Authors: Sonia Anand, Shreni Patel, Scott Lear, Trevor Dummer, Vikki Ho, Jean-Claude Tardif, Jennifer Vena, Karleen Schulze, Paul Poirier, Dipika Desai, Matthias Friedrich, from the Canadian Alliance for Healthy Hearts and Minds Study. Journal: PLOS Public Health Abstract High-income countries like Canada report some of the worlds’ highest life-satisfaction levels, yet less is known about how life satisfaction varies by race and immigration status. This study investigates the factors that influence subjective well-being among 8,063 adults from the Canadian Alliance of Healthy Hearts and Minds study recruited between 2014 and 2018, including a subset of 2,142 immigrants. Measures of demographic, socioeconomic, health, healthcare access, and self-reported ethnicity were investigated in relation to self-reported life satisfaction as measured by the validated Cantril ladder score in which people were classified as suffering [1–4], struggling [5–6], or thriving [7–10]. Among 8,063 adults, approximately half were women, 18.6% were racialized, and 26.6% were immigrants. The mean life satisfaction score was 7.2 (1.4), with 71% classified as thriving. However racialized immigrants reported significantly lower life satisfaction than Canadian born non-racialized participants [6.6 (1.6) vs 7.2 (1.4); P < 0.001, and a lower proportion were classified as thriving [57% vs 73%]. In the overall sample, multivariable linear regression showed higher life satisfaction was associated with older age, male sex, having trusted neighbours, and having a language-concordant family doctor. Lower life satisfaction was associated with social disadvantage, being female, having poorer cardiovascular health, being unable to afford prescription medications, seeking care in an emergency department, and being racialized. Amongst the subset of immigrants, the life satisfaction associated factors were directionally consistent and racialized immigrants reported lower life satisfaction due to discrimination based on skin colour. Although Canada has amongst the highest life-satisfaction scores globally, the average masks persistent inequities as racialized people (especially racialized immigrants) have lower life satisfaction than non-racialized people. The findings highlight actionable levers—language-concordant primary care attachment, affordable medications, neighbourhood trust, and improved cardiometabolic health—that can be targeted to close the observed well-being gap. doi: https://doi.org/10.1371/journal.pgph.0005257

Authors: Rachel Murphy, Jennifer Vena, Alyssa Milano, Guy Faulkner, Benoit Lamarche, Charles Matthews, Leia Minaker, Dylan Spicker, Ellen Sweeney, Michael Wallace, Michael Widener, Sharon Kirkpatrick Journal: JMIR Research Protocols Abstract Background: Suboptimal diet quality and physical inactivity are key risk factors for chronic disease and disability in Canada. However, the lack of high-quality population-level data hinders the development of evidence-based strategies to support improvements in diet quality, movement behaviors (physical inactivity, activity, and sleep), and health. The lack of data is also a barrier to developing capacity in diet and physical activity assessment and epidemiology in Canada. Objective: This protocol describes the development of the largest known repository of dietary intake and movement behavior data in Canada by drawing upon an existing longitudinal cohort study, the Canadian Partnership for Tomorrow’s Health (CanPath). In the short-term, the data will be used to examine associations between system factors (eg, retail food environments) and dietary intake. In the longer-term, data will be available to pursue a range of research questions, including longitudinal associations between diet, movement behavior, and health outcomes. Methods: Participants in CanPath (>330,000 adults) who can complete online questionnaires are eligible and will be asked to complete a baseline web-based questionnaire including questions on demographic characteristics and screeners capturing dietary intake and movement behaviors. Subsequently, participants will be invited to complete an online 24-hour dietary recall using the Automated Self-Administered 24-Hour Dietary Assessment Tool (ASA24-Canada-2018) and an online 24-hour activity recall using Activities Completed Over Time in 24 Hours (ACT24). Repeat recalls will be administered 1-2 weeks later. A subset of participants will be invited to complete 2 additional ASA24-Canada-2018 and Activities Completed Over Time in 24 Hours recalls 6 months later. One year after baseline, participants will be invited to complete past-year diet and movement behavior questionnaires. In Québec, dietary intake and movement behavior data are from 3000 CanPath participants enrolled in the NutriQuébec study. Participant addresses will be linked to geospatial data on the food, built, and social environment. Results: Data collection began in 2025. As of manuscript acceptance (November 4, 2025), 3171 participants had been recruited. Data processing and cleaning will be completed in 2027, and analyses will occur in 2028. It is anticipated that dietary intake and movement behavior data will be available for up to 100,000 adults. Conclusions: This protocol outlines the collection of detailed data on dietary intake and movement behavior in a large cohort spanning all provinces in Canada. In addition to allowing examination of a range of research questions related to diet, movement behavior, and health, the combination of assessment tools will support methodological research, including expanding analytical strategies to mitigate the effects of error in dietary and movement behavior data. This effort will also build capacity in the collection, processing, and harmonization of dietary and movement behavior data among cohorts and provide a training ground for emerging researchers. doi:10.2196/71680

Authors: Cindy Feng, Ellen Sweeney Journal: International Journal of Environmental Research and Public Health Abstract: Breast cancer is a major public health concern, and modifiable health behaviors such as sleep quality and physical activity may influence risk. This study examined the associations between self-reported sleep trouble, sleep duration, and physical activity with breast cancer incidence in a prospective longitudinal cohort of 10,305 females from Nova Scotia. Breast cancer cases were identified through record linkage to the Nova Scotia Cancer Registry. Multivariable logistic regression models were used to estimate adjusted odds ratios (AORs) and 95% confidence intervals (CIs), accounting for sociodemographic factors, reproductive history, comorbidities, and other health behaviors. Frequent sleep trouble (“all of the time”) was significantly associated with increased odds of breast cancer (AOR = 2.41, 95% CI = 1.09–5.34, p = 0.03), while no significant associations were observed between sleep duration and breast cancer risk. High physical activity was significantly associated with a lower risk of breast cancer (AOR = 0.58, 95% CI = 0.39–0.86, p < 0.01). These findings suggest that frequent sleep disturbances may be associated with an increased risk of breast cancer, while high physical activity appears to be linked to a lower risk of breast cancer. Further research is needed to explore these relationships and their underlying mechanisms. doi: https://doi.org/10.3390/ijerph22040471

Authors: Aleksandra Budarick, Cheryl Hubley-Kozey, Linda Li, Olga Theou, William Stanish Journal: Musculoskeletal Care Objectives: To evaluate the quality and types of care individuals with mild‐to‐moderate knee osteoarthritis receive in the Canadian Maritime provinces, and determine associations with demographic, social, and patient‐reported factors. Methods: Individuals with knee osteoarthritis were invited to complete a healthcare quality survey based on the British Columbia Osteoarthritis (BC OA) survey. The cross‐sectional descriptive observational survey assessed four healthcare quality indicators: advice to exercise, advice to lose weight, assessment of ambulatory function, and assessment of non‐ambulatory function. Pass‐rates were calculated overall and for each quality indicator. Binary logistic regressions determined associations between quality indicators and demographic, social, and patient‐reported outcomes. Patient‐reported use of exercise and diet as arthritis treatments were added to the quality indicator eligibility criteria as a sensitivity analysis. Results: Participants (n = 241) had a mean age of 67 (7) years, body mass index of 30.7 (7.5) kg/m2 and were 77% female. The overall pass rate was 42.9% using the BC OA criteria, and 49.3% in the sensitivity analysis. Individual quality indicator pass‐rates ranged from 4.3% for non‐ambulatory function to 85.7% for ambulatory function assessments. The sensitivity analysis increased pass‐rates for advice to exercise (61.9%–69.3%) and advice to lose weight (27.9%–35.1%). Pass‐rates were not driven by demographic, social, or patient‐reported factors. Conclusions: Over half of individuals with mild‐to‐moderate knee osteoarthritis did not receive recommended core treatments in the Maritimes, highlighting a need to improve care for this patient group. Quality indicators should be routinely evaluated to determine whether clinical care aligns with best practice guidelines. doi: 10.1002/msc.70047

Authors: François Lagacé, Farhan Mahmood, Santina Conte, Lorena Mija, Amina Moustaquim-Barrette, Jonathan LeBeau, Alyson McKenna, Mahan Maazi, Johnny Hanna, Alexandra Kelly, Raquel Lazarowitz, Elham Rahme, Travis Hrubeniuk, Ellen Sweeney, Ivan Litvinov. Journal: Current Oncology Background: Skin cancer prevention relies on effective sun safety practices. Previous studies have shown that LGBTQ+ individuals exhibit lower sunscreen use and higher tanning bed usage compared to their non-LGBTQ+ counterparts. This study is the first to assess skin cancer risk factors, sun-protective behaviors, and skin cancer concerns among LGBTQ+ individuals across Canada. Methods: A national survey study was conducted between July 2020 and March 2024 and included LGBTQ+ respondents aged ≥ 16 years who had completed the survey. Responses were summarized using frequency counts/percentages for categorical variables and means/standard deviations for continuous variables. Logistic regression models were used to calculate age- and gender-adjusted odds ratios for subgroup analyses. Results: Of the 700 LGBTQ+ participants included (59.3% women; median age 38 years), the majority had a Fitzpatrick skin phototype (FSP) I–III (76.4%). Concerningly, 60% reported >10 lifetime sunburns, 58% reported ≥1 blistering sunburn, 34% had used a tanning bed ≥1 time in their lifetime, and 69% reported having a tan in the last 12 months. Sunscreen was worn regularly by only half of the respondents, and half of the participants agreed or strongly agreed with “I look better and/or healthier with a tan”. Additional comparisons are presented based on gender, FSP, education, and income. Conclusion: The findings of this study highlight the need for public health campaigns tailored to the LGBTQ+ community, emphasizing culturally sensitive sun safety education, particularly for LGBTQ+ men, individuals with FSP IV–VI, and those with lower education levels, to help reduce future skin cancer risk. doi: https://doi.org/10.3390/curroncol31120593  

Authors: Vanessa DeClercq, Robyn J. Wright, Jacob Nearing, and Morgan G.I. Langille Journal: Scientific Reports Abstract: This study aimed to assess the association between the oral microbiome, age, and frailty. Data and saliva samples were obtained from male and female participants aged 35–70 years (n = 1357). Saliva samples were analysed by 16S rRNA gene sequencing and differences in microbial diversity and community compositions were examined in relation to chronological age and the frailty index (FI). Most alpha diversity measures (Richness, Shannon Diversity, Faith’s Phylogenetic Diversity) showed an inverse association with frailty, whereas a positive association was observed with age and Shannon Diversity and Evenness. A further sex-stratified analysis revealed differences in measures of microbial diversity and composition. Multiple genera were detected as significantly differentially abundant with increasing frailty and age by at least two methods. With age, the relative abundance of Veillonella was reduced in both males and females, whereas increases in Corynebacterium appeared specific to males and Aggregatibacter, Fusobacterium, Neisseria, Stomatobaculum, and Porphyromonas specific to females. Beta diversity was significantly associated with multiple mental health components of the FI. This study shows age and frailty are differentially associated with measures of microbial diversity and composition, suggesting the oral microbiome may be a useful indicator of increased risk of frailty or a potential target for improving health in ageing adults. doi: | https://doi.org/10.1038/s41598-024-60409-8

Authors: Maartje Basten, Kuan-Yu Pan, Lonneke A. vanTuijl, Alexander deGraeff, Joost Dekker, Adriaan W.Hoogendoorn, Femke Lamers, Adelita V. Ranchor, Roel Vermeulen, Lützen Portengen, Adri C. Voogd, Jessica Abell, Philip Awadalla, Aartjan T.F. Beekman, Ottar Bjerkeset, Andy Boyd, Yunsong Cui, Philipp Frank, Henrike Galenkamp, Bert Garssen, Sean Hellingman, Martijn Huisman, Anke Huss, Melanie R. Keats, Almar A.L. Kok, Steinar Krokstad, Flora E. vanLeeuwen, Annemarie I. Luik, NolwennNoisel, Yves Payette, Brenda W.J.H. Penninx, Ina Rissanen, Annelieke M. Roest, Judith G.M. Rosmalen, Rikje Ruiter, Robert A. Schoevers, David Soave, Mandy Spaan, Andrew Steptoe, Karien Stronks, Erik R. Sund, Ellen Sweeney, Emma L. Twait, Alison Teyhan, W.M. Monique Verschuren, Kimberly D. vanderWillik, Mirjam I. Geerlings Journal: International Journal of Cancer Abstract: Depression, anxiety and other psychosocial factors are hypothesized to be involved in cancer development. We examined whether psychosocial factors interact with or modify the effects o fhealth behaviors, such as smoking and alcohol use, in relation to cancer incidence. Two-stage individual participant data meta-analyses were performed based on 22cohorts of the PSYchosocial factors and CAncer (PSY-CA) study. We examined nine psychosocial factors (depression diagnosis, depression symptoms, anxiety diagnosis, anxiety symptoms, perceived social support, loss events, general distress, neuroticism, relationship status), seven health behaviors/behavior-related factors (smoking, alcohol use, physical activity, body mass index, sedentary behavior, sleep quality, sleep duration)and seven cancer outcomes (overall cancer, smoking-related, alcohol-related, breast, lung, prostate, colorectal). Effects of the psychosocial factor, health behavior and their product term on cancer incidence were estimated using Cox regression. We pooled cohort-specific estimates using multivariate random-effects meta-analyses. Additive and multiplicative interaction/effect modification was examined. This study involved 437,827 participants, 36,961 incident cancer diagnoses, and 4,749,481 person years of follow-up. Out of 744 combinations of psychosocial factors, health behaviors, and cancer outcomes, we found no evidence of interaction. Effect modification was found for some combinations, but there were no clear patterns for any particular factors or outcomes involved. In this first large study to systematically examine potential interaction and effect modification, we found no evidence for psychosocial factors to interact with or modify health behaviors in relation to cancer incidence. The behavioral risk profile for cancer incidence is similar in people with and without psychosocial stress. doi: 10.1002/ijc.34852