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Schuchardt JP, Beinhorn P, Hu XF, Chan HM, Roke K, Bernasconi A, Hahn A, Sala-Vila A, Stark KD, Harris WS. Omega-3 world map: 2024 update. Prog Lipid Res 2024; 95:101286. [PMID: 38879135 DOI: 10.1016/j.plipres.2024.101286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 05/31/2024] [Accepted: 06/05/2024] [Indexed: 07/06/2024]
Abstract
In 2016, the first worldwide n3 PUFA status map was published using the Omega-3 Index (O3I) as standard biomarker. The O3I is defined as the percentage of EPA + DHA in red blood cell (RBC) membrane FAs. The purpose of the present study was to update the 2016 map with new data. In order to be included, studies had to report O3I and/or blood EPA + DHA levels in metrics convertible into an estimated O3I, in samples drawn after 1999. To convert the non-RBC-based EPA + DHA metrics into RBC we used newly developed equations. Baseline data from clinical trials and observational studies were acceptable. A literature search identified 328 studies meeting inclusion criteria encompassing 342,864 subjects from 48 countries/regions. Weighted mean country O3I levels were categorized into very low ≤4%, low >4-6%, moderate >6-8%, and desirable >8%. We found that the O3I in most countries was low to very low. Notable differences between the current and 2016 map were 1) USA, Canada, Italy, Turkey, UK, Ireland and Greece (moving from the very low to low category); 2) France, Spain and New Zealand (low to moderate); and 3) Finland and Iceland (moderate to desirable). Countries such as Iran, Egypt, and India exhibited particularly poor O3I levels.
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Affiliation(s)
- Jan Philipp Schuchardt
- The Fatty Acid Research Institute, 5009 W. 12(th) St. Ste 5, Sioux Falls, SD 57106, United States; Institute of Food and One Health, Leibniz University Hannover, Am kleinen Felde 30, 30167 Hannover, Germany.
| | - Philine Beinhorn
- Institute of Food and One Health, Leibniz University Hannover, Am kleinen Felde 30, 30167 Hannover, Germany
| | - Xue Feng Hu
- Department of Biology, University of Ottawa, Ottawa, ON, Canada
| | - Hing Man Chan
- Department of Biology, University of Ottawa, Ottawa, ON, Canada
| | - Kaitlin Roke
- Global Organization for EPA and DHA Omega-3s (GOED), 222 South Main Street, Suite 500, Salt Lake City, UT 84101, United States
| | - Aldo Bernasconi
- Global Organization for EPA and DHA Omega-3s (GOED), 222 South Main Street, Suite 500, Salt Lake City, UT 84101, United States
| | - Andreas Hahn
- Institute of Food and One Health, Leibniz University Hannover, Am kleinen Felde 30, 30167 Hannover, Germany
| | - Aleix Sala-Vila
- The Fatty Acid Research Institute, 5009 W. 12(th) St. Ste 5, Sioux Falls, SD 57106, United States; Hospital del Mar Medical Research Institute, Dr. Aiguader 88, 08003 Barcelona, Spain
| | - Ken D Stark
- Department of Kinesiology and Health Sciences, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada
| | - William S Harris
- The Fatty Acid Research Institute, 5009 W. 12(th) St. Ste 5, Sioux Falls, SD 57106, United States; Department of Internal Medicine, Sanford School of Medicine, University of South Dakota, 1400 W. 22nd St., Sioux Falls, SD 57105, United States
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Ly R, MacIntyre BC, Philips SM, McGlory C, Mutch DM, Britz-McKibbin P. Lipidomic studies reveal two specific circulating phosphatidylcholines as surrogate biomarkers of the omega-3 index. J Lipid Res 2023; 64:100445. [PMID: 37730162 PMCID: PMC10622695 DOI: 10.1016/j.jlr.2023.100445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 09/13/2023] [Accepted: 09/14/2023] [Indexed: 09/22/2023] Open
Abstract
Optimal dietary intake of omega-3 long-chain polyunsaturated fatty acids (n3-LCPUFAs) is critical to human health across the lifespan. However, omega-3 index (O3I) determination is not routinely assessed due to complicated procedures for n3-LCPUFA analysis from the phospholipid (PL) fraction of erythrocytes. Herein, a high-throughput method for lipidomics based on multisegment injection-nonaqueous capillary electrophoresis-mass spectrometry was applied to identify circulating PLs as surrogate biomarkers of O3I in two randomized placebo-controlled trials. An untargeted lipidomic data workflow using a subgroup analysis of serum extracts from sunflower oil versus high-dose fish oil (FO)-supplemented participants revealed that ingested n3-LCPUFAs were primarily distributed as their phosphatidylcholines (PCs) relative to other PL classes. In both high-dose FO (5.0 g/day) and EPA-only trials (3.0 g/day), PC (16:0_20:5) was the most responsive PL, whereas PC (16:0_22:6) was selective to DHA-only supplementation. We also demonstrated that the sum concentration of both these PCs in fasting serum or plasma samples was positively correlated to the O3I following FO (r = 0.708, P = 1.02 × 10-11, n = 69) and EPA- or DHA-only supplementation (r = 0.768, P = 1.01 × 10-33, n = 167). Overall, DHA was more effective in improving the O3I (ΔO3I = 4.90 ± 1.33%) compared to EPA (ΔO3I = 2.99 ± 1.19%) in young Canadian adults who had a poor nutritional status with an O3I (3.50 ± 0.68%) at baseline. Our method enables the rapid assessment of the O3I by directly measuring two circulating PC species in small volumes of blood, which may facilitate screening applications for population and precision health.
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Affiliation(s)
- Ritchie Ly
- Department of Chemistry and Chemical Biology, McMaster University, Hamilton, ON, Canada
| | - Brittany C MacIntyre
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - Stuart M Philips
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Chris McGlory
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada; School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada
| | - David M Mutch
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - Philip Britz-McKibbin
- Department of Chemistry and Chemical Biology, McMaster University, Hamilton, ON, Canada.
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Yisak H, Yaya EE, Chandravanshi BS, Redi-Abshiro M. GC-MS profiling of fatty acids and nutritional properties of the white and brown teff [Eragrostis tef (Zuccagni) Trotter] varieties cultivated in different parts of Ethiopia. J Food Compost Anal 2022. [DOI: 10.1016/j.jfca.2022.104405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Shtonda O, Semeniuk K. Aspects of the influence of vegetable-oil-based marinade on organoleptic and physicochemical indicators of the quality of semi-finished natural marinated meat products. POTRAVINARSTVO 2021. [DOI: 10.5219/1527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
This work evidences the expediency of marinade application based on blends of refined vegetable oils in the technology of natural marinated semi-finished meat products. Formulations of natural marinated semi-finished meat products using blends of refined vegetable oils (rapeseed, olive, and sunflower) enriched with the enzyme bromelain were developed in this work. Such formulations can provide the human body with the necessary amount of protein, released by enzymatic hydrolysis of the connective tissue proteins collagen and elastin catalyzed by the plant-based enzyme bromelain, as well as the necessary ω-3 and ω-6 polyunsaturated fatty acids, which are not synthesized in the human body but sourced from food and are one of the main structural units for many vital processes. The article presents the results of a study of organoleptic and physicochemical parameters of natural marinated semi-finished meat products from beef and pork. It is confirmed that the use of rapeseed oil and rapeseed:sunflower oil blend in a ratio of 70:30 produce the best organoleptic characteristics in both semi-finished beef and semi-finished pork: a tender, juicy texture, a pleasant taste and aroma, and an attractive appearance. It has been proven that the use of marinades based on blends of refined vegetable oils reduces the free moisture content and moisture-retaining capacity of the product, due to the presence of refined vegetable oils in the marinade, which contributes to the binding of moisture. The use of marinades based on refined vegetable oils can increase product yield. Vegetable oil, when used in meat marinade, mitigates the ill effects of acid inclusion. It dissolves well the aromas of added spices, and as it seeps through the structure of the meat, the oil gently envelops it, sealing in moisture and preventing drying out during cooking.
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Caron-Beaudoin É, Ayotte P, Blanchette C, Muckle G, Avard E, Ricard S, Lemire M. Perfluoroalkyl acids in pregnant women from Nunavik (Quebec, Canada): Trends in exposure and associations with country foods consumption. ENVIRONMENT INTERNATIONAL 2020; 145:106169. [PMID: 33041046 DOI: 10.1016/j.envint.2020.106169] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/22/2020] [Accepted: 09/24/2020] [Indexed: 05/25/2023]
Abstract
BACKGROUND Perfluoroalkyl acids (PFAAs) are persistent and ubiquitous environmental contaminants that potentially disrupt endocrine system functions. While some PFAAs (perfluorooctane sulfonate (PFOS), perfluorooctanoic acid (PFOA)) are regulated, currently used fluorotelomer alcohols (FTOHs) can be transported to the Arctic and are degraded in a number of PFAAs which biomagnify in Arctic wildlife (e.g. perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), perfluoroundecanoic acid (PFUdA)). OBJECTIVES From 2004 to 2017, 279 pregnant Inuit women were recruited as part of biomonitoring projects in Nunavik. Our goal was to evaluate: (i) time-trends in plasma/serum PFAAs levels in pregnant Nunavimmiut women between 2004 and 2017; (ii) compare plasma/serum PFAAs levels in Nunavimmiut women in 2016-2017 to those measured in women of childbearing age in the Canadian Health Measure Survey (CHMS); and (iii) evaluate the associations of PFAAs levels with the consumption of country foods and pregnancy and maternal characteristics during pregnancy in the 97 participants recruited in 2016-2017. METHODS Individual blood sample were collected for serum or plasma PFAAs (PFOS, PFOA, pentafluorobenzoic acid (PFBA), perfluorohexanoic acid (PFHxA), perfluorobutanesulfonic acid (PFBS), perfluorohexane-1-sulfonic acid (PFHxS), PFNA, PFDA, PFUdA) analyses. Socio-demographic data, pregnancy and maternal characteristics and country foods consumption were documented using a questionnaire. Omega-3 and -6 polyunsaturated fatty acids (PUFA) were measured in red blood cell membranes and their ratio used as a biomarker of marine country foods consumption. Time-trends in PFAAs levels were evaluated using ANCOVA models adjusted for relevant co-variables. Serum/plasma levels of PFAAs in the 97 pregnant women aged 16 to 40 years old and recruited in 2016-2017 were compared to those measured in women aged 18 to 40 years old from the CHMS cycle 5 (2016-2017) using the geometric means (GM) and 95% confidence intervals (95% CI). Multivariate regression analyses were performed to examine associations between concentrations of PFAAs and country foods consumption data. RESULTS Statistically-significant downward time trends were noted for concentrations of PFOS, PFOA and PFHxS in pregnant Nunavik women between 2004 and 2017. Conversely, between 2011 and 2016-2017, PFNA, PFDA and PFUdA maternal serum levels increased by 19, 13 and 21% respectively. Among participants in 2016-2017, mean concentrations for PFNA (GM: 2.4 μg/L), PFDA (0.53 μg/L) and PFUdA (0.61 μg/L) were higher than those measured in women aged 18-40 years old in the Cycle 5 (2016-2017) of the CHMS. PFOA (0.53 μg/L) and PFHxS (0.26 μg/L) were lower than in CHMS, whereas PFBA, PFHxA and PFBS were not detected in 2016-2017. Ratios of serum/plasma levels of PFNA/PFOA, PFNA/PFOS, PFNA/PFHxS and PFUdA/PFDA were significantly higher in the 97 pregnant women from Nunavik recruited in 2016-2017 compared to CHMS, highlighting their distinct exposure profile. In multivariate models, PFHxS, PFOS, PFNA, PFDA and PFUdA levels in 2016-2017 were strongly associated with the omega-3/omega-6 PUFA ratio, indicating a positive association between marine country foods consumption and higher exposure to PFAAs. CONCLUSIONS The exposure of pregnant women to long-chain PFAAs (PFNA, PFDA and PFUdA) increased from 2004 to 2017 in Nunavik. Associations noted between PFAAs levels and the omega-3/omega-6 ratio highlights the importance of implementing additional strict regulations on PFAAs and their precursors to protect the high nutritional quality and cultural importance of country foods in Nunavik.
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Affiliation(s)
- Élyse Caron-Beaudoin
- Department of Health and Society and Department of Environmental and Physical Sciences, University of Toronto Scarborough, Toronto, ON, Canada; Centre for Clinical Epidemiology and Evaluation, VCH Research Institute, University of British Columbia, Vancouver, BC, Canada
| | - Pierre Ayotte
- Axe santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec - Université Laval, Québec, QC, Canada; Département de médecine sociale et préventive, Université Laval, Québec, QC, Canada; Centre de toxicologie du Québec, Institut national de santé publique du Québec, Québec, QC, Canada
| | - Caty Blanchette
- Axe santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec - Université Laval, Québec, QC, Canada
| | - Gina Muckle
- Axe santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec - Université Laval, Québec, QC, Canada; École de psychologie, Université Laval, Québec, QC, Canada
| | - Ellen Avard
- Nunavik Research Centre, Makivik Corporation, Kuujjuaq, QC, Canada
| | - Sylvie Ricard
- Nunavik Regional Board of Health and Social Services, Kuujjuaq, QC, Canada
| | - Mélanie Lemire
- Axe santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec - Université Laval, Québec, QC, Canada; Département de médecine sociale et préventive, Université Laval, Québec, QC, Canada.
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Adamou TY, Riva M, Muckle G, Laouan Sidi EA, Lemire M, Ayotte P. Blood mercury and plasma polychlorinated biphenyls concentrations in pregnant Inuit women from Nunavik: Temporal trends, 1992-2017. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 743:140495. [PMID: 32758811 DOI: 10.1016/j.scitotenv.2020.140495] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 06/09/2020] [Accepted: 06/22/2020] [Indexed: 05/18/2023]
Abstract
The Inuit of Nunavik (Northern Quebec, Canada) are exposed to polychlorinated biphenyls (PCBs) and mercury (Hg) through their consumption of marine country foods. A temporal trend study was initiated in 1992 to monitor circulating levels of PCBs and Hg in pregnant Inuit women, since the fetus is most at risk of adverse health effects. We set out (1) to describe temporal trends of PCBs and Hg levels in pregnant Nunavik women between 1992 and 2017; (2) to determine the prevalence of participants exceeding the guidance values in 2017; (3) to investigate relations between marine country food intake and contaminant levels over the study period. A total of 559 pregnant women provided a blood sample for contaminant analysis from 1992 to 2017. PCB congeners were quantified in plasma (serum) by gas chromatography (GC) coupled to electron capture detection or mass spectrometry (MS). We determined whole blood mercury concentration by cold vapor atomic absorption or inductively-coupled plasma MS. We performed multilevel modeling to assess temporal trends in contaminant levels and relations with marine country food consumption. Concentrations of total PCBs and Hg decreased by 84% and 65% between 1992 and 2017, respectively. Nevertheless, 10% and 22% of women in 2017 exceeded guidance values for PCBs and Hg, respectively. While the decline in marine country food intake is the only factor associated with decreasing Hg levels, other factors may explain the decline in PCB levels. Despite the significant decline in PCBs and Hg levels from 1992 to 2017, exposure to these contaminants is still quite prevalent among pregnant Nunavik women. Most of the decline in Hg exposure is likely due to a shift away from marine country foods to store-bought foods, which is a concern given the cultural and nutritional importance of country foods and the high food insecurity that prevails in Nunavik.
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Affiliation(s)
- Thérèse Yéro Adamou
- Centre de recherche du CHU de Québec - Axe Santé des Populations et Pratiques Optimales en Santé, Hôpital Saint-Sacrement, 1050 Chemin Ste-Foy, Québec, QC G1S 4L8, Canada; Faculté des sciences infirmières, Université Laval, Pavillon Ferdinand Vandry 1050, avenue de la Médecine, Québec, QC G1V 0A6, Canada.
| | - Mylène Riva
- Canada Research Chair in Housing, Community, and Health, Institute for Health and Social Policy, McGill University, Avenue des Pins, Montréal, QC H3A 1A3, Canada; Department of Geography, McGill University, Burnside Hall Building, 805 Sherbrooke Street West, Montreal, QC H3A 0B9, Canada.
| | - Gina Muckle
- Centre de recherche du CHU de Québec - Axe Santé des Populations et Pratiques Optimales en Santé, Hôpital Saint-Sacrement, 1050 Chemin Ste-Foy, Québec, QC G1S 4L8, Canada; École de psychologie, Université Laval, Pavillon Félix-Antoine-Savard, 2325 rue des Bibliothèques, Québec, QC G1V 0A6, Canada.
| | - Elhadji Anassour Laouan Sidi
- Centre de recherche du CHU de Québec - Axe Santé des Populations et Pratiques Optimales en Santé, Hôpital Saint-Sacrement, 1050 Chemin Ste-Foy, Québec, QC G1S 4L8, Canada.
| | - Mélanie Lemire
- Centre de recherche du CHU de Québec - Axe Santé des Populations et Pratiques Optimales en Santé, Hôpital Saint-Sacrement, 1050 Chemin Ste-Foy, Québec, QC G1S 4L8, Canada; Département de médecine sociale et préventive, Université Laval, Pavillon Ferdinand Vandry 1050, avenue de la Médecine, Québec, QC G1V 0A6, Canada.
| | - Pierre Ayotte
- Centre de recherche du CHU de Québec - Axe Santé des Populations et Pratiques Optimales en Santé, Hôpital Saint-Sacrement, 1050 Chemin Ste-Foy, Québec, QC G1S 4L8, Canada; Département de médecine sociale et préventive, Université Laval, Pavillon Ferdinand Vandry 1050, avenue de la Médecine, Québec, QC G1V 0A6, Canada; Centre de toxicologie, Institut National de Santé Publique du Québec, 945 avenue Wolfe, Québec, QC G1V 5B3, Canada.
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Drivers and health implications of the dietary transition among Inuit in the Canadian Arctic: a scoping review. Public Health Nutr 2020; 24:2650-2668. [PMID: 32914743 DOI: 10.1017/s1368980020002402] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The current study undertook a systematic scoping review on the drivers and implications of dietary changes among Inuit in the Canadian Arctic. DESIGN A keyword search of peer-reviewed articles was performed using PubMed, Web of Science, CINAHL, Academic Search Premier, Circumpolar Health Bibliographic Database and High North Research Documents. Eligibility criteria included all full-text articles of any design reporting on research on food consumption, nutrient intake, dietary adequacy, dietary change, food security, nutrition-related chronic diseases or traditional food harvesting and consumption among Inuit populations residing in Canada. Articles reporting on in vivo and in vitro experiments or on health impacts of environmental contaminants were excluded. RESULTS A total of 162 studies were included. Studies indicated declining country food (CF) consumption in favour of market food (MF). Drivers of this transition include colonial processes, poverty and socio-economic factors, changing food preferences and knowledge, and climate change. Health implications of the dietary transition are complex. Micro-nutrient deficiencies and dietary inadequacy are serious concerns and likely exacerbated by increased consumption of non-nutrient dense MF. Food insecurity, overweight, obesity and related cardiometabolic health outcomes are growing public health concerns. Meanwhile, declining CF consumption is entangled with shifting culture and traditional knowledge, with potential implications for psychological, spiritual, social and cultural health and well-being. CONCLUSIONS By exploring and synthesising published literature, this review provides insight into the complex factors influencing Inuit diet and health. Findings may be informative for future research, decision-making and intersectoral actions around risk assessment, food policy and innovative community programmes.
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Prevalence of heart attack and stroke and associated risk factors among Inuit in Canada: A comparison with the general Canadian population. Int J Hyg Environ Health 2019; 222:319-326. [DOI: 10.1016/j.ijheh.2018.12.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 12/08/2018] [Accepted: 12/11/2018] [Indexed: 11/18/2022]
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Milinovic J, Garcia R, Rato AE, Cabrita MJ. Rapid Assessment of Monovarietal Portuguese Extra Virgin Olive Oil's (EVOO's) Fatty Acids by Fourier‐Transform Near‐Infrared Spectroscopy (FT‐NIRS). EUR J LIPID SCI TECH 2019. [DOI: 10.1002/ejlt.201800392] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Jelena Milinovic
- Instituto de Ciências Agrárias e Ambientais Mediterrânicas (ICAAM)Universidade de ÉvoraPolo da Mitra, Ap. 947006‐554 ÉvoraPortugal
| | - Raquel Garcia
- Instituto de Ciências Agrárias e Ambientais Mediterrânicas (ICAAM)Universidade de ÉvoraPolo da Mitra, Ap. 947006‐554 ÉvoraPortugal
- LAQVREQUIMTE Universidade Nova de Lisboa2829‐516 CaparicaPortugal
| | - Ana Elisa Rato
- Instituto de Ciências Agrárias e Ambientais Mediterrânicas (ICAAM)Universidade de ÉvoraPolo da Mitra, Ap. 947006‐554 ÉvoraPortugal
- Departamento de FitotecniaEscola de Ciências e Tecnologia (ICAAM)Universidade de ÉvoraPólo da Mitra, Ap. 947006‐554 ÉvoraPortugal
| | - Maria João Cabrita
- Instituto de Ciências Agrárias e Ambientais Mediterrânicas (ICAAM)Universidade de ÉvoraPolo da Mitra, Ap. 947006‐554 ÉvoraPortugal
- Departamento de FitotecniaEscola de Ciências e Tecnologia (ICAAM)Universidade de ÉvoraPólo da Mitra, Ap. 947006‐554 ÉvoraPortugal
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Rapinski M, Cuerrier A, Harris C, Ivujivik EO, Kangiqsujuaq EO, Lemire M. Inuit Perception of Marine Organisms: From Folk Classification to Food Harvest. J ETHNOBIOL 2018. [DOI: 10.2993/0278-0771-38.3.333] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Michel Rapinski
- Institut de recherche en biologie végétale, Université de Montréal, 4101 Sherbrooke est, Montréal, QC, H1X 2B2, Canada
| | - Alain Cuerrier
- Institut de recherche en biologie végétale, Université de Montréal, 4101 Sherbrooke est, Montréal, QC, H1X 2B2, Canada
| | - Cory Harris
- Department of Biology & School of Epidemiology and Public Health, University of Ottawa, Canada
| | | | | | - Mélanie Lemire
- Axe santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec, Département de médecine sociale et préventive, Université Laval, Québec, Canada
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11
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Adamou TY, Riva M, Muckle G, Laouan-Sidi EA, Ayotte P. Socio-economic inequalities in blood mercury (Hg) and serum polychlorinated biphenyl (PCB) concentrations among pregnant Inuit women from Nunavik, Canada. Canadian Journal of Public Health 2018; 109:671-683. [PMID: 30030682 DOI: 10.17269/s41997-018-0077-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 12/16/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVE We examined the relationships between socio-economic characteristics and mercury (Hg) and polychlorinated biphenyl (PCB) concentrations among pregnant Inuit women from Nunavik. METHOD We used biomonitoring data from 208 pregnant Inuit women recruited in the 14 villages of Nunavik between September 2011 and December 2013. Blood samples were collected to monitor levels of blood Hg and serum congener PCB-153 (surrogate of total PCB concentration). Ratio of omega 3/omega 6 polyunsaturated fatty acids, a validated biomarker of marine country food consumption, was also measured in red blood cell membranes to determine maternal dietary profile. Data on socio-economic characteristics (income and education), health-related lifestyles, and reproductive history were collected through questionnaires. Association between socio-economic characteristics and contaminant concentrations was assessed using linear regressions. RESULTS We observed a significant inverse relationship between education and Hg levels. Lower concentrations of Hg were observed among women who had completed high school compared to women who had not completed high school. However, no association was observed between level of education and concentration of PCBs. CONCLUSION Socio-economic disparities in maternal exposure to Hg exist in Nunavik. Further research is needed to determine whether environmental health inequalities also exist in other subgroups of the Nunavik population and in other Indigenous communities in Canada.
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Affiliation(s)
- Thérèse Yéro Adamou
- Population Health and Practice-changing Research Group, CHU de Québec Research Centre, Hôpital Saint-Sacrement, 1050 Chemin Sainte-Foy, Québec, Qc, G1S 4L8, Canada. .,Faculty of Nursing, Université Laval, Pavillon Ferdinand Vandry, 1050 avenue de la médecine, Québec, QC, G1V 0A6, Canada.
| | - Mylène Riva
- Department of Geography, McGill University, Burnside Hall Building, 805 Sherbrooke street west, Montreal, QC, H3A 0B9, Canada.,Institute for Health and Social Policy, McGill University, Avenue des pins, Montréal, QC, H3A 1A3, Canada
| | - Gina Muckle
- Population Health and Practice-changing Research Group, CHU de Québec Research Centre, Hôpital Saint-Sacrement, 1050 Chemin Sainte-Foy, Québec, Qc, G1S 4L8, Canada.,School of Psychology, Université Laval, Pavillon Félix-Antoine-Savard, 2325 rue des Bibliothèques, Québec, Qc, G1V 0A6, Canada
| | - Elhadji Anassour Laouan-Sidi
- Population Health and Practice-changing Research Group, CHU de Québec Research Centre, Hôpital Saint-Sacrement, 1050 Chemin Sainte-Foy, Québec, Qc, G1S 4L8, Canada
| | - Pierre Ayotte
- Population Health and Practice-changing Research Group, CHU de Québec Research Centre, Hôpital Saint-Sacrement, 1050 Chemin Sainte-Foy, Québec, Qc, G1S 4L8, Canada.,Institut National de Santé Publique du Québec, 945 avenue Wolfe, Québec, Qc, G1V 5B3, Canada
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Marushka L, Batal M, Sharp D, Schwartz H, Ing A, Fediuk K, Black A, Tikhonov C, Chan HM. Fish consumption is inversely associated with type 2 diabetes in Manitoba First Nations communities. Facets (Ott) 2017. [DOI: 10.1139/facets-2017-0023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Consumption of fish and n-3 fatty acids (n-3 FAs) has been postulated to prevent type 2 diabetes (T2D).Objective: To explore the association between self-reported T2D and fish consumption, dietary n-3 FAs, and persistent organic pollutants (POP) intake in a regionally representative sample of First Nations (FNs) in Manitoba.Design: Data from the cross-sectional First Nations Food, Nutrition and Environment Study (FNFNES) collected from 706 members of 8 Manitoba FNs in 2010 were used. Household interviews were used to collect social and lifestyle data. The consumption of fish was estimated using a traditional food frequency questionnaire. Fish samples were analyzed for the presence of POP. Multiple logistic regression models adjusted for potential risk factors for T2D were developed.Results: A negative, dose–response relationship was found between fish intake and self-reported T2D. Fish consumptions of 2–3 portions per month and ≥1/week were inversely associated with T2D with odds ratio (OR) values of 0.51 (95% CI: 0.28–0.91) and 0.40 (95% CI: 0.19–0.82), respectively, compared with no fish intake. Similarly, intake of n-3 FAs was negatively associated with T2D (OR = 0.48 (95% CI: 0.30–0.77). Dietary POP intake was not associated with T2D.Conclusion: These findings suggest that the consumption of traditionally harvested fish may have a beneficial effect on T2D in Manitoba FNs.
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Affiliation(s)
- Lesya Marushka
- Biology Department, University of Ottawa, 180 Gendron Hall, 30 Marie Curie, Ottawa, ON K1N 6N5, Canada
| | - Malek Batal
- Nutrition Department, Faculty of Medicine, Université de Montréal, Pavillon Liliane de Stewart, 2405 Côte-Sainte-Catherine Street, Montreal, QC H3T 1A8, Canada
| | - Donald Sharp
- Assembly of First Nations, 55 Metcalfe St #1600, Ottawa, ON K1P 6L5, Canada
| | - Harold Schwartz
- Health Canada, Environmental Public Health Division, First Nations and Inuit Health Branch (FNIHB), Room 2000A Jeanne Mance Bldg. AL 1920A, Tunney’s Pasture, Ottawa, ON K1A 0K9, Canada
| | - Amy Ing
- Nutrition Department, Faculty of Medicine, Université de Montréal, Pavillon Liliane de Stewart, 2405 Côte-Sainte-Catherine Street, Montreal, QC H3T 1A8, Canada
| | - Karen Fediuk
- Dietitian and Nutrition Researcher, Ladysmith, BC, Canada
| | - Andrew Black
- Assembly of First Nations, 55 Metcalfe St #1600, Ottawa, ON K1P 6L5, Canada
| | - Constantine Tikhonov
- Health Canada, Environmental Public Health Division, First Nations and Inuit Health Branch (FNIHB), Room 2000A Jeanne Mance Bldg. AL 1920A, Tunney’s Pasture, Ottawa, ON K1A 0K9, Canada
| | - Hing Man Chan
- Biology Department, University of Ottawa, 180 Gendron Hall, 30 Marie Curie, Ottawa, ON K1N 6N5, Canada
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13
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Hu XF, Laird BD, Chan HM. Mercury diminishes the cardiovascular protective effect of omega-3 polyunsaturated fatty acids in the modern diet of Inuit in Canada. ENVIRONMENTAL RESEARCH 2017; 152:470-477. [PMID: 27297029 DOI: 10.1016/j.envres.2016.06.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 05/30/2016] [Accepted: 06/01/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Inuit in Canada have low reported incidence of myocardial infarction (MI) because of their traditional rich n-3 fatty acids marine diet. They are experiencing rapid nutrition transition and ischemic heart disease is now becoming a health concern. OBJECTIVES Our goal was to describe the modern Inuit diet, the eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) and methyl mercury (MeHg) intake and estimate their contributions to the risk of MI. We also estimated the effect of promoting the consumption of more traditional food on Inuit's MI risk. METHODS We estimated the effect of Inuit diet on MI risk with modelling. Model formulas and assumptions were extracted from various epidemiology studies and literatures. International Polar Year Inuit Health Survey (IHS) was a comprehensive health and nutrition survey conducted in 2007-8 with 2072 participants (aged 18-79) in Canada. Traditional food intake, blood biomarkers values from the IHS served as the baseline parameters of model input. RESULTS Inuit traditional diet contained both high level of EPA, DHA and MeHg and their combined net effect was estimated to reduce the relative risk of MI by 1% for men and 2% for women. Arctic char meat provided the largest amount of EPA and DHA. Ringed seal liver was the main source for MeHg. Increase intake of selected fish, like salmon, herring and Arctic char by 75g per day can reduce the relative risk of MI (RR 0.70, 0.78 and 0.90 respectively). CONCLUSIONS In the Inuit diet, the beneficial effect on MI of EPA and DHA is diminished by the adverse effect of MeHg. Promoting the increase consumption of fish species with high EPA+DHA and low MeHg may help to prevent MI among Inuit.
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Affiliation(s)
- Xue Feng Hu
- Department of Biology, University of Ottawa, Canada; Center for Advanced Research in Environmental Genomics, University of Ottawa, Canada
| | - Brian D Laird
- School of Public Health and Health Systems, University of Waterloo, Canada
| | - Hing Man Chan
- Department of Biology, University of Ottawa, Canada; Center for Advanced Research in Environmental Genomics, University of Ottawa, Canada.
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14
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Weihe P, Bjerregaard P, Bonefeld-Jørgensen E, Dudarev A, Halling J, Hansen S, Muckle G, Nøst T, Odland JØ, Petersen MS, Rautio A, Veyhe AS, Wennberg M, Bergdahl I. Overview of ongoing cohort and dietary studies in the Arctic. Int J Circumpolar Health 2016; 75:33803. [PMID: 27974135 PMCID: PMC5156866 DOI: 10.3402/ijch.v75.33803] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
This article gives an overview of the ongoing cohort and dietary studies underlying the assessment of population health in the Arctic. The emphasis here is on a description of the material, methods and results or preliminary results for each study. Detailed exposure information is available in an article in this journal, whereas another paper describes the effects associated with contaminant exposure in the Arctic. The cohort descriptions have been arranged geographically, beginning in Norway and moving east to Finland, Sweden, Russia and the other Arctic countries and ultimately to the Faroe Islands. No cohort studies have been reported for Alaska or Iceland.
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Affiliation(s)
- Pál Weihe
- Department of Occupational Medicine and Public Health, The Faroese Hospital System, Torshavn, Faroe Islands;
| | - Peter Bjerregaard
- National Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Eva Bonefeld-Jørgensen
- Centre for Arctic Health, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Alexey Dudarev
- Northwest Public Health Research Center, St. Petersburg, Russia
| | - Jónrit Halling
- Department of Occupational Medicine and Public Health, The Faroese Hospital System, Torshavn, Faroe Islands
| | - Solrunn Hansen
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø - The Arctic University of Norway, Tromsø, Norway
| | - Gina Muckle
- École de Psychologie, Centre de Recherche du CHU de Québec, Université Laval, Québec, Canada
| | - Therese Nøst
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø - The Arctic University of Norway, Tromsø, Norway
| | - Jon Øyvind Odland
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø - The Arctic University of Norway, Tromsø, Norway
| | - Maria Skaalum Petersen
- Department of Occupational Medicine and Public Health, The Faroese Hospital System, Torshavn, Faroe Islands
| | - Arja Rautio
- Thule Institute, University of Oulu, Oulu, Finland
| | - Anna Sofía Veyhe
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø - The Arctic University of Norway, Tromsø, Norway
| | - Maria Wennberg
- Department of Biobank Research, Umeå University, Umeå, Sweden
| | - Ingvar Bergdahl
- Department of Biobank Research, Umeå University, Umeå, Sweden
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15
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Li J, Yin H, Bibus DM, Byelashov OA. The role of Omega-3 docosapentaenoic acid in pregnancy and early development. EUR J LIPID SCI TECH 2016. [DOI: 10.1002/ejlt.201600076] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Juan Li
- Omega Protein Corporation; Houston; TX USA
| | | | - Douglas M. Bibus
- University of Minnesota; Minneapolis; MN USA
- Lipid Technologies; LLC.; Austin MN USA
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16
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Omega-3 PUFAs Lower the Propensity for Arachidonic Acid Cascade Overreactions. BIOMED RESEARCH INTERNATIONAL 2015; 2015:285135. [PMID: 26301244 PMCID: PMC4537720 DOI: 10.1155/2015/285135] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 12/18/2014] [Accepted: 12/22/2014] [Indexed: 02/02/2023]
Abstract
A productive view of the benefits from omega-3 (n-3) nutrients is that the dietary essential omega-6 (n-6) linoleic acid has a very narrow therapeutic window which is widened by n-3 nutrients. The benefit from moderate physiological actions of the arachidonic acid cascade can easily shift to harm from excessive pathophysiological actions. Recognizing the factors that predispose the cascade to an unwanted overactivity gives a rational approach for arranging beneficial interactions between the n-3 and n-6 essential nutrients that are initial components of the cascade. Much detailed evidence for harmful cascade actions was collected by pharmaceutical companies as they developed drugs to decrease those actions. A remaining challenge is to understand the factors that predispose the cascade toward unwanted outcomes and create the need for therapeutic interventions. Such understanding involves recognizing the similar dynamics for dietary n-3 and n-6 nutrients in forming the immediate precursors of the cascade plus the more vigorous actions of the n-6 precursor, arachidonic acid, in forming potent mediators that amplify unwanted cascade outcomes. Tools have been developed to aid deliberate day-to-day quantitative management of the propensity for cascade overactivity in ways that can decrease the need for drug treatments.
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17
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Orsavova J, Misurcova L, Ambrozova JV, Vicha R, Mlcek J. Fatty Acids Composition of Vegetable Oils and Its Contribution to Dietary Energy Intake and Dependence of Cardiovascular Mortality on Dietary Intake of Fatty Acids. Int J Mol Sci 2015; 16:12871-90. [PMID: 26057750 PMCID: PMC4490476 DOI: 10.3390/ijms160612871] [Citation(s) in RCA: 444] [Impact Index Per Article: 49.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 06/01/2015] [Indexed: 12/14/2022] Open
Abstract
Characterizations of fatty acids composition in % of total methylester of fatty acids (FAMEs) of fourteen vegetable oils--safflower, grape, silybum marianum, hemp, sunflower, wheat germ, pumpkin seed, sesame, rice bran, almond, rapeseed, peanut, olive, and coconut oil--were obtained by using gas chromatography (GC). Saturated (SFA), monounsaturated (MUFA) and polyunsaturated fatty acids (PUFA), palmitic acid (C16:0; 4.6%-20.0%), oleic acid (C18:1; 6.2%-71.1%) and linoleic acid (C18:2; 1.6%-79%), respectively, were found predominant. The nutritional aspect of analyzed oils was evaluated by determination of the energy contribution of SFAs (19.4%-695.7% E(RDI)), PUFAs (10.6%-786.8% E(RDI)), n-3 FAs (4.4%-117.1% E(RDI)) and n-6 FAs (1.8%-959.2% E(RDI)), expressed in % E(RDI) of 1 g oil to energy recommended dietary intakes (E(RDI)) for total fat (E(RDI)--37.7 kJ/g). The significant relationship between the reported data of total fat, SFAs, MUFAs and PUFAs intakes (% E(RDI)) for adults and mortality caused by coronary heart diseases (CHD) and cardiovascular diseases (CVD) in twelve countries has not been confirmed by Spearman's correlations.
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Affiliation(s)
- Jana Orsavova
- Language Centre, Faculty of Humanities, Tomas Bata University in Zlín, nám. T. G. Masaryka 5555, 760 01 Zlín, Czech Republic.
| | - Ladislava Misurcova
- Department of Food Analysis and Chemistry, Faculty of Technology, Tomas Bata University in Zlín, nám. T. G. Masaryka 5555, 760 01 Zlín, Czech Republic.
| | - Jarmila Vavra Ambrozova
- Department of Food Analysis and Chemistry, Faculty of Technology, Tomas Bata University in Zlín, nám. T. G. Masaryka 5555, 760 01 Zlín, Czech Republic.
| | - Robert Vicha
- Department of Chemistry, Faculty of Technology, Tomas Bata University in Zlín, nám. T. G. Masaryka 5555, 760 01 Zlín, Czech Republic.
| | - Jiri Mlcek
- Department of Food Analysis and Chemistry, Faculty of Technology, Tomas Bata University in Zlín, nám. T. G. Masaryka 5555, 760 01 Zlín, Czech Republic.
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18
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Zhou S, Xiong L, Xie P, Ambalavanan A, Bourassa CV, Dionne-Laporte A, Spiegelman D, Turcotte Gauthier M, Henrion E, Diallo O, Dion PA, Rouleau GA. Increased missense mutation burden of Fatty Acid metabolism related genes in nunavik inuit population. PLoS One 2015; 10:e0128255. [PMID: 26010953 PMCID: PMC4444093 DOI: 10.1371/journal.pone.0128255] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 04/24/2015] [Indexed: 12/29/2022] Open
Abstract
Background Nunavik Inuit (northern Quebec, Canada) reside along the arctic coastline where for generations their daily energy intake has mainly been derived from animal fat. Given this particular diet it has been hypothesized that natural selection would lead to population specific allele frequency differences and unique variants in genes related to fatty acid metabolism. A group of genes, namely CPT1A, CPT1B, CPT1C, CPT2, CRAT and CROT, encode for three carnitine acyltransferases that are important for the oxidation of fatty acids, a critical step in their metabolism. Methods Exome sequencing and SNP array genotyping were used to examine the genetic variations in the six genes encoding for the carnitine acyltransferases in 113 Nunavik Inuit individuals. Results Altogether ten missense variants were found in genes CPT1A, CPT1B, CPT1C, CPT2 and CRAT, including three novel variants and one Inuit specific variant CPT1A p.P479L (rs80356779). The latter has the highest frequency (0.955) compared to other Inuit populations. We found that by comparison to Asians or Europeans, the Nunavik Inuit have an increased mutation burden in CPT1A, CPT2 and CRAT; there is also a high level of population differentiation based on carnitine acyltransferase gene variations between Nunavik Inuit and Asians. Conclusion The increased number and frequency of deleterious variants in these fatty acid metabolism genes in Nunavik Inuit may be the result of genetic adaptation to their diet and/or the extremely cold climate. In addition, the identification of these variants may help to understand some of the specific health risks of Nunavik Inuit.
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Affiliation(s)
- Sirui Zhou
- Montreal Neurological Institute and Hospital, McGill University, Montréal (Que), Canada
- Département de médecine, Faculté de médecine, Université de Montréal, Montréal (Que), Canada
| | - Lan Xiong
- Département de psychiatrie, Faculté de médecine, Université de Montréal, Montréal (Que), Canada
- Centre de recherche, Institut universitaire en santé mentale de Montréal (Que), Canada
| | - Pingxing Xie
- Montreal Neurological Institute and Hospital, McGill University, Montréal (Que), Canada
- Department of Human Genetics, McGill University, Montréal (Que), Canada
| | - Amirthagowri Ambalavanan
- Montreal Neurological Institute and Hospital, McGill University, Montréal (Que), Canada
- Department of Human Genetics, McGill University, Montréal (Que), Canada
| | - Cynthia V. Bourassa
- Montreal Neurological Institute and Hospital, McGill University, Montréal (Que), Canada
| | | | - Dan Spiegelman
- Montreal Neurological Institute and Hospital, McGill University, Montréal (Que), Canada
| | | | - Edouard Henrion
- Montreal Neurological Institute and Hospital, McGill University, Montréal (Que), Canada
| | - Ousmane Diallo
- Montreal Neurological Institute and Hospital, McGill University, Montréal (Que), Canada
| | - Patrick A. Dion
- Montreal Neurological Institute and Hospital, McGill University, Montréal (Que), Canada
- Department of Neurology and Neurosurgery, McGill University, Montréal (Que), Canada
| | - Guy A. Rouleau
- Montreal Neurological Institute and Hospital, McGill University, Montréal (Que), Canada
- Department of Neurology and Neurosurgery, McGill University, Montréal (Que), Canada
- * E-mail:
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Valera B, Sohani Z, Rana A, Poirier P, Anand SS. The ethnoepidemiology of obesity. Can J Cardiol 2014; 31:131-41. [PMID: 25661548 DOI: 10.1016/j.cjca.2014.10.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 10/02/2014] [Accepted: 10/06/2014] [Indexed: 12/25/2022] Open
Abstract
The prevalence of overweight and obesity varies significantly across ethnic groups and among aboriginal people in Canada and appears to be increasing overall in children and youth, which will have significant health consequences in the future. Individual health behaviours, genetic predisposition, and community-level factors all contribute to the high burden of overweight and obesity across communities in Canada. Preliminary studies indicate that individuals who live in neighbourhoods in Canada with increased walkability, fewer fast food outlets, and higher socioeconomic status have lower rates of overweight/obesity when compared with other neighbourhoods. However, more research is required to understand the impact of community level factors on overweight/obesity trends in Canadian ethnic groups, including children and youth, and aboriginal people.
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Affiliation(s)
- Beatriz Valera
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, Québec, Canada
| | - Zahra Sohani
- Population Genomics Program, Department of Clinical Epidemiology & Biostatistics, Hamilton, Ontario, Canada; Chanchlani Research Centre, McMaster University, Hamilton, Ontario, Canada
| | - Ayesha Rana
- Population Genomics Program, Department of Clinical Epidemiology & Biostatistics, Hamilton, Ontario, Canada; Chanchlani Research Centre, McMaster University, Hamilton, Ontario, Canada
| | - Paul Poirier
- Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, Québec, Canada; Faculté de pharmacie de l'Université Laval, Québec, Québec, Canada
| | - Sonia S Anand
- Population Genomics Program, Department of Clinical Epidemiology & Biostatistics, Hamilton, Ontario, Canada; Chanchlani Research Centre, McMaster University, Hamilton, Ontario, Canada; Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
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