 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

High-resolution genomic analysis of human mitochondrial RNA sequence variation.

High-resolution genomic analysis of human mitochondrial RNA sequence variation. Journal: Science| Pages: 413-415 |Date: April 2014 | Authors: Hodgkinson A, Idaghdour Y, Gbeha E, Grenier JC, Hip-Ki E, Bruat V, Goulet JP, de Malliard T, Awadalla P. Mutations in the mitochondrial genome are associated with multiple diseases and biological processes; however, little is known about the extent of sequence variation in the mitochondrial transcriptome. By ultra-deeply sequencing mitochondrial RNA (>6000×) from the whole blood of ~1000 individuals from the CARTaGENE project, we identified remarkable levels of sequence variation within and across individuals, as well as sites that show consistent patterns of posttranscriptional modification. Using a genome-wide association study, we find that posttranscriptional modification of functionally important sites in mitochondrial transfer RNAs (tRNAs) is under strong genetic control, largely driven by a missense mutation in MRPP3 that explains ~22% of the variance. These results reveal a major nuclear genetic determinant of posttranscriptional modification in mitochondria and suggest that tRNA posttranscriptional modification may affect cellular energy production. http://www.ncbi.nlm.nih.gov/pubmed/24763589

Recombination affects accumulation of damaging and disease-associated mutations in human populations.

Recombination affects accumulation of damaging and disease-associated mutations in human populations. Journal: Nature Genetics| Pages: 400-404 |Date: April 2015 | Authors: Julie G Hussin, Alan Hodgkinson, Youssef Idaghdour, Jean-Christophe Grenier, Jean-Philippe Goulet, Elias Gbeha, Elodie Hip-Ki, Philip Awadalla Many decades of theory have demonstrated that, in non-recombining systems, slightly deleterious mutations accumulate non-reversibly, potentially driving the extinction of many asexual species. Non-recombining chromosomes in sexual organisms are thought to have degenerated in a similar fashion; however, it is not clear the extent to which damaging mutations accumulate along chromosomes with highly variable rates of crossing over. Using high-coverage sequencing data from over 1,400 individuals in the 1000 Genomes and CARTaGENE projects, we show that recombination rate modulates the distribution of putatively deleterious variants across the entire human genome. Exons in regions of low recombination are significantly enriched for deleterious and disease-associated variants, a signature varying in strength across worldwide human populations with different demographic histories. Regions with low recombination rates are enriched for highly conserved genes with essential cellular functions and show an excess of mutations with demonstrated effects on health, a phenomenon likely affecting disease susceptibility in humans. http://www.ncbi.nlm.nih.gov/pubmed/25685891

A two-stage association study identifies methyl-CpG-binding domain protein 2 gene polymorphisms as candidates for breast cancer susceptibility

A two-stage association study identifies methyl-CpG-binding domain protein 2 gene polymorphisms as candidates for breast cancer susceptibility Journal: Eur J Hum Genet | Pages: 682-689 | Date: June 2012 | Authors: Sapkota Y, Robson P, Lai R, Cass CE, Mackey JR, Damaraju S. Genome-wide association studies for breast cancer have identified over 40 single-nucleotide polymorphisms (SNPs), a subset of which remains statistically significant after genome-wide correction. Improved strategies for mining of genome-wide association data have been suggested to address heritable component of genetic risk in breast cancer. In this study, we attempted a two-stage association design using markers from a genome-wide study (stage 1, Affymetrix Human SNP 6.0 array, cases=302, controls=321). We restricted our analysis to DNA repair/modifications/metabolism pathway related gene polymorphisms for their obvious role in carcinogenesis in general and for their known protein-protein interactions vis-à-vis, potential epistatic effects. We selected 22 SNPs based on linkage disequilibrium patterns and high statistical significance. Genotyping assays in an independent replication study of 1178 cases and 1314 controls were attempted using Sequenom iPLEX Gold platform (stage 2). Six SNPs (rs8094493, rs4041245, rs7614, rs13250873, rs1556459 and rs2297381) showed consistent and statistically significant associations with breast cancer risk in both stages, with allelic odds ratios (and P-values) of 0.85 (0.0021), 0.86 (0.0026), 0.86 (0.0041), 1.17 (0.0043), 1.20 (0.0103) and 1.13 (0.0154), respectively, in combined analysis (N=3115). Of these, three polymorphisms were located in methyl-CpG-binding domain protein 2 gene regions and were in strong linkage disequilibrium. The remaining three SNPs were in proximity to RAD21 homolog (S. pombe), O-6-methylguanine-DNA methyltransferase and RNA polymerase II-associated protein 1. The identified markers may be relevant to breast cancer susceptibility in populations if these findings are confirmed in independent cohorts.

Cohorts and consortia conference: a summary report (Banff, Canada, June 17-19, 2009)

Cohorts and consortia conference: a summary report (Banff, Canada, June 17-19, 2009) Journal: Cancer Causes Control | Pages: 463-468 | Date: March 2011 | Authors: Boffetta P, Colditz GA, Potter JD, Kolonel L, Robson PJ, Malekzadeh R, Seminara D, Goode EL, Yoo KY, Demers P, Gallagher R, Prentice R, Yasui Y, O’Doherty K, Petersen GM, Ulrich CM, Csizmadi I, Amankwah EK, Brockton NT, Kopciuk K, McGregor SE, Kelemen LE. Epidemiologic studies have adapted to the genomics era by forming large international consortia to overcome issues of large data volume and small sample size. Whereas both cohort and well-conducted case-control studies can inform disease risk from genetic susceptibility, cohort studies offer the additional advantages of assessing lifestyle and environmental exposure-disease time sequences often over a life course. Consortium involvement poses several logistical and ethical issues to investigators, some of which are unique to cohort studies, including the challenge to harmonize prospectively collected lifestyle and environmental exposures validly across individual studies. An open forum to discuss the opportunities and challenges of large-scale cohorts and their consortia was held in June 2009 in Banff, Canada, and is summarized in this report.   http://www.ncbi.nlm.nih.gov/pubmed/21203821

Exploring statistical approaches to diminish subjectivity of cluster analysis to derive dietary patterns: The Tomorrow Project.

Exploring statistical approaches to diminish subjectivity of cluster analysis to derive dietary patterns: The Tomorrow Project. Journal: Am J Epidemiol | Pages: 956-967 | Date: April 2011 | Authors: Lo Siou G, Yasui Y, Csizmadi I, McGregor SE, Robson PJ. Dietary patterns derived by cluster analysis are commonly reported with little information describing how decisions are made at each step of the analytical process. Using food frequency questionnaire data obtained in 2001-2007 on Albertan men (n = 6,445) and women (n = 10,299) aged 35-69 years, the authors explored the use of statistical approaches to diminish the subjectivity inherent in cluster analysis. Reproducibility of cluster solutions, defined as agreement between 2 cluster assignments, by 3 clustering methods (Ward’s minimum variance, flexible beta, K means) was evaluated. Ratios of between- versus within-cluster variances were examined, and health-related variables across clusters in the final solution were described. K means produced cluster solutions with the highest reproducibility. For men, 4 clusters were chosen on the basis of ratios of between- versus within-cluster variances, but for women, 3 clusters were chosen on the basis of interpretability of cluster labels and descriptive statistics. In comparison with those in other clusters, men and women in the “healthy” clusters by greater proportions reported normal body mass index, smaller waist circumference, and lower energy intakes. The authors’ approach appeared helpful when choosing the clustering method for both sexes and the optimal number of clusters for men, but additional analyses are required to understand why it performed differently for women. http://www.ncbi.nlm.nih.gov/pubmed/21421742

Hours spent and energy expended in physical activity domains: results from the Tomorrow Project cohort in Alberta, Canada

Hours spent and energy expended in physical activity domains: results from the Tomorrow Project cohort in Alberta, Canada Journal: Int J Behav Nutr Phys Act | Date: October 2011 | Authors: Csizmadi I, Lo Siou G, Friedenreich CM, Owen N, Robson PJ. BACKGROUND: Knowledge of adult activity patterns across domains of physical activity is essential for the planning of population-based strategies that will increase overall energy expenditure and reduce the risk of obesity and related chronic diseases. We describe domain-specific hours of activity and energy expended among participants in a prospective cohort in Alberta, Canada. METHODS: The Past Year Total Physical Activity Questionnaire was completed by 15,591 Tomorrow Project®o participants, between 2001 and 2005 detailing physical activity type, duration, frequency and intensity. Domain-specific hours of activity and activity-related energy expenditure, expressed as a percent of total energy expenditure (TEE) (Mean (SD); Median (IQR)) are reported across inactive (<1.4), low active (1.4 to 1.59), active (1.6 to 1.89) and very active (≥ 1.9) Physical Activity Level (PAL = TEE:REE) categories. RESULTS: In very active women and amongst all men except those classified as inactive, activity-related energy expenditure comprised primarily occupational activity. Amongst inactive men and women in active, low active and inactive groups, activity-related energy expenditure from household activity was comparable to, or exceeded that for occupational activity. Leisure-time activity-related energy expenditure decreased with decreasing PAL categories; however, even amongst the most active men and women it accounted for less than 10 percent of TEE. When stratified by employment status, leisure-time activity-related energy expenditure was greatest for retired men [mean (SD): 10.8 (8.5) percent of TEE], compared with those who were fully employed, employed part-time or not employed. Transportation-related activity was negligible across all categories of PAL and employment status. CONCLUSIONS: For the inactive portion of this population, active non-leisure activities, specifically in the transportation and occupational domains, need to be considered for inclusion in daily routines as a means of increasing population-wide activity levels. Environmental and policy changes to promote active transport and workplace initiatives could increase overall daily energy expenditure through reducing prolonged sitting time. http://www.ncbi.nlm.nih.gov/pubmed/21985559