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Frehlich L, Turin TC, Doyle-Baker PK, McCormack GR. Neighbourhood walkability and greenspace and their associations with health-related fitness in urban dwelling Canadian adults. Prev Med 2024; 184:107998. [PMID: 38735586 DOI: 10.1016/j.ypmed.2024.107998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 05/08/2024] [Accepted: 05/09/2024] [Indexed: 05/14/2024]
Abstract
OBJECTIVE Muscular strength and body composition are important components of health-related fitness (HRF). Grip strength and body fat percent, in particular, are associated with chronic disease and affected by health behaviours. Evidence suggests relationships between the neighbourhood built environment (BE) and HRF exist, however, few studies have focused on grip strength and body fat percent. Therefore, our study aimed to estimate the sex-specific associations between the neighbourhood BE, grip strength, and body fat percent among urban-dwelling Canadian adults. METHODS We analyzed cross-sectional survey and HRF data collected in 2011-2015 from 4052 males and 7841 females (Alberta's Tomorrow Project, Canada). Grip strength and body fat percent were measured via handgrip dynamometry and bioelectrical impedance analysis, respectively. Walkability (Canadian Active Living Index) and greenness (Normalized Difference Vegetation Index) estimates were linked to participant data. Sex-stratified covariate-adjusted linear regression models estimated the associations between the BE and HRF variables. RESULTS Walkability was negatively associated with grip strength and body fat percent in males (β -0.21, 95%CI: -0.31 to -0.11 and β -0.08, 95%CI: -0.15 to -0.02, respectively) and females (β -0.06, 95%CI: -0.10 to -0.01 and β -0.08, 95%CI: -0.14 to -0.02, respectively). Greenness was positively associated with grip strength in males (β 6.99, 95%CI: 3.62 to 10.36) and females (β 2.72, 95%CI: 1.22 to 4.22) but not with body fat percent. Controlling for physical activity and sitting did not attenuate these associations. CONCLUSION Characteristics of the neighbourhood BE appear to be associated with muscular strength and body composition, independent of physical activity and sedentary behaviour.
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Affiliation(s)
- Levi Frehlich
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary T2N 1N4, Canada.
| | - Tanvir C Turin
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary T2N 1N4, Canada.
| | | | - Gavin R McCormack
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary T2N 1N4, Canada.
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Shearer J, Shah S, Shen-Tu G, Schlicht K, Laudes M, Mu C. Microbial Features Linked to Medication Strategies in Cardiometabolic Disease Management. ACS Pharmacol Transl Sci 2024; 7:991-1001. [PMID: 38665607 PMCID: PMC11040554 DOI: 10.1021/acsptsci.3c00261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 01/05/2024] [Accepted: 01/15/2024] [Indexed: 04/28/2024]
Abstract
Human gut microbiota are recognized as critical players in both metabolic disease and drug metabolism. However, medication-microbiota interactions in cardiometabolic diseases are not well understood. To gain a comprehensive understanding of how medication intake impacts the gut microbiota, we investigated the association of microbial structure with the use of single or multiple medications in a cohort of 134 middle-aged adults diagnosed with cardiometabolic disease, recruited from Alberta's Tomorrow Project. Predominant cardiometabolic prescription medication classes (12 total) were included in our analysis. Multivariate Association with Linear Model (MaAsLin2) was employed and results were corrected for age, BMI, sex, and diet to evaluate the relationship between microbial features and single- or multimedication use. Highly individualized microbiota profiles were observed across participants, and increasing medication use was negatively correlated with α-diversity. A total of 46 associations were identified between microbial composition and single medications, exemplified by the depletion of Akkermansia muciniphila by β-blockers and statins, and the enrichment of Escherichia/Shigella and depletion of Bacteroides xylanisolvens by metformin. Metagenomics prediction further indicated alterations in microbial functions associated with single medications such as the depletion of enzymes involved in energy metabolism encoded by Eggerthella lenta due to β-blocker use. Specific dual medication combinations also had profound impacts, including the depletion of Romboutsia and Butyriciocccus by statin plus metformin. Together, these results show reductions in bacterial diversity as well as species and microbial functional potential associated with both single- and multimedication use in cardiometabolic disease.
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Affiliation(s)
- Jane Shearer
- Department
of Biochemistry and Molecular Biology, Cumming School of Medicine,
University of Calgary, Calgary, Alberta T2N 1N4, Canada
- Libin
Cardiovascular Institute, University of Calgary, Calgary, Alberta T2N 1N4, Canada
- Faculty
of Kinesiology, University of Calgary, Calgary, Alberta T2N 1N4, Canada
| | - Shrushti Shah
- Libin
Cardiovascular Institute, University of Calgary, Calgary, Alberta T2N 1N4, Canada
- Faculty
of Kinesiology, University of Calgary, Calgary, Alberta T2N 1N4, Canada
| | - Grace Shen-Tu
- Alberta’s
Tomorrow Project, Cancer Control Alberta, Alberta Health Services, Calgary, Alberta T2T 5C7, Canada
| | - Kristina Schlicht
- Institute
of Diabetes and Clinical Metabolic Research, University Medical Center Schleswig-Holstein, Kiel 24105, Germany
| | - Matthias Laudes
- Institute
of Diabetes and Clinical Metabolic Research, University Medical Center Schleswig-Holstein, Kiel 24105, Germany
- Division
of Endocrinology, Diabetes and Clinical Nutrition, Department of Medicine, University Medical Center Schleswig-Holstein, 24105 Kiel, Germany
| | - Chunlong Mu
- Department
of Biochemistry and Molecular Biology, Cumming School of Medicine,
University of Calgary, Calgary, Alberta T2N 1N4, Canada
- Libin
Cardiovascular Institute, University of Calgary, Calgary, Alberta T2N 1N4, Canada
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3
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Ye M, Vena JE, Shen-Tu G, Johnson JA, Eurich DT. Reduced incidence of diabetes during the COVID-19 pandemic in Alberta: A time-segmented longitudinal study of Alberta's Tomorrow Project. Diabetes Obes Metab 2024; 26:1244-1251. [PMID: 38131246 DOI: 10.1111/dom.15420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/30/2023] [Accepted: 11/30/2023] [Indexed: 12/23/2023]
Abstract
AIM To characterize the impact of the COVID-19 pandemic on diabetes diagnosis using data from Alberta's Tomorrow Project (ATP), a population-based cohort study of chronic diseases in Alberta, Canada. MATERIALS AND METHODS The ATP participants who were free of diabetes on 1 April 2018 were included in the study. A time-segmented regression model was used to compare incidence rates of diabetes before the COVID-19 pandemic, during the first two COVID-19 states of emergency, and in the period when the state of emergency was relaxed, after adjusting for seasonality, sociodemographic factors, socioeconomic status, and lifestyle behaviours. RESULTS Among 43 705 ATP participants free of diabetes (65.5% females, age 60.4 ± 9.5 years in 2018), the rate of diabetes was 4.75 per 1000 person-year (PY) during the COVID-19 pandemic (up to 31 March 2021), which was 32% lower (95% confidence interval [CI] 21%, 42%; p < 0.001) than pre-pandemic (6.98 per 1000 PY for the period 1 April 2018 to 16 March 2020). In multivariable regression analysis, the first COVID-19 state of emergency (first wave) was associated with an 87.3% (95% CI -98.6%, 13.9%; p = 0.07) reduction in diabetes diagnosis; this decreasing trend was sustained to the second COVID-19 state of emergency and no substantial rebound (increase) was observed when the COVID-19 state of emergency was relaxed. CONCLUSIONS The COVID-19 public health emergencies had a negative impact on diabetes diagnosis in Alberta. The reduction in diabetes diagnosis was likely due to province-wide health service disruptions during the COVID-19 pandemic. Systematic plans to close the post-COVID-19 diagnostic gap are required in diabetes to avoid substantial downstream sequelae of undiagnosed disease.
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Affiliation(s)
- Ming Ye
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Jennifer E Vena
- Alberta's Tomorrow Project, Cancer Care Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Grace Shen-Tu
- Alberta's Tomorrow Project, Cancer Care Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Jeffrey A Johnson
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Dean T Eurich
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
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Koohsari MJ, Oka K, Nakaya T, McCormack GR. Urban Form Metrics for Promoting Walking: Street Layouts and Destinations. J Urban Health 2023; 100:1024-1031. [PMID: 37581709 PMCID: PMC10618131 DOI: 10.1007/s11524-023-00775-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/17/2023] [Indexed: 08/16/2023]
Abstract
There is evidence that higher street connectivity and availability of destinations can support walking behavior. However, the availability of data and comparability between previous studies remain a challenge. Based on a large Canadian adult sample, this study examined the associations between street layout and walking behaviors and explored whether objectively measured destinations may mediate these relationships. This study used data from 12,378 adults from Alberta's Tomorrow Project (ATP), a prospective cohort study conducted in Alberta, Canada. Walking behaviors were obtained by questionnaires. Street layout and destination measures were calculated objectively. Covariate-adjusted multivariate linear models estimated the associations between the space syntax street integration and duration of transport and leisure walking. The mediation effects of the availability of destinations in these associations were tested by the structural equation modelling. Street integration was significantly positively associated with transportation walking (b=0.01, 95% CI 0.00, 0.01, p = 0.01) (indirect effect). The availability of destinations partially mediated this association. Using the natural movement theory in space syntax, our study provides insights into using street layouts as a primary measure to (re)design the built environment to support walking.
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Affiliation(s)
- Mohammad Javad Koohsari
- School of Advanced Science and Technology, Japan Advanced Institute of Science and Technology, 1 Chome-1 Asahidai, Nomi, Ishikawa, 923-1211, Japan.
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan.
- School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia.
| | - Koichiro Oka
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Tomoki Nakaya
- Graduate School of Environmental Studies, Tohoku University, Sendai, Japan
| | - Gavin R McCormack
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
- School of Architecture, Planning and Landscape, University of Calgary, Calgary, Canada
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Scime NV, Brown HK, Shea AK, Brennand EA. Association of infertility with type and timing of menopause: a prospective cohort study. Hum Reprod 2023; 38:1843-1852. [PMID: 37451681 PMCID: PMC10477942 DOI: 10.1093/humrep/dead143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/06/2023] [Indexed: 07/18/2023] Open
Abstract
STUDY QUESTION What is the association between past infertility and the type and timing of menopause in midlife women? SUMMARY ANSWER Women with a history of infertility were more likely to experience surgical menopause overall and had elevated risk of earlier surgical menopause until age 43 years but experienced no differences in the timing of natural menopause. WHAT IS KNOWN ALREADY Infertility is experienced by 12-25% of women and is thought to reveal a propensity for poor health outcomes, such as chronic illness, later in life. However, little is known about whether infertility is linked with characteristics of the menopausal transition as women age, despite possible shared underlying pathways involving ovarian function and gynecologic disease. STUDY DESIGN, SIZE, DURATION Secondary analysis of a prospective cohort study of 13 243 midlife females recruited in Phase 1 of the Alberta's Tomorrow Project (Alberta, Canada) and followed approximately every 4 years (2000-2022). PARTICIPANTS/MATERIALS, SETTING, METHODS Data were collected through standardized self-report questionnaires. History of infertility, defined as ever trying to become pregnant for more than 1 year without conceiving, was measured at baseline. Menopause characteristics were measured at each study follow-up. Menopause type was defined as premenopause, natural menopause, surgical menopause (bilateral oophorectomy), or indeterminate menopause (premenopausal hysterectomy with ovarian conservation). Timing of natural menopause was defined as the age at 1 full year after the final menstrual period, and timing of surgical and indeterminate menopause was defined as the age at the time of surgery. We used flexible parametric survival analysis for the outcome of menopause timing with age as the underlying time scale and multinomial logistic regression for the outcome of menopause type. Multivariable models controlled for race/ethnicity, education, parity, previous pregnancy loss, and smoking. Sensitivity analyses additionally accounted for birth history, menopausal hormone therapy, body mass index, chronic medical conditions, and age at baseline. MAIN RESULTS AND THE ROLE OF CHANCE Overall, 18.2% of women reported a history of infertility. Past infertility was associated with earlier timing of surgical menopause exclusively before age 43 years (age 35: adjusted hazard ratio 3.13, 95% CI 1.95-5.02; age 40: adjusted hazard ratio 1.83, 95% CI 1.40-2.40; age 45: adjusted hazard ratio 1.13, 95% CI 0.87-1.46) as well as greater odds of experiencing surgical menopause compared to natural menopause (adjusted odds ratio 1.40, 95% CI 1.18-1.66). Infertility was not associated with the timing of natural or indeterminate menopause. LIMITATIONS, REASONS FOR CAUTION Information on the underlying cause of infertility and related interventions was not collected, which precluded us from disentangling whether associations differed by infertility cause and treatment. Residual confounding is possible given that some covariates were measured at baseline and may not have temporally preceded infertility. WIDER IMPLICATIONS OF THE FINDINGS Women with a history of infertility were more likely to experience early surgical menopause and may therefore benefit from preemptive screening and treatment for gynecologic diseases to reduce bilateral oophorectomy, where clinically appropriate, and its associated health risks in midlife. Moreover, the lack of association between infertility and timing of natural menopause adds to the emerging knowledge that diminishing ovarian reserve does not appear to be a primary biological mechanism of infertility nor its downstream implications for women's health. STUDY FUNDING/COMPETING INTEREST(S) Alberta's Tomorrow Project is only possible due to the commitment of its research participants, its staff and its funders: Alberta Health, Alberta Cancer Foundation, Canadian Partnership Against Cancer and Health Canada, and substantial in-kind funding from Alberta Health Services. The views expressed herein represent the views of the author(s) and not of Alberta's Tomorrow Project or any of its funders. This secondary analysis is funded by Project Grant Priority Funding in Women's Health Research from the Canadian Institutes of Health Research (Grant no. 491439). N.V.S. is supported by a Banting Postdoctoral Fellowship from the Canadian Institutes of Health Research. H.K.B. is supported by the Canada Research Chairs Program. E.A.B. is supported by an Early Career Investigator Award in Maternal, Reproductive, Child and Youth Health from the Canadian Institutes of Health Research. A.K.S. has received honoraria from Pfizer, Lupin, Bio-Syent, and Eisai and has received grant funding from Pfizer. N.V.S., H.K.B., and E.A.B. have no conflicts of interest to report. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- Natalie V Scime
- Department of Health and Society, University of Toronto Scarborough, Toronto, ON, Canada
| | - Hilary K Brown
- Department of Health and Society, University of Toronto Scarborough, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Alison K Shea
- Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON, Canada
- McMaster Institute for Research on Aging (MIRA), McMaster University, Hamilton, ON, Canada
| | - Erin A Brennand
- Department of Obstetrics and Gynecology, University of Calgary, Calgary, AB, Canada
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6
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Weaver OR, Ye M, Vena JE, Eurich DT, Proctor SD. Non-fasting lipids and cardiovascular disease in those with and without diabetes in Alberta's Tomorrow Project: A prospective cohort study. Diabet Med 2023; 40:e15133. [PMID: 37171453 DOI: 10.1111/dme.15133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 04/26/2023] [Accepted: 05/05/2023] [Indexed: 05/13/2023]
Abstract
AIMS Non-fasting remnant cholesterol (RC) is a novel marker of cardiovascular disease (CVD) risk, however, data on this relationship in Canadians with diabetes (at high risk of CVD) is lacking. The objective of this analysis was to determine the relationship of RC with CVD in individuals with and without diabetes in the Alberta's Tomorrow Project (ATP) cohort. METHODS Non-fasting lipid data collected as part of the ATP was linked to administrative health records (October 2000-March 2015) to ascertain incident CVD and prevalent diabetes. Participants without prevalent CVD or incident diabetes and who had complete, non-negative non-fasting lipid data collected with triglycerides <4.5 mmol/L were included (n = 13,631). The relationship between non-fasting RC and incident CVD diagnoses was assessed by Cox proportional hazards regression, after stratification by diabetes status. RESULTS Participants were 69.8% women with a mean age of 61.6 ± 9.7 years, and 6.5% had prevalent diabetes. Non-fasting RC was higher in participants with diabetes compared to those without (mean 0.94 ± 0.41 mmol/L vs. 0.77 ± 0.38 mmol/L, p < 0.0001) and was associated with increased risk of incident CVD among those without diabetes (adjusted hazard ratio (aHR) 1.22, 95% CI 1.03-1.43, p = 0.02). Although a similar trend was observed in participants with diabetes it did not reach statistical significance (aHR 1.31, 95% CI 0.84-2.05, p = 0.23). CONCLUSIONS Elevated non-fasting RC predicted increased CVD risk in middle and older-aged adults without diabetes; similar trends were observed in participants with diabetes and require further testing in a larger sample.
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Affiliation(s)
- Olivia R Weaver
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Ming Ye
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Jennifer E Vena
- Alberta's Tomorrow Project, Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Dean T Eurich
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Spencer D Proctor
- Metabolic and Cardiovascular Diseases Laboratory, University of Alberta, Edmonton, Alberta, Canada
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Koohsari MJ, Oka K, Nakaya T, Vena J, Williamson T, Quan H, McCormack GR. Urban design and cardio-metabolic risk factors. Prev Med 2023; 173:107552. [PMID: 37211251 DOI: 10.1016/j.ypmed.2023.107552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 05/17/2023] [Accepted: 05/18/2023] [Indexed: 05/23/2023]
Abstract
Accumulating evidence suggests that the built environment may be associated with cardiovascular disease via its influence on health behaviours. The aim of this study was to estimate the associations between traditional and novel neighbourhood built environment metrics and clinically assessed cardio-metabolic risk factors among a sample of adults in Canada. A total of 7171 participants from Albertas Tomorrow Project living in Alberta, Canada, were included. Cardio-metabolic risk factors were clinically measured. Two composite built environment metrics of traditional walkability and space syntax walkability were calculated. Among men, space syntax walkability was negatively associated with systolic and diastolic blood pressure (b = -0.87, 95% CI -1.43, -0.31 and b = -0.45, 95% CI -0.86, -0.04, respectively). Space syntax walkability was also associated with lower odds of overweight/obese among women and men (OR = 0.93, 95% CI 0.87, 0.99 and OR = 0.88, 95% CI 0.79, 0.97, respectively). No significant associations were observed between traditional walkability and cardio-metabolic outcomes. This study showed that the novel built environment metric based on the space syntax theory was associated with some cardio-metabolic risk factors.
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Affiliation(s)
- Mohammad Javad Koohsari
- School of Knowledge Science, Japan Advanced Institute of Science and Technology, Japan; Faculty of Sport Sciences, Waseda University, Japan; School of Exercise and Nutrition Sciences, Deakin University, Australia.
| | - Koichiro Oka
- Faculty of Sport Sciences, Waseda University, Japan
| | - Tomoki Nakaya
- Graduate School of Environmental Studies, Tohoku University, Japan.
| | - Jennifer Vena
- Alberta's Tomorrow Project, Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Canada.
| | - Tyler Williamson
- Centre for Health Informatics and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Canada.
| | - Hude Quan
- Centre for Health Informatics and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Canada.
| | - Gavin R McCormack
- Faculty of Sport Sciences, Waseda University, Japan; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Canada; Faculty of Kinesiology, University of Calgary, Canada; School of Architecture, Planning and Landscape, University of Calgary, Canada.
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Biziaev T, Aktary ML, Wang Q, Chekouo T, Bhatti P, Shack L, Robson PJ, Kopciuk KA. Development and External Validation of Partial Proportional Odds Risk Prediction Models for Cancer Stage at Diagnosis among Males and Females in Canada. Cancers (Basel) 2023; 15:3545. [PMID: 37509208 PMCID: PMC10377619 DOI: 10.3390/cancers15143545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 07/30/2023] Open
Abstract
Risk prediction models for cancer stage at diagnosis may identify individuals at higher risk of late-stage cancer diagnoses. Partial proportional odds risk prediction models for cancer stage at diagnosis for males and females were developed using data from Alberta's Tomorrow Project (ATP). Prediction models were validated on the British Columbia Generations Project (BCGP) cohort using discrimination and calibration measures. Among ATP males, older age at diagnosis was associated with an earlier stage at diagnosis, while full- or part-time employment, prostate-specific antigen testing, and former/current smoking were associated with a later stage at diagnosis. Among ATP females, mammogram and sigmoidoscopy or colonoscopy were associated with an earlier stage at diagnosis, while older age at diagnosis, number of pregnancies, and hysterectomy were associated with a later stage at diagnosis. On external validation, discrimination results were poor for both males and females while calibration results indicated that the models did not over- or under-fit to derivation data or over- or under-predict risk. Multiple factors associated with cancer stage at diagnosis were identified among ATP participants. While the prediction model calibration was acceptable, discrimination was poor when applied to BCGP data. Updating our models with additional predictors may help improve predictive performance.
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Affiliation(s)
- Timofei Biziaev
- Department of Mathematics and Statistics, University of Calgary, Calgary, AB T2N 4N2, Canada
| | - Michelle L Aktary
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Qinggang Wang
- Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB T2S 3C3, Canada
| | - Thierry Chekouo
- Department of Mathematics and Statistics, University of Calgary, Calgary, AB T2N 4N2, Canada
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA
| | - Parveen Bhatti
- Cancer Control Research, BC Cancer, Vancouver, BC V5Z 1L3, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Lorraine Shack
- Cancer Surveillance and Reporting, Alberta Health Services, Calgary, AB T2S 3C3, Canada
| | - Paula J Robson
- Department of Agricultural, Food and Nutritional Science and School of Public Health, University of Alberta, Edmonton, AB T6G 2P5, Canada
- Cancer Care Alberta and Cancer Strategic Clinical Network, Alberta Health Services, Edmonton, AB T5J 3H1, Canada
| | - Karen A Kopciuk
- Department of Mathematics and Statistics, University of Calgary, Calgary, AB T2N 4N2, Canada
- Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB T2S 3C3, Canada
- Departments of Oncology, Community Health Sciences, University of Calgary, Calgary, AB T2N 4N2, Canada
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Weaver OR, Krysa JA, Ye M, Vena JE, Eurich DT, Proctor SD. Nonfasting remnant cholesterol and cardiovascular disease risk prediction in Albertans: a prospective cohort study. CMAJ Open 2023; 11:E645-E653. [PMID: 37491049 PMCID: PMC10374248 DOI: 10.9778/cmajo.20210318] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND European studies have shown that nonfasting remnant cholesterol can be a strong predictor of cardiovascular disease risk and may contribute to identifying residual risk; however, Canadian data are lacking on nonfasting remnant cholesterol. In this study, we aimed to determine the relation between nonfasting remnant cholesterol, low-density lipoprotein (LDL) cholesterol and cardiovascular disease among people in Alberta. METHODS In this retrospective analysis, we used data from Alberta's Tomorrow Project, a large prospective cohort that enrolled Albertans aged 35-69 years (2000-2015). Participants with consent to data linkage, with complete nonfasting lipid data and without existing cardiovascular disease were included. The nonfasting remnant cholesterol and LDL cholesterol relation with a composite cardiovascular disease outcome of major incident cardiovascular diagnoses, ascertained by linking to Alberta Health databases, was determined by multivariable logistic regression, adjusting for age, sex, statin use, comorbidities, and LDL cholesterol or remnant cholesterol. RESULTS The final sample of 13 988 participants was 69.4% female, and the mean age was 61.8 (standard deviation [SD] 9.7) years. Follow-up time was approximately 15 years. Mean remnant cholesterol was significantly higher among individuals with versus without cardiovascular disease (0.87 [SD 0.40] mmol/L v. 0.78 [SD 0.38] mmol/L, standardized mean difference [SMD] -0.24), and mean LDL cholesterol was significantly lower (2.69 [SD 0.93] mmol/L v. 2.88 [SD 0.84] mmol/L, SMD 0.21). The odds of incident composite cardiovascular disease were significantly increased per mmol/L increase in remnant cholesterol (adjusted odds ratio [OR] 1.48, 95% confidence interval [CI] 1.27-1.73) but significantly decreased per mmol/L increase in LDL cholesterol (adjusted OR 0.73, 95% CI 0.68-0.79). INTERPRETATION In this large Albertan cohort of predominantly older females, nonfasting remnant cholesterol had a positive relation with cardiovascular disease incidence, whereas LDL cholesterol did not. These findings support the clinical utility of measuring non-fasting remnant cholesterol to detect cardiovascular disease risk.
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Affiliation(s)
- Olivia R Weaver
- School of Public Health (Weaver, Ye, Eurich) and Metabolic and Cardiovascular Diseases Laboratory (Krysa, Proctor), University of Alberta, Edmonton, Alta.; Alberta's Tomorrow Project (Vena), Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, Calgary, Alta
| | - Jacqueline A Krysa
- School of Public Health (Weaver, Ye, Eurich) and Metabolic and Cardiovascular Diseases Laboratory (Krysa, Proctor), University of Alberta, Edmonton, Alta.; Alberta's Tomorrow Project (Vena), Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, Calgary, Alta
| | - Ming Ye
- School of Public Health (Weaver, Ye, Eurich) and Metabolic and Cardiovascular Diseases Laboratory (Krysa, Proctor), University of Alberta, Edmonton, Alta.; Alberta's Tomorrow Project (Vena), Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, Calgary, Alta
| | - Jennifer E Vena
- School of Public Health (Weaver, Ye, Eurich) and Metabolic and Cardiovascular Diseases Laboratory (Krysa, Proctor), University of Alberta, Edmonton, Alta.; Alberta's Tomorrow Project (Vena), Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, Calgary, Alta
| | - Dean T Eurich
- School of Public Health (Weaver, Ye, Eurich) and Metabolic and Cardiovascular Diseases Laboratory (Krysa, Proctor), University of Alberta, Edmonton, Alta.; Alberta's Tomorrow Project (Vena), Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, Calgary, Alta
| | - Spencer D Proctor
- School of Public Health (Weaver, Ye, Eurich) and Metabolic and Cardiovascular Diseases Laboratory (Krysa, Proctor), University of Alberta, Edmonton, Alta.; Alberta's Tomorrow Project (Vena), Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, Calgary, Alta.
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10
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Nearing JT, DeClercq V, Langille MGI. Investigating the oral microbiome in retrospective and prospective cases of prostate, colon, and breast cancer. NPJ Biofilms Microbiomes 2023; 9:23. [PMID: 37127667 PMCID: PMC10151362 DOI: 10.1038/s41522-023-00391-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 04/14/2023] [Indexed: 05/03/2023] Open
Abstract
The human microbiome has been proposed as a potentially useful biomarker for several cancers. To examine this, we made use of salivary samples from the Atlantic Partnership for Tomorrow's Health (PATH) project and Alberta's Tomorrow Project (ATP). Sample selection was divided into both a retrospective and prospective case control design examining prostate, breast, and colon cancer. In total 89 retrospective and 260 prospective cancer cases were matched to non-cancer controls and saliva samples were sequenced using 16S rRNA gene sequencing. We found no significant differences in alpha diversity. All beta diversity measures were insignificant except for unweighted UniFrac profiles in retrospective breast cancer cases and weighted UniFrac, Bray-Curtis and Robust Atchinson's distances in colon cancer after testing with age and sex adjusted MiRKAT models. Differential abundance (DA) analysis showed several taxa that were associated with previous cancer in all three groupings. Only one genus (Clostridia UCG-014) in breast cancer and one ASV (Fusobacterium periodonticum) in colon cancer was identified by more than one DA tool. In prospective cases three ASVs were associated with colon cancer, one ASV with breast cancer, and one ASV with prostate cancer. Random Forest classification showed low levels of signal in both study designs in breast and prostate cancer. Contrastingly, colon cancer did show signal in our retrospective analysis (AUC: 0.737) and in one of two prospective cohorts (AUC: 0.717). Our results indicate that it is unlikely that reliable microbial oral biomarkers for breast and prostate cancer exist.. However, further research into the oral microbiome and colon cancer could be fruitful.
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Affiliation(s)
- Jacob T Nearing
- Department of Microbiology and Immunology, Dalhousie University, Halifax, NS, Canada.
| | - Vanessa DeClercq
- Department of Pharmacology, Dalhousie University, Halifax, NS, Canada
| | - Morgan G I Langille
- Department of Microbiology and Immunology, Dalhousie University, Halifax, NS, Canada
- Department of Pharmacology, Dalhousie University, Halifax, NS, Canada
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11
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Shah S, Mu C, Moossavi S, Shen-Tu G, Schlicht K, Rohmann N, Geisler C, Laudes M, Franke A, Züllig T, Köfeler H, Shearer J. Physical activity-induced alterations of the gut microbiota are BMI dependent. FASEB J 2023; 37:e22882. [PMID: 36943402 DOI: 10.1096/fj.202201571r] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 01/31/2023] [Accepted: 03/06/2023] [Indexed: 03/23/2023]
Abstract
Physical inactivity is one of the leading causes of chronic metabolic disease including obesity. Increasing physical activity (PA) has been shown to improve cardiometabolic and musculoskeletal health and to be associated with a distinct gut microbiota composition in trained athletes. However, the impact of PA on the gut microbiota is inconclusive for individuals performing PA in their day-to-day life. This study examined the role of PA and hand-grip strength on gut microbiome composition in middle-aged adults (40-65 years, n = 350) with normal (18.5-24.9 kg/m2 ) and overweight (25-29.9 kg/m2 ) body mass index (BMI). PA was recorded using the International Physical Activity Questionnaire, and hand-grip strength was measured using a dynamometer. Serum samples were assessed for lipidomics while DNA was extracted from fecal samples for microbiome analysis. Overweight participants showed a higher concentration of triacylglycerols, and lower concentrations of cholesteryl esters, sphingomyelin, and lyso-phosphotidylcholine lipids (p < .05) compared with those with normal BMI. Additionally, overweight participants had a lower abundance of the Oscillibacter genus (p < .05). The impact of PA duration on the gut microbiome was BMI dependent. In normal but not overweight participants, high PA duration showed greater relative abundance of commensal taxa such as Actinobacteria and Proteobacteria phyla, as well as Collinsella and Prevotella genera (p < .05). Furthermore, in males with normal BMI, a stronger grip strength was associated with a higher relative abundance of Faecalibacterium and F. prausnitzii (p < .05) compared with lower grip strength. Taken together, data suggest that BMI plays a significant role in modeling PA-induced changes in gut microbiota.
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Affiliation(s)
- Shrushti Shah
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Chunlong Mu
- Department of Biochemistry and Molecular Biology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Shirin Moossavi
- Department of Physiology and Pharmacology, University of Calgary, Calgary, Alberta, Canada
| | - Grace Shen-Tu
- Alberta's Tomorrow Project, Cancer Control Alberta, Alberta Health Services, Edmonton, Alberta, Canada
| | - Kristina Schlicht
- Institute of Diabetes and Clinical Metabolic Research, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Nathalie Rohmann
- Institute of Diabetes and Clinical Metabolic Research, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Corinna Geisler
- Institute of Diabetes and Clinical Metabolic Research, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Matthias Laudes
- Institute of Diabetes and Clinical Metabolic Research, University Medical Center Schleswig-Holstein, Kiel, Germany
- Division of Endocrinology, Diabetes and Clinical Nutrition, Department of Medicine, University Medical Center Schleswig-Holstein, Kiel, Germany
| | - Andre Franke
- Institute of Clinical Molecular Biology, Kiel University, Kiel, Germany
| | - Thomas Züllig
- Core Facility Mass Spectrometry, Medical University of Graz, Graz, Austria
| | - Harald Köfeler
- Core Facility Mass Spectrometry, Medical University of Graz, Graz, Austria
| | - Jane Shearer
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
- Department of Biochemistry and Molecular Biology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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12
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McCormack GR, Koohsari MJ, Vena JE, Oka K, Nakaya T, Chapman J, Martinson R, Matsalla G. Associations between neighborhood walkability and walking following residential relocation: Findings from Alberta's Tomorrow Project. Front Public Health 2023; 10:1116691. [PMID: 36726629 PMCID: PMC9885132 DOI: 10.3389/fpubh.2022.1116691] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 12/28/2022] [Indexed: 01/18/2023] Open
Abstract
Introduction Cross-sectional studies consistently find that the neighborhood built environment (e.g., walkability) is associated with walking. However, findings from the few existing longitudinal residential relocation studies that have estimated associations between changes in neighborhood built characteristics and walking are equivocal. The study objective was to estimate whether changes in neighborhood walkability resulting from residential relocation were associated with leisure, transportation, and total walking levels among adults. Methods This study included longitudinal data from the "Alberta's Tomorrow Project"-a province-wide cohort study (Alberta, Canada). The analysis included data collected at two time points (i.e., baseline and follow-up) from 5,977 urban adults. The International Physical Activity Questionnaire (IPAQ) captured self-reported walking. We estimated neighborhood walkability, an index capturing intersection, destination, and population counts for the 400 m Euclidean buffer around participants' homes. Using household postal codes reported at baseline and follow-up, we categorized participants into three groups reflecting residential relocation ("non-movers:" n = 5,679; "movers to less walkability:" n = 164, and; "movers to more walkability:" n = 134). We used Inverse-Probability-Weighted Regression Adjustment to estimate differences [i.e., average treatment effects in the treated (ATET)] in weekly minutes of leisure, transportation, and total walking at follow-up between residential relocation groups, adjusting for baseline walking, sociodemographic characteristics, and walkability. The median time between baseline and follow-up was 2-years. Results The three residential relocation groups mainly included women (61.6-67.2%) and had a mean age of between 52.2 and 55.7 years. Compared to "non-movers" (reference group), weekly minutes of transportation walking at follow-up was significantly lower among adults who moved to less walkable neighborhoods (ATET: -41.34, 95 CI: -68.30, -14.39; p < 0.01). We found no other statistically significant differences in walking between the groups. Discussion Our findings suggest that relocating to less walkable neighborhoods could have detrimental effects on transportation walking to the extent of adversely affecting health. Public health strategies that counteract the negative impacts of low walkable neighborhoods and leverage the supportiveness of high walkable neighborhoods might promote more walking.
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Affiliation(s)
- Gavin R. McCormack
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada,Faculty of Kinesiology, University of Calgary, Calgary, AB, Canada,School of Architecture, Planning and Landscape, University of Calgary, Calgary, AB, Canada,School of Knowledge Science, Japan Advanced Institute of Science and Technology, Nomi, Japan,*Correspondence: Gavin R. McCormack ✉
| | - Mohammad Javad Koohsari
- School of Knowledge Science, Japan Advanced Institute of Science and Technology, Nomi, Japan,Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Jennifer E. Vena
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada,Cancer Care Alberta, Alberta Health Services, Calgary, AB, Canada
| | - Koichiro Oka
- Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan
| | - Tomoki Nakaya
- Graduate School of Environmental Studies, Tohoku University, Sendai, Japan
| | - Jonathan Chapman
- Public Space and Mobility Policy, Planning and Development Services Department, Calgary, AB, Canada
| | | | - Graham Matsalla
- Mental Health Promotion and Illness Prevention, Alberta Health Services, Calgary, AB, Canada
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13
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Chowdhury MZI, Leung AA, Walker RL, Sikdar KC, O’Beirne M, Quan H, Turin TC. A comparison of machine learning algorithms and traditional regression-based statistical modeling for predicting hypertension incidence in a Canadian population. Sci Rep 2023; 13:13. [PMID: 36593280 PMCID: PMC9807553 DOI: 10.1038/s41598-022-27264-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 12/29/2022] [Indexed: 01/03/2023] Open
Abstract
Risk prediction models are frequently used to identify individuals at risk of developing hypertension. This study evaluates different machine learning algorithms and compares their predictive performance with the conventional Cox proportional hazards (PH) model to predict hypertension incidence using survival data. This study analyzed 18,322 participants on 24 candidate features from the large Alberta's Tomorrow Project (ATP) to develop different prediction models. To select the top features, we applied five feature selection methods, including two filter-based: a univariate Cox p-value and C-index; two embedded-based: random survival forest and least absolute shrinkage and selection operator (Lasso); and one constraint-based: the statistically equivalent signature (SES). Five machine learning algorithms were developed to predict hypertension incidence: penalized regression Ridge, Lasso, Elastic Net (EN), random survival forest (RSF), and gradient boosting (GB), along with the conventional Cox PH model. The predictive performance of the models was assessed using C-index. The performance of machine learning algorithms was observed, similar to the conventional Cox PH model. Average C-indexes were 0.78, 0.78, 0.78, 0.76, 0.76, and 0.77 for Ridge, Lasso, EN, RSF, GB and Cox PH, respectively. Important features associated with each model were also presented. Our study findings demonstrate little predictive performance difference between machine learning algorithms and the conventional Cox PH regression model in predicting hypertension incidence. In a moderate dataset with a reasonable number of features, conventional regression-based models perform similar to machine learning algorithms with good predictive accuracy.
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Affiliation(s)
- Mohammad Ziaul Islam Chowdhury
- grid.22072.350000 0004 1936 7697Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada ,grid.22072.350000 0004 1936 7697Department of Family Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB T2N 4N1 Canada ,grid.22072.350000 0004 1936 7697Present Address: Department of Psychiatry, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada
| | - Alexander A. Leung
- grid.22072.350000 0004 1936 7697Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada ,grid.22072.350000 0004 1936 7697Department of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada
| | - Robin L. Walker
- grid.22072.350000 0004 1936 7697Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada ,grid.413574.00000 0001 0693 8815Primary Health Care Integration Network, Primary Health Care, Alberta Health Services, Calgary, AB Canada
| | - Khokan C. Sikdar
- grid.413574.00000 0001 0693 8815Health Status Assessment, Surveillance and Reporting, Public Health Surveillance and Infrastructure, Provincial Population and Public Health, Alberta Health Services, 10101 Southport Rd. SW, Calgary, AB T2W 3N2 Canada
| | - Maeve O’Beirne
- grid.22072.350000 0004 1936 7697Department of Family Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB T2N 4N1 Canada
| | - Hude Quan
- grid.22072.350000 0004 1936 7697Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada
| | - Tanvir C. Turin
- grid.22072.350000 0004 1936 7697Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, AB T2N 4Z6 Canada ,grid.22072.350000 0004 1936 7697Department of Family Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, AB T2N 4N1 Canada
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14
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Yuzbashian E, Pakseresht M, Vena J, Chan CB. Association of dairy consumption patterns with the incidence of type 2 diabetes: Findings from Alberta's Tomorrow Project. Nutr Metab Cardiovasc Dis 2022; 32:2760-2771. [PMID: 36333201 DOI: 10.1016/j.numecd.2022.09.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 08/22/2022] [Accepted: 09/27/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND AIMS We aimed to extract dairy consumption patterns of men and women from a population-based cohort and then assess the association of each consumption pattern with incident T2D risk. METHODS AND RESULTS This prospective study was conducted within the framework of Alberta's Tomorrow Project (ATP), in which 8615 men and 15,016 women provided information on dietary intake by completing a food-frequency questionnaire at baseline, and then were followed up over time to determine the incidence of T2D via questionnaires. Principal Component Analysis (PCA) was used to extract dairy consumption patterns (DCPs). The association between each extracted pattern and T2D incidence was estimated using multivariable logistic regression models.The incidence of T2D among men and women was 3.8 and 3.2%, respectively, and the mean duration of follow-up was 5.2 years. Three major DCPs were identified. After controlling for potential confounders, the OR for risk of T2D in men in the highest compared with those in the lowest quartile of the DCP3 (whole milk, regular cheese, and non-fat milk as a beverage and in cereal) was 0.64 (95%CI: 0.47 to 0.88, P-trend=0.001), whereas it was not significant for women. DCP1 and DCP2 were not associated with incident T2D in men or women. CONCLUSION Adherence to a DCP characterized by higher consumption of whole milk, regular cheese, and non-fat milk was associated with decreased risk of incident T2D only in men. Our results support current evidence that a combination of different dairy products, regardless of their fat content, might be favorable for health maintenance, at least in men.
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Affiliation(s)
- Emad Yuzbashian
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Mohammadreza Pakseresht
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada; Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, Alberta, Canada
| | - Jennifer Vena
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada; Cancer Research & Analytics, Cancer Care Alberta, Alberta Health Services, Alberta, Canada
| | - Catherine B Chan
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada; Department of Physiology, University of Alberta, Edmonton, Alberta, Canada.
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15
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Loewen OK, Sandila N, Shen Tu G, Vena JE, Yang H, Patterson K, Xu JY. Patterns and predictors of adherence to breast cancer screening recommendations in Alberta’s Tomorrow Project. Prev Med Rep 2022; 30:102056. [DOI: 10.1016/j.pmedr.2022.102056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 10/03/2022] [Accepted: 11/14/2022] [Indexed: 11/16/2022] Open
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16
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Kirsh VA, Skead K, McDonald K, Kreiger N, Little J, Menard K, McLaughlin J, Mukherjee S, Palmer LJ, Goel V, Purdue MP, Awadalla P. Cohort Profile: The Ontario Health Study (OHS). Int J Epidemiol 2022; 52:e137-e151. [PMID: 35962976 DOI: 10.1093/ije/dyac156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 07/20/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Victoria A Kirsh
- Ontario Institute for Cancer Research, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada (formerly for N.K.)
| | - Kimberly Skead
- Ontario Institute for Cancer Research, Toronto, ON, Canada.,Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
| | - Kelly McDonald
- Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - Nancy Kreiger
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada (formerly for N.K.).,Prevention and Cancer Control, Ontario Health, Cancer Care Ontario, Toronto, ON, Canada
| | - Julian Little
- Faculty of Medicine, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Karen Menard
- Office of Institutional Research and Planning, University of Guelph, Guelph, ON, Canada
| | - John McLaughlin
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada (formerly for N.K.)
| | - Sutapa Mukherjee
- Adelaide Institute for Sleep Health, Flinders University, Adelaide, South Australia, Australia
| | - Lyle J Palmer
- School of Public Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Vivek Goel
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada (formerly for N.K.).,Office of the President, University of Waterloo, Waterloo, ON, Canada
| | - Mark P Purdue
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Philip Awadalla
- Ontario Institute for Cancer Research, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada (formerly for N.K.).,Department of Molecular Genetics, University of Toronto, Toronto, ON, Canada
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17
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Development and validation of a hypertension risk prediction model and construction of a risk score in a Canadian population. Sci Rep 2022; 12:12780. [PMID: 35896590 PMCID: PMC9329335 DOI: 10.1038/s41598-022-16904-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 07/18/2022] [Indexed: 11/09/2022] Open
Abstract
Identifying high-risk individuals for targeted intervention may prevent or delay hypertension onset. We developed a hypertension risk prediction model and subsequent risk sore among the Canadian population using measures readily available in a primary care setting. A Canadian cohort of 18,322 participants aged 35-69 years without hypertension at baseline was followed for hypertension incidence, and 625 new hypertension cases were reported. At a 2:1 ratio, the sample was randomly divided into derivation and validation sets. In the derivation sample, a Cox proportional hazard model was used to develop the model, and the model's performance was evaluated in the validation sample. Finally, a risk score table was created incorporating regression coefficients from the model. The multivariable Cox model identified age, body mass index, systolic blood pressure, diabetes, total physical activity time, and cardiovascular disease as significant risk factors (p < 0.05) of hypertension incidence. The variable sex was forced to enter the final model. Some interaction terms were identified as significant but were excluded due to their lack of incremental predictive capacity. Our model showed good discrimination (Harrel's C-statistic 0.77) and calibration (Grønnesby and Borgan test, [Formula: see text] statistic = 8.75, p = 0.07; calibration slope 1.006). A point-based score for the risks of developing hypertension was presented after 2-, 3-, 5-, and 6 years of observation. This simple, practical prediction score can reliably identify Canadian adults at high risk of developing incident hypertension in the primary care setting and facilitate discussions on modifying this risk most effectively.
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18
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Associations between neighbourhood street connectivity and sedentary behaviours in Canadian adults: Findings from Alberta’s Tomorrow Project. PLoS One 2022; 17:e0269829. [PMID: 35771873 PMCID: PMC9246119 DOI: 10.1371/journal.pone.0269829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 05/30/2022] [Indexed: 11/19/2022] Open
Abstract
Evidence suggests that neighbourhood street connectivity is positively associated with physical activity, yet few studies have estimated its associations with sedentary behaviour. We estimated the associations between space syntax derived street integration, a novel measure of street connectivity, and sedentary behaviours among Canadian adults. Data were sourced from a population-based study–Alberta’s Tomorrow Project (n = 14,758). Items from the International Physical Activity Questionnaire captured sedentary behaviour, including sitting and motor vehicle travel time and walking. Street integration was measured within a 1600m radius of participants’ homes. Covariate-adjusted linear regression models estimated the associations between street integration and sedentary behaviour. Street integration was significantly positively associated with daily minutes of sitting on week (b 6.44; 95CI 3.60, 9.29) and weekend (b 4.39; 95CI 1.81, 6.96) days, and for week and weekend days combined (b 5.86; 95CI 3.30, 8.41) and negatively associated with daily minutes of motor vehicle travel (b -3.72; 95CI -3.86, -1.55). These associations remained significant after further adjustment for daily walking participation and duration. More research is needed to understand the pathways by which street integration positively and or negatively affects sedentary behaviour.
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19
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Christie CD, Friedenreich CM, Vena JE, Turley L, McCormack GR. Cross-sectional and longitudinal associations between the built environment and walking: effect modification by socioeconomic status. BMC Public Health 2022; 22:1233. [PMID: 35729509 PMCID: PMC9210749 DOI: 10.1186/s12889-022-13611-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 06/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although socioeconomic status (SES) has been shown to modify associations between the neighborhood built environment and physical activity, contradictory results exist. Objectives of this cross-sectional and longitudinal analysis were to: 1) examine whether overall neighborhood walkability and specific built characteristics were associated with walking among adults at a single point in time and after they relocate neighborhoods, and 2) test for effect modification of these associations by SES. METHODS We linked longitudinal data from 703 adults who relocated urban neighborhoods between two waves of Alberta's Tomorrow Project (2008-2015) to neighborhood built environment data. We created a walkability index from measures of population counts, street connectivity, and destination diversity within 400 m of participants' homes. In cross-sectional analyses, we used generalized linear models to estimate associations between built characteristics and minutes walked per week at baseline. For the longitudinal analyses, we used fixed-effects linear regression models to estimate associations between changes in built characteristics and minutes walked per week. We also assessed if indicators of SES (individual education or household income) modified both sets of associations. RESULTS Most cross-sectional and longitudinal associations were small and statistically non-significant. Neighborhood population count (b = 0.03, 95% CI: 0.01, 0.07) and street connectivity (b = - 1.75, 95% CI: - 3.26, - 0.24) were cross-sectionally associated with walking duration among the overall sample. None of the longitudinal associations were statistically significant among the overall sample. There was limited evidence of effect modification by SES, however, we found negative cross-sectional associations between street connectivity and walking among adults with lower education and income, and a positive association between percent change in walkability and change in walking among lower educated adults. CONCLUSIONS Despite population count and street connectivity being associated with walking at baseline, changes in these built environment variables were not associated with changes in walking following residential relocation. Our findings also provide evidence, albeit weak, that changes in neighborhood walkability, resulting from residential relocation, might more strongly affect walking among low SES adults. Further longitudinal research is needed to examine built environment characteristics with walking for different purposes and to test for inequitable socioeconomic impacts.
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Affiliation(s)
- Chelsea D Christie
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, TRW 3rd floor, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada.
| | - Christine M Friedenreich
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, TRW 3rd floor, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada.,Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, 2210 2nd St SW, Calgary, Alberta, T2S 3C3, Canada
| | - Jennifer E Vena
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, TRW 3rd floor, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada.,Alberta's Tomorrow Project, Cancer Care Alberta, Alberta Health Services, Richmond Road Diagnostic and Treatment Centre, 1820 Richmond Road SW, Calgary, Alberta, T2T 5C7, Canada
| | - Liam Turley
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, TRW 3rd floor, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada
| | - Gavin R McCormack
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, TRW 3rd floor, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada.,School of Architecture, Planning and Landscape, University of Calgary, 2500 University Dr NW, Calgary, Alberta, T2N 4N1, Canada
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20
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Henneke L, Schlicht K, Andreani NA, Hollstein T, Demetrowitsch T, Knappe C, Hartmann K, Jensen-Kroll J, Rohmann N, Pohlschneider D, Geisler C, Schulte DM, Settgast U, Türk K, Zimmermann J, Kaleta C, Baines JF, Shearer J, Shah S, Shen-Tu G, Schwarz K, Franke A, Schreiber S, Laudes M. A dietary carbohydrate - gut Parasutterella - human fatty acid biosynthesis metabolic axis in obesity and type 2 diabetes. Gut Microbes 2022; 14:2057778. [PMID: 35435797 PMCID: PMC9037427 DOI: 10.1080/19490976.2022.2057778] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Recent rodent microbiome experiments suggest that besides Akkermansia, Parasutterella sp. are important in type 2 diabetes and obesity development. In the present translational human study, we aimed to characterize Parasutterella in our European cross-sectional FoCus cohort (n = 1,544) followed by validation of the major results in an independent Canadian cohort (n = 438). In addition, we examined Parasutterella abundance in response to a weight loss intervention (n = 55). Parasutterella was positively associated with BMI and type 2 diabetes independently of the reduced microbiome α/β diversity and low-grade inflammation commonly found in obesity. Nutritional analysis revealed a positive association with the dietary intake of carbohydrates but not with fat or protein consumption. Out of 126 serum metabolites differentially detectable by untargeted HPLC-based MS-metabolomics, L-cysteine showed the strongest reduction in subjects with high Parasutterella abundance. This is of interest, since Parasutterella is a known high L-cysteine consumer and L-cysteine is known to improve blood glucose levels in rodents. Furthermore, metabolic network enrichment analysis identified an association of high Parasutterella abundance with the activation of the human fatty acid biosynthesis pathway suggesting a mechanism for body weight gain. This is supported by a significant reduction of the Parasutterella abundance during our weight loss intervention. Together, these data indicate a role for Parasutterella in human type 2 diabetes and obesity, whereby the link to L-cysteine might be relevant in type 2 diabetes development and the link to the fatty acid biosynthesis pathway for body weight gain in response to a carbohydrate-rich diet in obesity development.
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Affiliation(s)
- Lea Henneke
- Institute of Diabetes and Clinical Metabolic Research, University of Kiel, Kiel, Germany
| | - Kristina Schlicht
- Institute of Diabetes and Clinical Metabolic Research, University of Kiel, Kiel, Germany
| | - Nadia A. Andreani
- Section of Evolutionary Medicine, Institute for Experimental Medicine University of Kiel, Kiel, Germany,Guest group for evolutionary medicine Max-Planck-Institute of Evolutionary Biology, Plön, Germany
| | - Tim Hollstein
- Institute of Diabetes and Clinical Metabolic Research, University of Kiel, Kiel, Germany
| | - Tobias Demetrowitsch
- Division of Food Technology, Department of Human Nutrition, University of Kiel, Kiel, Germany
| | - Carina Knappe
- Institute of Diabetes and Clinical Metabolic Research, University of Kiel, Kiel, Germany
| | - Katharina Hartmann
- Institute of Diabetes and Clinical Metabolic Research, University of Kiel, Kiel, Germany
| | - Julia Jensen-Kroll
- Division of Food Technology, Department of Human Nutrition, University of Kiel, Kiel, Germany
| | - Nathalie Rohmann
- Institute of Diabetes and Clinical Metabolic Research, University of Kiel, Kiel, Germany
| | - Daniela Pohlschneider
- Institute of Diabetes and Clinical Metabolic Research, University of Kiel, Kiel, Germany
| | - Corinna Geisler
- Institute of Diabetes and Clinical Metabolic Research, University of Kiel, Kiel, Germany
| | - Dominik M. Schulte
- Institute of Diabetes and Clinical Metabolic Research, University of Kiel, Kiel, Germany
| | - Ute Settgast
- Institute of Diabetes and Clinical Metabolic Research, University of Kiel, Kiel, Germany
| | - Kathrin Türk
- Institute of Diabetes and Clinical Metabolic Research, University of Kiel, Kiel, Germany
| | - Johannes Zimmermann
- Research Group Medical System Biology, Institute of Experimental Medicine, University of Kiel, Kiel, Germany
| | - Christoph Kaleta
- Research Group Medical System Biology, Institute of Experimental Medicine, University of Kiel, Kiel, Germany
| | - John F. Baines
- Section of Evolutionary Medicine, Institute for Experimental Medicine University of Kiel, Kiel, Germany,Guest group for evolutionary medicine Max-Planck-Institute of Evolutionary Biology, Plön, Germany
| | - Jane Shearer
- Department of Biochemistry and Molecular Biology, Cumming School of Medicine, Faculty Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Shrushti Shah
- Department of Biochemistry and Molecular Biology, Cumming School of Medicine, Faculty Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Grace Shen-Tu
- Alberta’s Tomorrow Project, Cancer Control Alberta, Alberta Health Services, Edmonton, AB, Canada
| | - Karin Schwarz
- Division of Food Technology, Department of Human Nutrition, University of Kiel, Kiel, Germany
| | - Andre Franke
- Institute of Clinical Molecular Biology, Kiel University, Kiel, Germany
| | - Stefan Schreiber
- Institute of Clinical Molecular Biology, Kiel University, Kiel, Germany
| | - Matthias Laudes
- Institute of Diabetes and Clinical Metabolic Research, University of Kiel, Kiel, Germany,Division of Endocrinology, Diabetes and Clinical Nutrition, Department of Medicine 1, University Medical Centre Schleswig-Holstein, Kiel University, Kiel, Germany,CONTACT Matthias Laudes Institute of Diabetes and Clinical Metabolic Research, University of Kiel, Düsternbrooker Weg 17, 24105Kiel, Germany
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Ye M, Vena JE, Johnson JA, Shen-Tu G, Eurich DT. Anti-Hyperglycemic Medication Adherence and Health Services Utilization in People with Diabetes: A Longitudinal Study of Alberta's Tomorrow Project. Patient Prefer Adherence 2022; 16:1457-1467. [PMID: 35722195 PMCID: PMC9199902 DOI: 10.2147/ppa.s362539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 05/13/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Little is known about the long-term (>2 years) relationship between the time-varying drug adherence and healthcare utilization for patients with diabetes. OBJECTIVE To characterize the relationship between time-varying anti-hyperglycemic medication adherence and healthcare utilization in patients with diabetes, using data from Alberta's Tomorrow Project, a population-based cohort study in Alberta, Canada. METHODS Incident cases of diabetes with at least 24 months of follow-up were included in the study. Anti-hyperglycemic drug adherence was measured by proportion of days covered (PDC) in the past 12 months for each year after diagnosis. The rate of healthcare utilization was assessed for the subsequent 12 months, 36 months and 60 months. A time-varying, negative binomial generalized estimating equation model was used to examine the association between medication adherence and healthcare utilization. RESULTS Among 2155 incident cases of diabetes, average age at diagnosis was 59.6±9.3, 51.0% were female and average duration of follow-up was 7.3±3.7 (range, 2.0-16.2) years. The proportion of patients taking anti-hyperglycemic medications was 47.6% during the first year of diagnosis, which increased to 77.3% by the end of follow-up. Compared to adherent patients (PDC≥0.8), non-adherent patients (PDC<0.8) had substantially higher rate of all-cause hospitalization [incident rate ratio, IRR=1.48 (1.22-1.79), ED visits [1.30 (1.15-1.47)] and GP visits [1.17 (1.08-1.27)] in the subsequent 12 months. However, these associations became weaker with longer follow-up [eg, IRR=1.18 (0.98-1.39) and 1.05 (0.94-1.18) for all-cause hospitalization in the subsequent 36 and 60 months, respectively]. CONCLUSION Poor adherence among diabetic patients was associated with substantially higher rate of healthcare utilization in the short term (eg, 12 months); however, this association weakened over a longer period (eg, 36-60 months).
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Affiliation(s)
- Ming Ye
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Jennifer E Vena
- Alberta’s Tomorrow Project, CancerCare Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Jeffrey A Johnson
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Grace Shen-Tu
- Alberta’s Tomorrow Project, CancerCare Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Dean T Eurich
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
- Correspondence: Dean T Eurich, School of Public Health, University of Alberta, Canada, Email
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22
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Ghebrial M, Aktary ML, Wang Q, Spinelli JJ, Shack L, Robson PJ, Kopciuk KA. Predictors of CRC Stage at Diagnosis among Male and Female Adults Participating in a Prospective Cohort Study: Findings from Alberta's Tomorrow Project. Curr Oncol 2021; 28:4938-4952. [PMID: 34898587 PMCID: PMC8628758 DOI: 10.3390/curroncol28060414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 11/12/2021] [Accepted: 11/18/2021] [Indexed: 11/22/2022] Open
Abstract
Colorectal cancer (CRC) is a leading cause of morbidity and mortality in Canada. CRC screening and other factors associated with early-stage disease can improve CRC treatment efficacy and survival. This study examined factors associated with CRC stage at diagnosis among male and female adults using data from a large prospective cohort study in Alberta, Canada. Baseline data were obtained from healthy adults aged 35–69 years participating in Alberta’s Tomorrow Project. Factors associated with CRC stage at diagnosis were evaluated using Partial Proportional Odds models. Analyses were stratified to examine sex-specific associations. A total of 267 participants (128 males and 139 females) developed CRC over the study period. Among participants, 43.0% of males and 43.2% of females were diagnosed with late-stage CRC. Social support, having children, and caffeine intake were predictors of CRC stage at diagnosis among males, while family history of CRC, pregnancy, hysterectomy, menopausal hormone therapy, lifetime number of Pap tests, and household physical activity were predictive of CRC stage at diagnosis among females. These findings highlight the importance of sex differences in susceptibility to advanced CRC diagnosis and can help inform targets for cancer prevention programs to effectively reduce advanced CRC and thus improve survival.
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Affiliation(s)
- Monica Ghebrial
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada;
| | - Michelle L. Aktary
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada;
| | - Qinggang Wang
- Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB T2S 3C3, Canada;
| | - John J. Spinelli
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z3, Canada;
- Population Oncology, BC Cancer, Vancouver, BC V5Z 1L3, Canada
| | - Lorraine Shack
- Cancer Surveillance and Reporting, Alberta Health Services, Calgary, AB T2S 3C3, Canada;
| | - Paula J. Robson
- Department of Agricultural, Food and Nutritional Science and School of Public Health, University of Alberta, Edmonton, AB T6G 2P5, Canada;
- Cancer Care Alberta and Cancer Strategic Clinical Network, Alberta Health Services, Edmonton, AB T5J 3H1, Canada
| | - Karen A. Kopciuk
- Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB T2S 3C3, Canada;
- Departments of Oncology, Community Health Sciences and Mathematics and Statistics, University of Calgary, Calgary, AB T2N 4N2, Canada
- Correspondence:
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23
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Ye M, Vena JE, Johnson JA, Shen-Tu G, Eurich DT. Chronic disease surveillance in Alberta's tomorrow project using administrative health data. Int J Popul Data Sci 2021; 6:1672. [PMID: 34734125 PMCID: PMC8530189 DOI: 10.23889/ijpds.v6i1.1672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction Alberta’s Tomorrow Project (ATP) is the largest population-based prospective cohort study of cancer and chronic diseases in Alberta, Canada. The ATP cohort data were primarily self-reported by participants on lifestyle behaviors and disease risk factors at the enrollment, which lacks sufficient and accurate data on chronic disease diagnosis for longer-term follow-up. Objectives To characterize the occurrence rate and trend of chronic diseases in the ATP cohort by linking with administrative healthcare data. Methods A set of validated algorithms using ICD codes were applied to Alberta Health (AH) administrative data (October 2000-March 2018) linked to the ATP cohort to determine the prevalence and incidence of common chronic diseases. Results There were 52,770 ATP participants (51.2±9.4 years old at enrollment and 63.7% females) linked to the AH data with average follow-up of 10.1±4.4 years. In the ATP cohort, hypertension (18.5%), depression (18.1%), chronic pain (12.8%), osteoarthritis (10.1%) and cardiovascular diseases (8.7%) were the most prevalent chronic conditions. The incidence rates varied across diseases, with the highest rates for hypertension (22.1 per 1000 person-year), osteoarthritis (16.2 per 1000 person-year) and ischemic heart diseases (13.0 per 1000 person-year). All chronic conditions had increased prevalence over time (p < for trend tests), while incidence rates were relatively stable. The proportion of participants with two or more of these conditions (multi-morbidity) increased from 3.9% in 2001 to 40.3% in 2017. Conclusions This study shows an increasing trend of chronic diseases in the ATP cohort, particularly related to cardiovascular diseases and multi-morbidity. Using administrative health data to monitor chronic diseases for large population-based prospective cohort studies is feasible in Alberta, and our approach could be further applied in a broader research area, including health services research, to enhance research capacity of these population-based studies in Canada.
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Affiliation(s)
- Ming Ye
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada, T6G 2E1
| | - Jennifer E Vena
- Alberta's Tomorrow Project, Cancer Care Alberta, Alberta Health Services, Alberta, Canada, T2T 5C7
| | - Jeffrey A Johnson
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada, T6G 2E1
| | - Grace Shen-Tu
- Alberta's Tomorrow Project, Cancer Care Alberta, Alberta Health Services, Alberta, Canada, T2T 5C7
| | - Dean T Eurich
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada, T6G 2E1
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Knoppers BM, Beauvais MJS. Three decades of genetic privacy: a metaphoric journey. Hum Mol Genet 2021; 30:R156-R160. [PMID: 34155499 PMCID: PMC8490012 DOI: 10.1093/hmg/ddab164] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 06/14/2021] [Accepted: 06/16/2021] [Indexed: 12/03/2022] Open
Abstract
Debates surrounding genetic privacy have taken on different forms over the past 30 years. Taking genetic privacy to mean an interest that individuals, families, or even communities have with respect to genetic information, we examine the metaphors used in these debates to chronicle the development of genetic privacy. In 1990-2000, we examine claims for ownership and of 'humanity' spurred by the launch of the Human Genome Project and related endeavors. In 2000-2010, we analyze the interface of law and ethics with research infrastructures such as biobanks, for which notions of citizenship and 'public goods' were central. In 2010-2020, we detail the relational turn of genetic privacy in response of large international research consortia and big data. Although each decade had its leading conceptions of genetic privacy, the subject is neither strictly chronological nor static. We conclude with reflections on the nature of genetic privacy and the necessity to bring together the unique and private genetic self with the human other.
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Affiliation(s)
- Bartha Maria Knoppers
- Centre of Genomics and Policy, Department of Human Genetics, Faculty of Medicine, McGill University, 740 av Dr Penfield, Montreal, Quebec H3A 0G1 Canada
- Canada Research Chair in Law and Medicine
| | - Michael J S Beauvais
- Centre of Genomics and Policy, Department of Human Genetics, Faculty of Medicine, McGill University, 740 av Dr Penfield, Montreal, Quebec H3A 0G1 Canada
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Associations between neighbourhood built characteristics and sedentary behaviours among Canadian men and women: findings from Alberta's Tomorrow Project. Prev Med 2021; 150:106663. [PMID: 34087320 DOI: 10.1016/j.ypmed.2021.106663] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 05/21/2021] [Accepted: 05/29/2021] [Indexed: 02/08/2023]
Abstract
Evidence of associations between neighbourhood built characteristics and sedentary behaviours is mixed. The study aim was to investigate the associations between objectively-derived neighbourhood built characteristics and self-reported sedentary behaviours among Canadian men and women. This study sourced survey data from Alberta's Tomorrow Project (2008; n = 14,785), in which sitting and motor vehicle travel times during the last 7 days was measured. Geographic Information System was used to calculate neighbourhood built characteristics within a 400 m buffer of participant's home and a walkability score was estimated. To estimate the associations between neighbourhood characteristics and sedentary behaviours, covariate-adjusted generalized linear regression models were used. Walkability, 3-way intersections, and population count were positively associated with sitting time. Business destinations and greenness were negatively associated with sitting time. Walkability, 3-way, and 4-way intersections were negatively associated with motor vehicle travel time. Sex-specific associations between neighbourhood characteristics and sedentary behaviour were found. Among men, business destinations were negatively associated with sitting time, and 3-way intersections, population count, and walkability were negatively associated with motor vehicle travel time. Among women, Normalized Difference Vegetation Index was negatively associated with sitting time. Interventions to reduce sedentary behaviours may need to target neighbourhoods that have built characteristics which might support these behaviours. More research is needed to disentangle the complex relationships between different neighbourhood built characteristics and specific types of sedentary behaviour.
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Lo Siou G, Akawung AK, Solbak NM, McDonald KL, Al Rajabi A, Whelan HK, Kirkpatrick SI. The effect of different methods to identify, and scenarios used to address energy intake misestimation on dietary patterns derived by cluster analysis. Nutr J 2021; 20:42. [PMID: 33964947 PMCID: PMC8106845 DOI: 10.1186/s12937-021-00696-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 04/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND All self-reported dietary intake data are characterized by measurement error, and validation studies indicate that the estimation of energy intake (EI) is particularly affected. METHODS Using self-reported food frequency and physical activity data from Alberta's Tomorrow Project participants (n = 9847 men 16,241 women), we compared the revised-Goldberg and the predicted total energy expenditure methods in their ability to identify misreporters of EI. We also compared dietary patterns derived by k-means clustering under different scenarios where misreporters are included in the cluster analysis (Inclusion); excluded prior to completing the cluster analysis (ExBefore); excluded after completing the cluster analysis (ExAfter); and finally, excluded before the cluster analysis but added to the ExBefore cluster solution using the nearest neighbor method (InclusionNN). RESULTS The predicted total energy expenditure method identified a significantly higher proportion of participants as EI misreporters compared to the revised-Goldberg method (50% vs. 47%, p < 0.0001). k-means cluster analysis identified 3 dietary patterns: Healthy, Meats/Pizza and Sweets/Dairy. Among both men and women, participants assigned to dietary patterns changed substantially between ExBefore and ExAfter and also between the Inclusion and InclusionNN scenarios (Hubert and Arabie's adjusted Rand Index, Kappa and Cramer's V statistics < 0.8). CONCLUSIONS Different scenarios used to account for EI misreporters influenced cluster analysis and hence the composition of the dietary patterns. Continued efforts are needed to explore and validate methods and their ability to identify and mitigate the impact of EI misestimation in nutritional epidemiology.
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Affiliation(s)
- Geraldine Lo Siou
- Cancer Research & Analytics, Alberta Health Services, Richmond Road Diagnostic & Treatment Centre, 1820 Richmond Rd SW, Calgary, Alberta, T2T 5C7, Canada
| | - Alianu K Akawung
- Cancer Research & Analytics, Alberta Health Services, Richmond Road Diagnostic & Treatment Centre, 1820 Richmond Rd SW, Calgary, Alberta, T2T 5C7, Canada
| | - Nathan M Solbak
- Cancer Research & Analytics, Alberta Health Services, Richmond Road Diagnostic & Treatment Centre, 1820 Richmond Rd SW, Calgary, Alberta, T2T 5C7, Canada
| | - Kathryn L McDonald
- Cancer Research & Analytics, Alberta Health Services, Richmond Road Diagnostic & Treatment Centre, 1820 Richmond Rd SW, Calgary, Alberta, T2T 5C7, Canada.
| | - Ala Al Rajabi
- Cancer Research & Analytics, Alberta Health Services, Richmond Road Diagnostic & Treatment Centre, 1820 Richmond Rd SW, Calgary, Alberta, T2T 5C7, Canada
- Health Sciences Department, College of Natural and Health Sciences, Zayed University, Abu Dhabi, UAE
| | - Heather K Whelan
- Department of Health and Physical Education, Faculty of Health, Community and Education, Mount Royal University, Calgary, AB, Canada
| | - Sharon I Kirkpatrick
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada
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A longitudinal residential relocation study of changes in street layout and physical activity. Sci Rep 2021; 11:7691. [PMID: 33833261 PMCID: PMC8032714 DOI: 10.1038/s41598-021-86778-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 03/19/2021] [Indexed: 11/18/2022] Open
Abstract
Few longitudinal residential relocation studies have explored associations between urban form and physical activity, and none has used the Space Syntax theory. Using a Canadian longitudinal dataset (n = 5944), we estimated: (1) differences in physical activity between non-movers, and those relocating to neighbourhoods with less or more integrated street layouts, and; (2) associations between changes in street layout integration exposure and differences in physical activity. Adjusting for covariates, we found relative to non-movers, those who moved to more integrated neighbourhoods undertook significantly (p < .05) more leisure walking (27.3 min/week), moderate-intensity (45.7 min/week), and moderate-to-vigorous intensity physical activity (54.4 min/week). Among movers, a one-unit increase in the relative change in street integration exposure ([Street integration at follow-up—street integration at baseline]/street integration at baseline) was associated with a 7.5 min/week increase in leisure walking. Our findings suggest that urban design policies that improve neighbourhood street integration might encourage more physical activity in adults.
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Newell M, Ghosh S, Goruk S, Pakseresht M, Vena JE, Dummer TJB, Field CJ. A Prospective Analysis of Plasma Phospholipid Fatty Acids and Breast Cancer Risk in 2 Provinces in Canada. Curr Dev Nutr 2021; 5:nzab022. [PMID: 33889794 PMCID: PMC8049855 DOI: 10.1093/cdn/nzab022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/23/2021] [Accepted: 03/09/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Studies suggest that fatty acid status influences breast cancer etiology, yet the roles of individual fatty acids in breast cancer risk are unclear, specifically when central adiposity and menopausal status are considered. OBJECTIVES This study examined the associations of fatty acid status with breast cancer risk including location, menopausal status, and waist-to-hip ratio as key variables. METHODS Prediagnostic plasma phospholipid fatty acids were measured in women with breast cancer (n = 393) and age-matched controls (n = 786) from a nested case-control prospective study within Alberta's Tomorrow Project (ATP) and British Columbia Generations Project (BCGP) cohorts. Binary logistic regression models were used to evaluate associations of fatty acids and breast cancer risk with subgroup analysis for menopausal status and waist-to-hip ratio. RESULTS Women from BCGP had a higher n-3 (ɷ-3) fatty acid status compared with the ATP (6.4% ± 0.08% vs. 5.3% ± 0.06%; P < 0.001), so subsequent analysis was blocked by cohort. Overall, fatty acids had inconsistent associations with risk. In the ATP among premenopausal women, total long-chain n-3 fatty acids (ORQ4vsQ1 = 1.78; 95% CI: 0.58, 5.43; P-trend = 0.007, P-interaction = 0.07) were positively associated with breast cancer risk, whereas in BCGP, DHA (ORQ4vsQ1 = 0.66; 95% CI: 0.28, 1.53; P-trend = 0.03, P-interaction = 0.05) and total long-chain n-3 fatty acids (ORQ4vsQ1 = 0.66; 95% CI: 0.28, 1.54; P-trend = 0.03) were associated with decreased cancer risk when the waist-to-hip ratio was <0.85. CONCLUSIONS Our findings suggest that regional variations in fatty acid status influence breast cancer risk, resulting in positive associations of total long-chain n-3 fatty acids in premenopausal ATP women and negative associations of these fatty acids in BCGP women with a waist-to-hip ratio below guidelines. This study highlights the complexity and difficulty in using fatty acid status to predict breast cancer risk in diverse populations without the consideration of other risk factors.
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Affiliation(s)
- Marnie Newell
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Canada
| | - Sunita Ghosh
- Department of Medical Oncology, University of Alberta, Edmonton, Canada
| | - Susan Goruk
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Canada
| | - Mohammedreza Pakseresht
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Canada
| | - Jennifer E Vena
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Canada
- Alberta's Tomorrow Project, CancerCare Alberta, Alberta Health Services, Calgary, Canada
| | - Trevor J B Dummer
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
- Cancer Control Research, BC Cancer, Vancouver, Canada
| | - Catherine J Field
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Canada
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Hu L, Harper A, Heer E, McNeil J, Cao C, Park Y, Martell K, Gotto G, Shen-Tu G, Peters C, Brenner D, Yang L. Social Jetlag and Prostate Cancer Incidence in Alberta's Tomorrow Project: A Prospective Cohort Study. Cancers (Basel) 2020; 12:E3873. [PMID: 33371502 PMCID: PMC7767515 DOI: 10.3390/cancers12123873] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Revised: 12/14/2020] [Accepted: 12/17/2020] [Indexed: 12/27/2022] Open
Abstract
We investigated the association of social jetlag (misalignment between the internal clock and socially required timing of activities) and prostate cancer incidence in a prospective cohort in Alberta, Canada. Data were collected from 7455 cancer-free men aged 35-69 years enrolled in Alberta's Tomorrow Project (ATP) from 2001-2007. In the 2008 survey, participants reported usual bed- and wake-times on weekdays and weekend days. Social jetlag was defined as the absolute difference in waking time between weekday and weekend days, and was categorized into three groups: 0-<1 h (from 0 to anything smaller than 1), 1-<2 h (from 1 to anything smaller than 2), and 2+ h. ATP facilitated data linkage with the Alberta Cancer Registry in June 2018 to determine incident prostate cancer cases (n = 250). Hazard ratios (HR) were estimated using Cox proportional hazards regressions, adjusting for a range of covariates. Median follow-up was 9.57 years, yielding 68,499 person-years. Baseline presence of social jetlag of 1-<2 h (HR = 1.52, 95% CI: 1.10 to 2.01), and 2+ hours (HR = 1.69, 95% CI: 1.15 to 2.46) were associated with increased prostate cancer risk vs. those reporting no social jetlag (p for trend = 0.004). These associations remained after adjusting for sleep duration (p for trend = 0.006). With respect to chronotype, the association between social jetlag and prostate cancer risk remained significant in men with early chronotypes (p for trend = 0.003) but attenuated to null in men with intermediate (p for trend = 0.150) or late chronotype (p for trend = 0.381). Our findings suggest that greater than one hour of habitual social jetlag is associated with an increased risk of prostate cancer. Longitudinal studies with repeated measures of social jetlag and large samples with sufficient advanced prostate cancer cases are needed to confirm these findings.
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Affiliation(s)
- Liang Hu
- Department of Sport and Exercise Science, Zhejiang University, Hangzhou 310028, China;
- Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB T2S 3C3, Canada; (A.H.); (E.H.); (J.M.); (C.P.)
| | - Andrew Harper
- Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB T2S 3C3, Canada; (A.H.); (E.H.); (J.M.); (C.P.)
| | - Emily Heer
- Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB T2S 3C3, Canada; (A.H.); (E.H.); (J.M.); (C.P.)
| | - Jessica McNeil
- Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB T2S 3C3, Canada; (A.H.); (E.H.); (J.M.); (C.P.)
| | - Chao Cao
- Department of Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA;
| | - Yikyung Park
- Program of Physical Therapy, Washington University School of Medicine, St. Louis, MO 63110, USA;
| | - Kevin Martell
- Department of Oncology, University of Calgary, Calgary, AB T2N 4N2, Canada; (K.M.); (D.B.)
| | - Geoffrey Gotto
- Department of Surgery, University of Calgary, Calgary, AB T2N 4N2, Canada;
| | - Grace Shen-Tu
- Alberta’s Tomorrow Project, Cancer Care Alberta, Alberta Health Services, Calgary, AB T2T 5C7, Canada;
| | - Cheryl Peters
- Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB T2S 3C3, Canada; (A.H.); (E.H.); (J.M.); (C.P.)
- Program of Physical Therapy, Washington University School of Medicine, St. Louis, MO 63110, USA;
- Department of Community Health Sciences, University of Calgary, Calgary, AB T2N 1N4, Canada
| | - Darren Brenner
- Department of Oncology, University of Calgary, Calgary, AB T2N 4N2, Canada; (K.M.); (D.B.)
| | - Lin Yang
- Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, AB T2S 3C3, Canada; (A.H.); (E.H.); (J.M.); (C.P.)
- Department of Oncology, University of Calgary, Calgary, AB T2N 4N2, Canada; (K.M.); (D.B.)
- Department of Community Health Sciences, University of Calgary, Calgary, AB T2N 1N4, Canada
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30
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Hall RE, Tusevljak N, Wu CF, Ibrahim Q, Schulze K, Khan AM, Desai D, Awadalla P, Broet P, Dummer TJ, Hicks J, Tardif JC, Teo KK, Vena J, Lee D, Friedrich M, Anand SS, Tu JV. The Canadian Alliance for Healthy Hearts and Minds: How Well Does It Reflect the Canadian Population? CJC Open 2020; 2:599-609. [PMID: 33305220 PMCID: PMC7711015 DOI: 10.1016/j.cjco.2020.07.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 07/10/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The intent of the Canadian Alliance for Healthy Hearts and Minds (CAHHM) cohort is to understand the early determinants of subclinical cardiac and vascular disease and progression in adults selected from existing cohorts-the Canadian Partnership for Tomorrow's Health, the Prospective Urban and Rural Evaluation (PURE) cohort, and the Montreal Heart Institute Biobank. We evaluated how well the CAHHM-Health Services Research (CAHHM-HSR) subcohort reflects the Canadian population. METHODS A cross-sectional design was used among a prospective cohort of community-dwelling adults aged 35-69 years who met the CAHHM inclusion criteria, and a cohort of adults aged 35-69 years who responded to the 2015 Canadian Community Health Survey-Rapid Response module. The INTERHEART risk score was calculated at the individual level with means and proportions reported at the overall and provincial level. RESULTS There are modest differences between CAHHM-HSR study participants and the 2015 Canadian Community Health Survey-Rapid Response respondents in age (56.3 vs 51.7 mean years), proportion of men (44.9% vs 49.3%), and mean INTERHEART risk score (9.7 vs 10.1). Larger differences were observed in postsecondary education (86.8% vs 70.2%), Chinese ethnicity (11.0% vs 3.3%), obesity (23.2% vs 29.3%), current smoker status (6.1% vs 18.4%), and having no cardiac testing (30.4% vs 55.9%). CONCLUSIONS CAHHM-HSR participants are older, of higher socioeconomic status, and have a similar mean INTERHEART risk score, compared with participants in the Canadian Community Health Survey. Differing sampling strategies and missing data may explain some differences between the CAHHM-HSR cohort and Canadian community-dwelling adults and should be considered when using the CAHHM-HSR for scientific research.
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Affiliation(s)
- Ruth E. Hall
- ICES, Toronto, Ontario, Canada
- Institute for Health Policy Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | | | - Quazi Ibrahim
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Department of Health Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Karleen Schulze
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | | | - Dipika Desai
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Philip Awadalla
- Department of Molecular Genetics, Ontario Institute for Cancer Research, University of Toronto, Toronto, Ontario, Canada
| | - Philippe Broet
- Department of Preventive and Social Medicine, School of Public Health, Montré University, Montreal, Quebec, Canada
- Research Centre, CHU Sainte Justine, Montreal, Quebec, Canada
| | - Trevor J.B. Dummer
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
- BC Cancer Agency, Vancouver, British Columbia, Canada
| | - Jason Hicks
- Atlantic PATH, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jean-Claude Tardif
- Research Centre, Montreal Heart Institute, University of Montreal, Montreal, Quebec, Canada
| | - Koon K. Teo
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Department of Health Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Jennifer Vena
- Cancer Research and Analytics, Cancer Control Alberta, Alberta Health Services, Edmonton, Alberta, Canada
| | - Douglas Lee
- ICES, Toronto, Ontario, Canada
- Institute for Health Policy Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada
- Ted Rogers Centre for Heart Research, Toronto, Ontario, Canada
| | - Matthias Friedrich
- Department of Medicine and Diagnostic Radiology, McGill University, Montreal, Quebec, Canada
| | - Sonia S. Anand
- Population Health Research Institute, Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Department of Health Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Jack V. Tu
- ICES, Toronto, Ontario, Canada
- Peter Munk Cardiac Centre, University Health Network, Toronto, Ontario, Canada
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Price TR, Friedenreich CM, Robson PJ, Li H, Brenner DR. High-sensitivity C-reactive protein, hemoglobin A1c and breast cancer risk: a nested case-control study from Alberta's Tomorrow Project cohort. Cancer Causes Control 2020; 31:1057-1068. [PMID: 32959132 DOI: 10.1007/s10552-020-01329-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 07/24/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE Our aim is to examine the associations between high-sensitivity C-reactive protein (hsCRP) and hemoglobin A1c (HbA1c), common biomarkers of inflammation and insulin resistance, respectively, with breast cancer risk, while adjusting for measures of excess body size. METHODS We conducted a nested case-control study within the Alberta's Tomorrow Project cohort (Alberta, Canada) including 197 incident breast cancer cases and 394 matched controls. The sample population included both pre- and postmenopausal women. Serum concentrations of hsCRP and HbA1c were measured from blood samples collected at baseline, along with anthropometric measurements, general health and lifestyle data. Conditional logistic regression was used to evaluate associations between hsCRP, HbA1c, and breast cancer risk adjusted for excess body size (body fat percentage) and other risk factors for breast cancer. RESULTS Higher concentrations of hsCRP were associated with elevated breast cancer risk (odds ratio [OR] 1.27; 95% confidence interval [95% CI] 1.03-1.55). The observed associations were unchanged with adjustment for body fat percentage. Higher HbA1c concentrations were not significantly associated with an increased breast cancer risk (OR 1.22; 95% CI 0.17-8.75). CONCLUSION These data suggest that hsCRP may be associated with elevated breast cancer risk, independent of excess body size. However, elevated concentrations of HbA1c did not appear to increase breast cancer risk in apparently healthy women.
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Affiliation(s)
- Tiffany R Price
- Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, AB, Canada
| | - Paula J Robson
- Cancer Research & Analytics, CancerControl Alberta, Alberta Health Services, Edmonton, AB, Canada
| | - Haocheng Li
- Department of Mathematics and Statistics, University of Calgary, Calgary, AB, Canada
| | - Darren R Brenner
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, AB, Canada.
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Diet Quality and Health Service Utilization for Depression: A Prospective Investigation of Adults in Alberta's Tomorrow Project. Nutrients 2020; 12:nu12082437. [PMID: 32823652 PMCID: PMC7468802 DOI: 10.3390/nu12082437] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/02/2020] [Accepted: 08/11/2020] [Indexed: 12/21/2022] Open
Abstract
Depression is a leading cause of disability and economic burden worldwide. Primary prevention strategies are urgently needed. We examined the association of diet quality with depression in a large provincial cohort of adults. A past year food frequency questionnaire was completed by Alberta’s Tomorrow Project (ATP) participants enrolled between 2000–2008 (n = 25,016; average age 50.4 years) and used to calculate Healthy Eating Index-Canada (HEI-C) 2015 scores. The number of physician visits for depression 2000–2015 was obtained via linkage with administrative health records. Negative binomial regression models assessed the relationship between HEI-C 2015 scores and physician visits for depression, adjusting for confounders. Every 10-unit increase in HEI-C 2015 scores was associated with 4.7% fewer physician visits for depression (rate ratio (RR): 0.95; 95% Confidence Interval (CI): 0.92–0.98). This relationship persisted when participants with physician visits for mental illness prior to cohort enrollment were excluded. Higher quality diets were associated with a lower number of physician visits for depression. Results highlight diet may be an important prevention strategy for reducing the burden of health service utilization for depression.
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Gilfoyle M, Chaurasia A, Garcia J, Oremus M. Perceived susceptibility to developing cancer and screening for colorectal and prostate cancer: A longitudinal analysis of Alberta's Tomorrow Project. J Med Screen 2020; 28:148-157. [PMID: 32700624 DOI: 10.1177/0969141320941900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
INTRODUCTION To assess the association between perceived susceptibility of developing cancer and being screened via sigmoidoscopy/colonoscopy and prostate-specific antigen, respectively. METHODS Participants aged 35-69, who resided in Alberta, Canada, were enrolled into the study between 2000 and 2008. We used general linear mixed models, adjusted for age, marital status, work status, education, family history and place of residence, to explore the association. RESULTS Perceived susceptibility of developing cancer was associated with both screening tests at baseline and a maximum of 14-year follow-up: (i) colorectal cancer screening - adjusted odds ratios were 1.97 (95% CI = 1.52-2.55) per one-unit increase in participants' personal belief in susceptibility to cancer, and 1.03 (95% CI = 1.00-1.04) per one-percent increase in participants' estimate of their own chance of developing cancer; (ii) prostate cancer screening - adjusted odds ratios were 1.36 times greater (95% CI = 1.07-1.72), and 1.02 times higher (95% CI = 1.01-1.03), for each respective perceived susceptibility measure. CONCLUSION Health promotion can focus on targeting and heightening personal perceived susceptibility of developing cancer in jurisdictions with low screening rates for colorectal or prostate cancer.
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Affiliation(s)
- Meghan Gilfoyle
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada
| | - Ashok Chaurasia
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada
| | - John Garcia
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada
| | - Mark Oremus
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada
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Nichani V, Turley L, Vena JE, McCormack GR. Associations between the neighbourhood characteristics and body mass index, waist circumference, and waist-to-hip ratio: Findings from Alberta's Tomorrow Project. Health Place 2020; 64:102357. [PMID: 32479266 DOI: 10.1016/j.healthplace.2020.102357] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 04/27/2020] [Accepted: 05/11/2020] [Indexed: 12/19/2022]
Abstract
This study estimated the associations between neighbourhood characteristics and self-reported body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) risk categories among Canadian men and women. Using data from the Alberta's Tomorrow Project (n = 14,550), we estimated 3- and 4-way intersections, business destinations, population count, and normalized difference vegetation index (NDVI) within a 400 m radius of participant's home. Intersections, business destinations, and population count (z-scores) were summed to create a walkability score. Four-way intersections and walkability were negatively associated with overweight and obesity. Walkability was negatively associated with obesity. NDVI was negatively associated with high-risk WHR and population count and walkability positively associated with high-risk WHR. Among men, population count and walkability were negatively associated with obesity, and business destinations and walkability were negatively associated with overweight and obesity. Among women, NDVI was negatively associated with overweight (including obesity), obesity, and high-risk WC. Interventions promoting healthy weight could incorporate strategies that take into consideration local built environment characteristics.
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Affiliation(s)
- Vikram Nichani
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, TRW 3rd Floor, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada.
| | - Liam Turley
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, TRW 3rd Floor, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada.
| | - Jennifer E Vena
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, TRW 3rd Floor, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada; Cancer Control Alberta, Alberta Health Services, 1820 Richmond Road SW, Calgary, Alberta, T2T 5C7, Canada.
| | - Gavin R McCormack
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, TRW 3rd Floor, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada.
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Nichani V, Vena JE, Friedenreich CM, Christie C, McCormack GR. A population-based study of the associations between neighbourhood walkability and different types of physical activity in Canadian men and women. Prev Med 2019; 129:105864. [PMID: 31654728 DOI: 10.1016/j.ypmed.2019.105864] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 10/01/2019] [Accepted: 10/11/2019] [Indexed: 11/19/2022]
Abstract
Few Canadian studies have examined whether or not associations between neighbourhood walkability and physical activity differ by sex. We estimated associations between perceived neighbourhood walkability and physical activity among Canadian men and women. This study included cross-sectional survey data from participants in 'Alberta's Tomorrow Project' (Canada; n = 14,078), a longitudinal cohort study. The survey included socio-demographic items as well as the International Physical Activity Questionnaire (IPAQ) and the abbreviated Neighbourhood Environment Walkability Scale (NEWS-A), which captured perceived neighbourhood built characteristics. We computed subscale and overall walkability scores from NEWS-A responses. Covariate-adjusted generalized linear models estimated the associations of participation (≥10 min/week) and minutes of different types of physical activity, including transportation walking (TW), leisure walking (LW), moderate-intensity physical activity (MPA), and vigorous-intensity physical activity (VPA) with walkability scores. Walkability was positively associated with participation in TW, LW, MPA and VPA and minutes of TW, LW, and VPA. Among men, a negative association was found between street connectivity and VPA participation. Additionally, crime safety was negatively associated with VPA minutes among men. Among women, pedestrian infrastructure was positively associated with LW participation and overall walkability was positively associated with VPA minutes. Notably, overall walkability was positively associated with LW participation among men and women. Different perceived neighbourhood walkability characteristics might be associated with participation and time spent in different types of physical activity among men and women living in Alberta. Interventions designed to modify perceptions of neighbourhood walkability might influence initiation or maintenance of different types of physical activity.
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Affiliation(s)
- Vikram Nichani
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, TRW 3rd floor, 3280 Hospital Drive NW, Calgary, Alberta T2N 4Z6, Canada.
| | - Jennifer E Vena
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, TRW 3rd floor, 3280 Hospital Drive NW, Calgary, Alberta T2N 4Z6, Canada; CancerControl Alberta, Alberta Health Services, Richmond Road Diagnostic and Treatment Centre, 1820 Richmond Road SW, Calgary, Alberta T2T 5C7, Canada.
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, 2210 2nd St SW, Calgary, Alberta T2S 3C3, Canada; Department of Community Health Sciences and Department of Oncology, Cumming School of Medicine, University of Calgary, TRW 3rd floor, 3280 Hospital Drive NW, Calgary, Alberta T2N 4Z6, Canada.
| | - Chelsea Christie
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, TRW 3rd floor, 3280 Hospital Drive NW, Calgary, Alberta T2N 4Z6, Canada.
| | - Gavin R McCormack
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, TRW 3rd floor, 3280 Hospital Drive NW, Calgary, Alberta T2N 4Z6, Canada.
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Strategies to Address Misestimation of Energy Intake Based on Self-Report Dietary Consumption in Examining Associations Between Dietary Patterns and Cancer Risk. Nutrients 2019; 11:nu11112614. [PMID: 31683814 PMCID: PMC6893710 DOI: 10.3390/nu11112614] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 10/24/2019] [Accepted: 10/29/2019] [Indexed: 11/16/2022] Open
Abstract
The objective of this study was to determine the influence of strategies of handling misestimation of energy intake (EI) on observed associations between dietary patterns and cancer risk. Data from Alberta's Tomorrow Project participants (n = 9,847 men and 16,241 women) were linked to the Alberta Cancer Registry. The revised-Goldberg method was used to characterize EI misestimation. Four strategies assessed the influence of EI misestimation: Retaining individuals with EI misestimation in the cluster analysis (Inclusion), excluding before (ExBefore) or after cluster analysis (ExAfter), or reassigning into ExBefore clusters using the nearest neighbor method (InclusionNN). Misestimation of EI affected approximately 50% of participants. Cluster analysis identified three patterns: Healthy, Meats/Pizza and Sweets/Dairy. Cox proportional hazard regression models assessed associations between the risk of cancer and dietary patterns. Among men, no significant associations (based on an often-used threshold of p < 0.05) between dietary patterns and cancer risk were observed. In women, significant associations were observed between the Sweets/Dairy and Meats/Pizza patterns and all cancer risk in the ExBefore (HR (95% CI): 1.28 (1.04-1.58)) and InclusionNN (HR (95% CI): 1.14 (1.00-1.30)), respectively. Thus, strategies to address misestimation of EI can influence associations between dietary patterns and disease outcomes. Identifying optimal approaches for addressing EI misestimation, for example, by leveraging biomarker-based studies could improve our ability to characterize diet-disease associations.
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Ye M, Vena JE, Johnson JA, Xu JY, Eurich DT. Validation of drug prescription records for senior patients in Alberta's Tomorrow Project: Assessing agreement between two population-level administrative pharmaceutical databases in Alberta, Canada. Pharmacoepidemiol Drug Saf 2019; 28:1417-1421. [PMID: 31348593 DOI: 10.1002/pds.4861] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 05/23/2019] [Accepted: 06/17/2019] [Indexed: 11/06/2022]
Abstract
PURPOSE To assess agreement between the Pharmaceutical Information Network (PIN), a newly implemented medication data repository in Alberta, Canada, and the Alberta Blue Cross (ABC) database, a long established database with medication records of all senior patients in Alberta. METHODS PIN data (2008-2015) were cross-validated with ABC medication records for senior participants (older than 65 years old) in Alberta's Tomorrow Project (ATP), a longitudinal cohort study in Alberta. The completeness and accuracy of PIN were respectively calculated as the percentage of ABC records coexisting (concordant) in PIN and the percentage of concordant records having mutually agreeable information on drug quantity. Generalized linear models were used to examine potential association of PIN completeness and accuracy with sociodemographic factors. RESULTS A total of 1 218 191 drug prescription records from 13 143 ATP participants were captured by PIN and ABC in 2008-2015, among which 91.6% were from PIN, 82.5% from ABC, and 74.2% coexisted in PIN and ABC. The overall completeness of PIN in capturing ABC medication records was 89.9%, with small variations (less than ±5%) across types of drugs. The completeness of PIN was improved on average by 1.3% annually over time (P < .001). PIN had 100% accuracy as defined by drug quantity data agreeable with ABC records. No significant associations were observed with age, sex, ethnicity, rural/urban areas, and socioeconomic status of the participants. CONCLUSIONS Cross-validated with the ABC dataset, our study showed that irrespective of drug type, PIN has a fairly good completeness (approximately 90%) and accuracy (100%) in capturing the ABC claimed medications for senior patients in Alberta.
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Affiliation(s)
- Ming Ye
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Jennifer E Vena
- Alberta's Tomorrow Project, CancerControl Alberta, Alberta Health Services, Alberta, Canada
| | - Jeffrey A Johnson
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Jian-Yi Xu
- Alberta's Tomorrow Project, CancerControl Alberta, Alberta Health Services, Alberta, Canada
| | - Dean T Eurich
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
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Ye M, Robson PJ, Eurich DT, Vena JE, Xu JY, Johnson JA. Anthropometric changes and risk of diabetes: are there sex differences? A longitudinal study of Alberta's Tomorrow Project. BMJ Open 2019; 9:e023829. [PMID: 31326923 PMCID: PMC6661609 DOI: 10.1136/bmjopen-2018-023829] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 02/19/2019] [Accepted: 06/21/2019] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES To characterise the sex-specific difference in the association between anthropometric changes and risk of diabetes in the general population in Canada. SETTING AND PARTICIPANTS From 2000 to 2008, Alberta's Tomorrow Project (ATP) invited Alberta's residents aged 35-69 years to a prospective cohort study. A total of 19 655 diabetes-free ATP participants having anthropometrics measured at the baseline and follow-ups were included. DESIGN AND OUTCOME MEASURES A longitudinal study design was used to examine the association between anthropometric changes and risk of diabetes and the sex difference in this association. Changes in weight, body mass index (BMI), waist circumference (WC) and waist-hip-ratio (WHR) were calculated as the difference between baseline and follow-up measures. Diabetes cases were identified using the Canadian National Diabetes Surveillance System algorithm with administrative healthcare data (2000-2015) linked to the ATP cohort. The sex-specific association between anthropometric changes and incidence of diabetes were examined by multivariable Cox regression models. RESULTS Changes in weight, BMI, WC and WHR over time were positively associated with incidence of diabetes in both men and women. The sex difference in risk of diabetes associated with 1 standard deviation (SD) increase in anthropometrics was 0.07 (95% CI -0.02 to 0.14) for weight, 0.08 (95% CI -0.03 to 0.17) for BMI, 0.07 (95% CI -0.02 to 0.15) for WC and 0.09 (95% CI 0.03 to 0.13) for WHR. Similar results were found in sex difference in the associations with changes per 5% and changes per categories (5% loss, ±5%, 5% gain). CONCLUSIONS The positive association between anthropometric changes and risk of diabetes was generally stronger in men than in women. However, this sex-specific difference of approximately 10% of the total risk associated with anthropometric changes had limited significance. For population-based public health programmes aiming to control obesity and incidence of diabetes, it may not be necessary to set up sex-specific goals for anthropometric reduction.
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Affiliation(s)
- Ming Ye
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Paula J Robson
- CancerControl Alberta, Alberta Health Services, Edmonton, Alberta, Canada
- Agricultural, Food and Nutritional Science, Faculty of Agricultural, Life & Environmental Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Dean T Eurich
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Jennifer E Vena
- Alberta's Tomorrow Project, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Jian-Yi Xu
- Alberta's Tomorrow Project, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Jeffrey A Johnson
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
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Impact of adherence to cancer-specific prevention recommendations on subsequent risk of cancer in participants in Alberta's Tomorrow Project. Public Health Nutr 2018; 22:235-245. [PMID: 30345944 PMCID: PMC6390391 DOI: 10.1017/s1368980018002689] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Objective The World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) publish recommendations for cancer prevention. The present study aimed to estimate the association between adherence to these cancer-specific prevention recommendations and subsequent development of cancer in a prospective cohort. Design A composite adherence score was constructed based on questionnaire data to reflect overall adherence to WCRF/AICR lifestyle-related recommendations on body fatness, physical activity, diet and alcoholic drinks. Multivariable Cox proportional hazard regression models were used to assess the association (hazard ratio; 95 % CI) between the adherence score and risk of developing cancer. Setting Alberta’s Tomorrow Project, a prospective cohort study. Participants Men and women (n 25 100, mean age at enrolment 50·5 years) recruited between 2001 and 2009 with no previous cancer diagnosis were included in analyses. Results Cancer cases (n 2066) were identified during a mean follow-up of 11·7 years. Participants who were most adherent to the selected WCRF/AICR recommendations (composite score: 4–6) were 13 % (0·87; 0·78, 0·98) less likely to develop cancer compared with those who were least adherent (composite score: 0–2). Each additional recommendation met corresponded to a 5 % (0·95; 0·91, 0·99) reduction in risk of developing cancer. When stratified by sex, the associations remained significant for women, but not for men. Conclusions Adherence to lifestyle-related cancer prevention recommendations was associated with reduced risk of developing cancer over the follow-up term in this Canadian cohort.
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Ye M, Robson PJ, Eurich DT, Vena JE, Xu JY, Johnson JA. Systemic use of antibiotics and risk of diabetes in adults: A nested case-control study of Alberta's Tomorrow Project. Diabetes Obes Metab 2018; 20:849-857. [PMID: 29152889 DOI: 10.1111/dom.13163] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 10/26/2017] [Accepted: 11/14/2017] [Indexed: 01/08/2023]
Abstract
AIMS Previous observational studies using administrative health records have suggested an increased risk of diabetes with use of antibiotics. However, unmeasured confounding factors may explain these results. This study characterized the association between systemic use of antibiotics and risk of diabetes in a cohort of adults in Canada, accounting for both clinical and self-reported disease risk factors. MATERIALS AND METHODS In this nested case-control study, we used data from Alberta's Tomorrow Project (ATP), a longitudinal cohort study in Canada, and the linked administrative health records (2000-2015). Incident cases of diabetes were matched with up to 8 age and sex-matched controls per case. Conditional logistic regression was used to examine the association between antibiotic exposures and incident diabetes after sequentially adjusting for important clinical and lifestyle factors. RESULTS This study included 1676 cases of diabetes and 13 401 controls. Although 17.9% of cases received more than 5 courses of antibiotics, compared to 13.8% of controls (P < .0001), the association between antibiotic use and risk of diabetes was progressively reduced as important clinical and lifestyle factors were accounted for. In fully adjusted models, compared to participants with 0 to 1 courses of antibiotics, participants receiving more antibiotics had no increased risk of diabetes [Odds Ratio, 0.97 (0.83-1.13) for 2 to 4 courses and 0.98 (0.82-1.18) for ≥5 courses]. CONCLUSIONS After adjustment for clinical and difficult-to-capture lifestyle data, we found no association between systemic use of antibiotics and risk of diabetes. Our results suggest that those positive associations observed in previous studies using only administrative records might have been confounded.
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Affiliation(s)
- Ming Ye
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Paula J Robson
- Alberta's Tomorrow Project, CancerControl Alberta, Alberta Health Services, Edmonton, Alberta, Canada
- Department of Agricultural, Food and Nutritional Science, Faculty of Agricultural, Life & Environmental Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Dean T Eurich
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Jennifer E Vena
- Alberta's Tomorrow Project, CancerControl Alberta, Alberta Health Services, Edmonton, Alberta, Canada
| | - Jian-Yi Xu
- Alberta's Tomorrow Project, CancerControl Alberta, Alberta Health Services, Edmonton, Alberta, Canada
| | - Jeffrey A Johnson
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
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Ye M, Robson PJ, Eurich DT, Vena JE, Xu JY, Johnson JA. Changes in body mass index and incidence of diabetes: A longitudinal study of Alberta's Tomorrow Project Cohort. Prev Med 2018; 106:157-163. [PMID: 29117506 DOI: 10.1016/j.ypmed.2017.10.036] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 09/11/2017] [Accepted: 10/30/2017] [Indexed: 02/08/2023]
Abstract
Although obesity is a known risk factor for diabetes, the impact of body mass index (BMI) changes over time, especially BMI reduction, on diabetes development is less than clear. The objective of this study is to characterize the association between BMI changes over time and incidence of diabetes in a cohort of adults in Alberta. From 2000 to 2008, Alberta's Tomorrow Project (ATP) enrolled participants aged 35-69 to a population-based prospective cohort study. BMI was calculated from self-reported height and weight; change in BMI (∆BMI) was calculated as the difference between baseline and follow-up measurements. Diabetes cases were identified using the Canadian National Diabetes Surveillance System algorithm applied to linked administrative data (2000-2015). Multivariable Cox regression was used to examine the association between ∆BMI and incidence of diabetes. In a subset of the ATP cohort (n=19,164), 1168 incident cases of diabetes were identified during 198,853person-years of follow-up. Overall, BMI increase was associated with increased risk and BMI reduction was associated with reduced risk of diabetes. Particularly, compared to minimal BMI change (±5%), moderate (5%-10%) reduction in BMI was associated with 34% (95% CI: 12%-51%) reduction in risk of diabetes in participants with obesity; whereas 10% or greater increase in BMI was associated with an increased risk of diabetes of 64% or more in participants with overweight and obesity; in participants with normal and underweight, BMI changes was not apparently associated with risk of diabetes. Public health programs promoting weight loss, even at a moderate extent, would reduce risk of diabetes.
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Affiliation(s)
- Ming Ye
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Paula J Robson
- Alberta's Tomorrow Project, CancerControl Alberta, Alberta Health Services, Alberta, Canada; Department of Agricultural, Food and Nutritional Science, Faculty of Agricultural, Life and Environmental Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Dean T Eurich
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Jennifer E Vena
- Alberta's Tomorrow Project, CancerControl Alberta, Alberta Health Services, Alberta, Canada
| | - Jian-Yi Xu
- Alberta's Tomorrow Project, CancerControl Alberta, Alberta Health Services, Alberta, Canada
| | - Jeffrey A Johnson
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
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