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Swann SA, King EM, Prior JC, Berger C, Mayer U, Pick N, Campbell AR, Côté HCF, Murray MCM. Longitudinal Assessment of Bone Mineral Density in Women Living With and Without HIV Across Reproductive Phases. J Acquir Immune Defic Syndr 2024; 95:197-206. [PMID: 37963371 DOI: 10.1097/qai.0000000000003336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 10/10/2023] [Indexed: 11/16/2023]
Abstract
BACKGROUND Women living with HIV commonly experience low areal bone mineral density (BMD), but whether this is affected by low ovarian hormonal states (prolonged amenorrhea or menopause) is unknown. We compared rates of BMD loss between women living with HIV and HIV-negative control women and investigated its association with low ovarian hormonal states. SETTING Women living with HIV were enrolled from Vancouver Canada and controls from 9 Canadian sites. METHODS This longitudinal analysis included age-matched women living with HIV in the Children and Women: AntiRetrovirals and Markers of Aging cohort and controls in the population-based Canadian Multicentre Osteoporosis Study. Rate of change/year in BMD at the total hip and lumbar spine (L1-L4) between 3 and 5 years was compared between groups, adjusting for sociodemographic and clinical variables. RESULTS Ninety-two women living with HIV (median [interquartile range] age: 49.5 [41.6-54.1] years and body mass index: 24.1 [20.7-30.8] kg/m 2 ) and 278 controls (age: 49.0 [43.0-55.0] years and body mass index: 25.8 [22.9-30.6] kg/m 2 ) were included. Total hip BMD loss was associated with HIV (β: -0.003 [95% CI: -0.006 to -0.0001] g/cm 2 /yr), menopause (β: -0.007 [-0.01 to -0.005] g/cm 2 /yr), and smoking (β: -0.003 [-0.006 to -0.0002] g/cm 2 /yr); BMD gain was linked with higher body mass index (β: 0.0002 [0.0007-0.0004] g/cm 2 /yr). Menopause was associated with losing L1-L4 BMD (β: -0.01 [-0.01 to -0.006] g/cm 2 /yr). Amenorrhea was not associated with BMD loss. CONCLUSIONS HIV and menopause negatively influenced total hip BMD. These data suggest women living with HIV require hip BMD monitoring as they age.
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Affiliation(s)
- Shayda A Swann
- Experimental Medicine, University of British Columbia, Vancouver, Canada
- Women's Health Research Institute, Vancouver, Canada
| | - Elizabeth M King
- Women's Health Research Institute, Vancouver, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Jerilynn C Prior
- Women's Health Research Institute, Vancouver, Canada
- Centre for Menstrual Cycle and Ovulation Research (CeMCOR), Endocrinology and Metabolism, University of British Columbia, Vancouver, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Claudie Berger
- CaM os National Coordinating Centre, McGill University, Montreal, Canada
| | - Ulrike Mayer
- Women's Health Research Institute, Vancouver, Canada
| | - Neora Pick
- Women's Health Research Institute, Vancouver, Canada
- Oak Tree Clinic, BC Women's Hospital and Health Centre, Vancouver, Canada
| | - Amber R Campbell
- Women's Health Research Institute, Vancouver, Canada
- Oak Tree Clinic, BC Women's Hospital and Health Centre, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
| | - Hélène C F Côté
- Experimental Medicine, University of British Columbia, Vancouver, Canada
- Women's Health Research Institute, Vancouver, Canada
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Canada
- Centre for Blood Research, University of British Columbia, Vancouver, Canada; and
- Edwin S.H. Leong Healthy Aging Program, University of British Columbia, Vancouver, Canada
| | - Melanie C M Murray
- Experimental Medicine, University of British Columbia, Vancouver, Canada
- Women's Health Research Institute, Vancouver, Canada
- Oak Tree Clinic, BC Women's Hospital and Health Centre, Vancouver, Canada
- Edwin S.H. Leong Healthy Aging Program, University of British Columbia, Vancouver, Canada
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Bird RP. Vitamin D and cancer. ADVANCES IN FOOD AND NUTRITION RESEARCH 2024; 109:92-159. [PMID: 38777419 DOI: 10.1016/bs.afnr.2023.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
The role of vitamin D in the prevention of chronic diseases including cancer, has received a great deal of attention during the past few decades. The term "Cancer" represents multiple disease states with varying biological complexities. The strongest link between vitamin D and cancer is provided by ecological and studies like observational, in preclinical models. It is apparent that vitamin D exerts diverse biological responses in a tissue specific manner. Moreover, several human factors could affect bioactivity of vitamin D. The mechanism(s) underlying vitamin D initiated anti-carcinogenic effects are diverse and includes changes at the muti-system levels. The oncogenic environment could easily corrupt the traditional role of vitamin D or could ensure resistance to vitamin D mediated responses. Several researchers have identified gaps in our knowledge pertaining to the role of vitamin D in cancer. Further areas are identified to solidify the role of vitamin D in cancer control strategies.
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Affiliation(s)
- Ranjana P Bird
- School of Health Sciences, University of Northern British Columbia, Prince George, BC, Canada.
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3
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Vatanparast H, Lane G, Islam N, Patil RP, Shafiee M, Whiting SJ. Comparative Analysis of Dietary and Supplemental Intake of Calcium and Vitamin D among Canadian Older Adults with Heart Disease and/or Osteoporosis in 2004 and 2015. Nutrients 2023; 15:5066. [PMID: 38140325 PMCID: PMC10745417 DOI: 10.3390/nu15245066] [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: 10/20/2023] [Revised: 12/08/2023] [Accepted: 12/10/2023] [Indexed: 12/24/2023] Open
Abstract
Despite the role of calcium and vitamin D in osteoporosis and heart disease, little research has examined changes in the intake of calcium and vitamin D among individuals with these conditions over time. Using data from the 2004 and 2015 Canadian Community Health Surveys, we investigated changes in dietary and supplemental intake of calcium and vitamin D among Canadian older adults aged ≥ 50 years, both with and without heart disease and/or osteoporosis, between 2004 and 2015. Notable declines in dietary calcium intake occurred, particularly among non-supplement users. Surprisingly, individuals with osteoporosis and heart disease, who are at higher nutritional risk, were less likely to use calcium supplements in 2015 compared to 2004. Among calcium supplement users, those with osteoporosis or both conditions experienced significant reductions in their usual calcium intake in 2015, with an increased proportion failing to meet recommended intake levels. Conversely, vitamin D supplement users experienced a substantial rise in vitamin D intake in 2015. In 2015, only a small proportion of supplement users did not meet the recommended vitamin D intake levels. These findings underscore the importance of public health initiatives to facilitate safe increases in calcium and vitamin D intake for older adults, particularly those with heart disease and osteoporosis.
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Affiliation(s)
- Hassan Vatanparast
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 4Z2, Canada; (N.I.); (R.P.P.); (M.S.); (S.J.W.)
- School of Public Health, University of Saskatchewan, Saskatoon, SK S7N 4Z2, Canada
| | - Ginny Lane
- Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, ID 83843, USA;
| | - Naorin Islam
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 4Z2, Canada; (N.I.); (R.P.P.); (M.S.); (S.J.W.)
| | - Rashmi Prakash Patil
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 4Z2, Canada; (N.I.); (R.P.P.); (M.S.); (S.J.W.)
| | - Mojtaba Shafiee
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 4Z2, Canada; (N.I.); (R.P.P.); (M.S.); (S.J.W.)
| | - Susan J. Whiting
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 4Z2, Canada; (N.I.); (R.P.P.); (M.S.); (S.J.W.)
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Vatanparast H, Longworth ZL. How does Canada's new vitamin D fortification policy affect the high prevalence of inadequate intake of the vitamin? Appl Physiol Nutr Metab 2023; 48:870-875. [PMID: 37390498 DOI: 10.1139/apnm-2023-0178] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/02/2023]
Abstract
TAKE-HOME MESSAGE The 2023 vitamin D fortification policy may significantly reduce inadequacies in non-supplement consumers; however, the policy is far from eliminating population-level vitamin D inadequacies and supplementation should still be encouraged.
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Affiliation(s)
- Hassan Vatanparast
- University of Saskatchewan (College of Pharmacy and Nutrition), Saskatoon, SK, Canada
- University of Saskatchewan (School of Public Health), Saskatoon, SK, Canada
| | - Zoe L Longworth
- University of Saskatchewan (College of Pharmacy and Nutrition), Saskatoon, SK, Canada
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Brassard D, Chevalier S. Relationship between Adherence to the 2019 Canada's Food Guide Recommendations on Healthy Food Choices and Nutrient Intakes in Older Adults. J Nutr 2023; 153:2699-2708. [PMID: 37460086 DOI: 10.1016/j.tjnut.2023.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 06/24/2023] [Accepted: 07/11/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Following Canada's food guide (CFG) recommendations should ensure adequate nutrient intakes. Older adults have increased needs for certain nutrients and nutrient density; the extent to which adherence to CFG recommendations can help reduce inadequate nutrient intakes is unknown. OBJECTIVES We aimed to assess the relationship between adherence to CFG recommendations on healthy food choices and intake of key nutrients in adults 65 y and older from the Canadian Community Health Survey 2015 - Nutrition. METHODS Secondary analysis of data from 4093 older adults of the Canadian Community Health Survey 2015 - Nutrition (mean age, 73.6 y, 54% females). Dietary intakes were measured using an interviewer-administered 24-h dietary recall, including 1 repeat in a subsample (42%). The National Cancer Institute multivariate method was used to estimate usual (i.e., long-term) dietary intakes. Adherence to CFG recommendations was measured using the Healthy Eating Food Index (HEFI)-2019 score. Simple linear and logistic regression models estimated the effect of increased HEFI-2019 score on usual nutrient intakes and the prevalence of inadequate nutrient intakes (i.e., below the estimated average requirements), respectively. RESULTS Compared with the prevalence of inadequate intakes at median HEFI-2019 score (46.4/80 points), a higher HEFI-2019 (+11 points) was associated with reductions in the prevalence of inadequate intakes of magnesium, vitamin B6 and protein [-19.8% (95% confidence interval (CI): -30.8, -8.9), -12.7% (95% CI: -22.5, -3.0), and -4.7% (95% CI: -9.4, -0.1), respectively]. In contrast, data for higher HEFI-2019 scores were compatible with increased prevalence of inadequate intakes of folate, vitamin D, and calcium [4.0% (95% CI: -8.4, 16.3), 2.6% (95% CI: 1.1, 4.0), and 2.3% (95% CI: -3.0, 7.5), respectively]. CONCLUSIONS Based on dietary intakes of Canadian older adults in 2015, increasing the degree of adherence to CFG recommendations on healthy food choices may reduce nutrient intake inadequacy for most key nutrients except folate, vitamin D, and calcium.
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Affiliation(s)
- Didier Brassard
- School of Human Nutrition, McGill University, Montréal, QC, Canada
| | - Stéphanie Chevalier
- School of Human Nutrition, McGill University, Montréal, QC, Canada; Research Institute of the McGill University Health Centre, Montréal, QC, Canada.
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Lee JJ, Srebot S, Ahmed M, Mulligan C, Hu G, L'Abbé MR. Nutritional quality and price of plant-based dairy and meat analogs in the Canadian food supply system. J Food Sci 2023; 88:3594-3606. [PMID: 37458282 DOI: 10.1111/1750-3841.16691] [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: 05/03/2023] [Revised: 06/15/2023] [Accepted: 06/21/2023] [Indexed: 08/05/2023]
Abstract
There has been an increased consumer interest and public health emphasis on plant-based protein foods, resulting in a rise in the availability of highly processed plant-based analogs. The objectives of this study were to assess the nutritional quality and the price of plant-based dairy and meat analogs compared to their respective animal-derived products and to examine the association between processing levels and the nutritional quality among these products. Using a branded food composition database, products in cheese, yogurt, milk, and meat categories were examined (n = 3231). Products were categorized as plant-based analogs versus animal-derived products using the ingredient list. Products were examined for their nutrient content, overall nutritional quality using the Food Standards Australia New Zealand nutrient profiling model, price, and processing levels using the NOVA classification. All plant-based analogs had lower protein and higher total carbohydrate, sugar, and fiber content compared to their respective animal-derived products. Compared to their respective animal-derived products, plant-based milk and meat analogs had lower energy, total fat, and saturated fat content; plant-based yogurt and meat analogs had lower sodium content; and all plant-based dairy analogs had lower calcium content. Plant-based cheese and yogurt analogs were more expensive than animal-based products; however, there was no significant difference among milk and meat products. There was no association between processing levels and overall nutritional quality among dairy and meat products. Plant-based analogs may be part of a healthy and affordable diet to reduce the intakes of nutrients of concern; however, additional compositional guidelines and/or labeling may be needed to highlight the differences in the levels of nutrients to encourage.
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Affiliation(s)
- Jennifer J Lee
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Sophia Srebot
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Mavra Ahmed
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Joannah & Brian Lawson Centre for Child Nutrition, University of Toronto, Toronto, Ontario, Canada
| | - Christine Mulligan
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Guanlan Hu
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Mary R L'Abbé
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Wilson Westmark NL, Sroussi H, Tamayo I, Villa A. Vitamin D status in patients with oropharyngeal cancer: Association with HPV status and prognosis. Oral Dis 2023; 29:542-546. [PMID: 34269501 DOI: 10.1111/odi.13965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 06/29/2021] [Accepted: 07/13/2021] [Indexed: 02/05/2023]
Affiliation(s)
| | - Hervé Sroussi
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, MA, USA
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
- Division of Oral Medicine and Oral Oncology, Dana Farber Cancer Institute, Boston, MA, USA
| | - Ibon Tamayo
- Division of Immunology and Immunotherapy, Cima Universidad de Navarra, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra (IdISNA), Pamplona, Spain
| | - Alessandro Villa
- Department of Orofacial Sciences, University of California, San Francisco, CA, USA
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8
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King EM, Swann SA, Prior JC, Berger C, Mayer U, Pick N, Campbell AR, Côté HCF, Murray MCM. Vitamin D intakes among women living with and without HIV in Canada. HIV Med 2023; 24:628-639. [PMID: 36597960 DOI: 10.1111/hiv.13454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 12/06/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Patterns of vitamin D intake are relatively unexplored among women living with HIV, despite its importance for women's health. We compared vitamin D dietary and supplement intakes in women with HIV and population-based national controls and investigated barriers to intake. METHODS In this case-control study, women with HIV in the Children and Women: AntiRetrovirals and Markers of Aging (CARMA) cohort were matched with Canadian Multicentre Osteoporosis Study (CaMos) controls. Participants were queried for vitamin D in dairy consumption, supplementation/dosage, and sociodemographic variables. We assessed barriers to supplementation and factors associated with dietary intake by regression modelling. RESULTS Ninety-five women living with HIV were age-matched to 284 controls. Women with HIV had lower income and bone mineral density and were more likely to smoke, take multiple medications and be non-white. Vitamin D dietary intake was lower in women living with HIV versus controls [0.76 vs. 1.79 μg/day; adjusted odds ratio (aOR) for greater than or equal to median intake 0.29 (0.12-0.61), p = 0.002], but any supplementation was higher [62.2% vs. 44.7%; aOR = 3.44 (95% CI: 1.16-11.00), p = 0.03]. Total vitamin D intake was similar between groups. Smoking was associated with no supplementation; non-white ethnicity and low income were related to lower dietary intake. CONCLUSIONS Women living with HIV showed lower dietary vitamin D intake but higher supplementation rates, suggesting that care providers are promoting supplementation. Women living with HIV who smoke, have low incomes and are non-white may particularly benefit from targeted efforts to improve vitamin D intake.
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Affiliation(s)
- Elizabeth M King
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada.,Women's Health Research Institute, Vancouver, British Columbia, Canada
| | - Shayda A Swann
- Women's Health Research Institute, Vancouver, British Columbia, Canada.,Experimental Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jerilynn C Prior
- Women's Health Research Institute, Vancouver, British Columbia, Canada.,Centre for Menstrual Cycle and Ovulation Research, Endocrinology and Metabolism, University of British Columbia, Vancouver, British Columbia, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.,Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Claudie Berger
- Research Institute of the McGill University Health Centre, McGill University, Montreal, Quebec, Canada
| | - Ulrike Mayer
- Women's Health Research Institute, Vancouver, British Columbia, Canada
| | - Neora Pick
- Women's Health Research Institute, Vancouver, British Columbia, Canada.,Oak Tree Clinic, BC Women's Hospital and Health Centre, Vancouver, British Columbia, Canada
| | - Amber R Campbell
- Women's Health Research Institute, Vancouver, British Columbia, Canada.,Oak Tree Clinic, BC Women's Hospital and Health Centre, Vancouver, British Columbia, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Hélène C F Côté
- Women's Health Research Institute, Vancouver, British Columbia, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Centre for Blood Research, University of British Columbia, Vancouver, British Columbia, Canada
| | - Melanie C M Murray
- Women's Health Research Institute, Vancouver, British Columbia, Canada.,Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.,Oak Tree Clinic, BC Women's Hospital and Health Centre, Vancouver, British Columbia, Canada
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Pedersen JE, Hansen J. Colorectal cancer and occupational exposure to solar ultraviolet B radiation in Denmark. ENVIRONMENTAL RESEARCH 2022; 215:114260. [PMID: 36084677 DOI: 10.1016/j.envres.2022.114260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 08/15/2022] [Accepted: 08/31/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES Solar ultraviolet B radiation (UV) may reduce the risk of cancer, including colorectal cancer (CRC), although the evidence is inconclusive. To contribute with evidence, the present largescale register-based nested case-control study aimed to investigate the association between occupational UV exposure and CRC in Denmark. METHODS The Danish Cancer Registry was used to identify a total of 12,268 men and women diagnosed with primary CRC before age 70. Five controls matched on year of birth and sex, alive and free of CRC at the time of diagnosis of the index case were randomly selected from The Danish Civil Registration System. Occupational UV exposure was assessed by obtainment of full employment history from the Danish Supplementary Pension Fund Register, which was linked to a job exposure matrix. Conditional logistic regression was used to estimate odds ratios (ORs) with corresponding 95% confidence intervals. RESULTS We observed an inverse association between longer duration of UV exposure and CRC in women (≥20 years: OR = 0.84, 95% CI: 0.69-1.03), while no noteworthy associations were observed in men. When focusing on colon cancer only, longer duration of UV exposure (>20 years: OR = 0.92, 95% CI: 0.83-1.01) and higher cumulative UV exposure (highest exposure category: OR = 0.90, 95% CI: 0.83-0.99) were indicated to lower the risk in the study population including both men and women, although the risk reduction appeared to be more evident for women. No consistent risk patterns were observed for rectal cancer. CONCLUSIONS The present study suggests a modest protective effect from long-term occupational UV exposure on the risk of colon cancer. The effect may be greater in women and these findings need further attention in future large-scale studies.
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Affiliation(s)
| | - Johnni Hansen
- Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark
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Lenighan YM, Tassy M, Nogueira-de-Almeida CA, Offord EA, Mak TN. Milk beverages can reduce nutrient inadequacy among Brazilian pre-school children: a dietary modelling study. BMC Nutr 2022; 8:121. [PMID: 36316737 PMCID: PMC9623914 DOI: 10.1186/s40795-022-00620-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 10/13/2022] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Previous studies found high prevalence of inadequate intakes of vitamins E, D and K, calcium and potassium among Brazilian pre-school children, with suboptimal consumption of dairy products. Dietary modelling was applied to determine the theoretical impact of improving dairy products consumption on nutrient adequacy in 4-5-year-old Brazilian children. METHODS Adherence to the dairy recommendation of two servings/day was calculated using data from the Brazil Kids Nutrition and Health Study (KNHS) (n = 228). Two modelling scenarios were applied to test the impact on nutrient intakes of (1) adding one or two servings of a frequently consumed cow's milk or a widely available fortified alternative: pre-school children milk (PCM), and of (2) substituting the current milk consumed by PCM. Mean nutrient intakes and percentage of children adhering to the nutrient recommendations were determined at baseline and after applying modelling scenarios. RESULTS Seventy-six percent (n = 174) of children did not meet the recommended daily two servings of dairy products, 56% had less than one serving of dairy products on the day of recall. The mean consumption of whole milk (fortified and unfortified) was 147 g/d, yoghurt 114 g/d and cheese 34 g/d. The addition of one serving of cow's milk demonstrated a 17% reduction in calcium inadequacy, 18% reduction in vitamin A and 3% reduction in zinc inadequacy. Adding one serving of PCM further reduced calcium inadequacy from 87 to 41%, vitamin E from 81 to 37%, and zinc inadequacy by 10%. Replacing the child's current milk with a PCM resulted in further reduction of micronutrient inadequacies, including calcium, vitamin D and vitamin E. CONCLUSIONS Dairy products consumption in pre-school children should be encouraged to reduce nutrient inadequacies. In particular, consumption of PCM would help to reduce calcium, vitamin D and vitamin E inadequacy, nutrients of concern in this population.
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Affiliation(s)
- Yvonne M. Lenighan
- grid.419905.00000 0001 0066 4948Department of Nutrition Sciences, Nestlé Institute of Health Sciences, Nestlé Research, Société des Produits Nestlé S.A., Vers-chez-les-Blanc, 1000 Lausanne, Switzerland
| | - Marie Tassy
- grid.419905.00000 0001 0066 4948Department of Nutrition Sciences, Nestlé Institute of Health Sciences, Nestlé Research, Société des Produits Nestlé S.A., Vers-chez-les-Blanc, 1000 Lausanne, Switzerland
| | | | - Elizabeth A. Offord
- grid.419905.00000 0001 0066 4948Department of Nutrition Sciences, Nestlé Institute of Health Sciences, Nestlé Research, Société des Produits Nestlé S.A., Vers-chez-les-Blanc, 1000 Lausanne, Switzerland
| | - Tsz Ning Mak
- grid.419905.00000 0001 0066 4948Department of Nutrition Sciences, Nestlé Institute of Health Sciences, Nestlé Research, Société des Produits Nestlé S.A., Vers-chez-les-Blanc, 1000 Lausanne, Switzerland
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Calvo MS, Whiting SJ. Perspective: School Meal Programs Require Higher Vitamin D Fortification Levels in Milk Products and Plant-Based Alternatives-Evidence from the National Health and Nutrition Examination Surveys (NHANES 2001-2018). Adv Nutr 2022; 13:1440-1449. [PMID: 35671093 PMCID: PMC9526833 DOI: 10.1093/advances/nmac068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 05/25/2022] [Accepted: 06/02/2022] [Indexed: 01/28/2023] Open
Abstract
Poor vitamin D status impairs bone growth and immune defense in school-aged children and adolescents, particularly in minorities. Vitamin D insufficiency/deficiency increases the risk of acute viral respiratory infection, underscoring the need for adequate vitamin D intakes during school sessions when viral exposure may be greatest. We studied available vitamin D-related survey data and published findings based on NHANES (2001-2018) to assess the dependency of vitamin D status {25-hydroxyvitamin D [25(OH)D]; in nmol/L} on vitamin D intake (μg/d) in elementary school-aged children (4-8 y), middle school children (9-13 y), and high school adolescents (14-18 y). We sought evidence supporting the need for school programs to facilitate vitamin D adequacy. Usual vitamin D intakes from food and beverages by children/adolescents (NHANES 2015-2018) examined at the 50th percentile intake by race/ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic) showed all age groups consumed less than half of the Estimated Average Requirement (EAR) for vitamin D (10 μg/d), independent of race/ethnicity. NHANES (2001-2010) analyses show evidence of lower vitamin D status in school-aged children that is linked to lower intakes of fortified milk varying over race/ethnicity and age. Adolescents had lower vitamin D status and milk intake than younger children. A total of 22-44% of vitamin D intakes occurred away from home, with larger percentages of total intakes at breakfast and lunch, at times consistent with school meals. Ever-present inadequate vitamin D intakes with a large percentage consumed away from home together with well-established benefits to growth, bone, and immune defense from enriched vitamin D-fortified milk in school intervention trials provide strong justification to require enriched vitamin D-fortified foods in school meals. An easy to implement plan for improving vitamin D intakes is possible through the FDA's amendment allowing higher vitamin D fortification levels of dairy and plant-based milk alternatives that could increase vitamin D intakes beyond the EAR with just 2 daily servings.
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Affiliation(s)
- Mona S Calvo
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
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12
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The relationship between diet quality and the severity of household food insecurity in Canada. Public Health Nutr 2022; 25:1013-1026. [PMID: 34551845 PMCID: PMC9991759 DOI: 10.1017/s1368980021004031] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To examine the relationship between the dietary quality of Canadian children and adults and household food insecurity status. DESIGN Dietary intake was assessed with one 24-h recall. Households were classified as food secure or marginally, moderately or severely food insecure based on their responses to the Household Food Security Survey Module. We applied multivariable analyses of variance to determine whether % energy from ultra-processed foods, fruit and vegetable intake, Healthy Eating Index (HEI) scores, macronutrient composition and micronutrient intakes per 1000 kcal differed by food insecurity status after accounting for income, education and region. Analyses were run separately for children 1-8 years and 9-18 years and men and women 19-64 years of age. SETTING Ten provinces in Canada. PARTICIPANTS Respondents to the 2015 Canadian Community Health Survey-Nutrition, aged 1-64 years, with complete food insecurity data and non-zero energy intakes, N 15 909. RESULTS Among adults and children, % energy from ultra-processed foods was strongly related to severity of food insecurity, but no significant trend was observed for fruit and vegetable intake or HEI score. Carbohydrate, total sugar, fat and saturated fat intake/1000 kcal did not differ by food insecurity status, but there was a significant negative trend in protein/1000 kcal among older children, a positive trend in Na/1000 kcal among younger children and inverse associations between food insecurity severity and several micronutrients/1000 kcal among adults and older children. CONCLUSIONS With more severe household food insecurity, ultra-processed food consumption was higher, and diet quality was generally lower among both adults and children.
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Amaya-Montoya M, Duarte-Montero D, Nieves-Barreto LD, Montaño-Rodríguez A, Betancourt-Villamizar EC, Salazar-Ocampo MP, Mendivil CO. 100 YEARS OF VITAMIN D: Dietary intake and main food sources of vitamin D and calcium in Colombian urban adults. Endocr Connect 2021; 10:1584-1593. [PMID: 34766920 PMCID: PMC8679881 DOI: 10.1530/ec-21-0341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 11/12/2021] [Indexed: 11/28/2022]
Abstract
Data on dietary calcium and vitamin D intake from Latin America are scarce. We explored the main correlates and dietary sources of calcium and vitamin D in a probabilistic, population-based sample from Colombia. We studied 1554 participants aged 18-75 from five different geographical regions. Dietary intake was assessed by employing a 157-item semi-quantitative food frequency questionnaire and national and international food composition tables. Daily vitamin D intake decreased with increasing age, from 230 IU/day in the 18-39 age group to 184 IU/day in the 60-75 age group (P -trend < 0.001). Vitamin D intake was positively associated with socioeconomic status (SES) (196 IU/day in lowest vs 234 in highest SES, P-trend < 0.001), and with educational level (176 IU/day in lowest vs 226 in highest education level, P-trend < 0.001). Daily calcium intake also decreased with age, from 1376 mg/day in the 18-39 age group to 1120 mg/day in the 60-75 age group (P -trend < 0.001). Calcium intake was lowest among participants with only elementary education, but the absolute difference in calcium intake between extreme education categories was smaller than for vitamin D (1107 vs 1274 mg/day, P-trend = 0.023). Daily calcium intake did not correlate with SES (P -trend = 0.74). Eggs were the main source of overall vitamin D, albeit their contribution decreased with increasing age. Dairy products contributed at least 48% of dietary calcium in all subgroups, mostly from cheese-containing traditional foods. SES and education were the key correlates of vitamin D and calcium intake. These findings may contribute to shape public health interventions in Latin American countries.
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Affiliation(s)
| | | | | | | | | | | | - Carlos O Mendivil
- School of Medicine, Universidad de los Andes, Bogotá, Colombia
- Fundación Santa Fe de Bogotá, Section of Endocrinology, Bogotá, Colombia
- Correspondence should be addressed to C O Mendivil:
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Consumption of Milk and alternatives decreased among Canadians from 2004 to 2015: evidence from the Canadian community health surveys. BMC Nutr 2021; 7:63. [PMID: 34719398 PMCID: PMC8559356 DOI: 10.1186/s40795-021-00465-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 08/26/2021] [Indexed: 11/10/2022] Open
Abstract
Background Milk and milk products make important contributions to the diet of Canadians. The aim of this study was to examine trends in Milk & Alternatives consumption among Canadians (≥2 years) from 2004 to 2015. Methods We used nutrition data from 2 nationally representative cross-sectional surveys conducted in 2004 and 2015 [Canadian Community Health Survey (CCHS) 2004 Cycle 2.2 and CCHS-Nutrition 2015] to compare Milk & Alternatives consumption between 2004 and 2015. Data from 24-h dietary recalls were collected using the Automated Multiple-Pass Method (AMPM). Result From 2004 to 2015, the proportion of Canadians consuming Milk & Alternatives food group significantly decreased from 89.5 to 87.7% and the number of servings consumed per day dropped from 1.9 to 1.7. Despite their low energy contribution (12.3% of energy), Milk & Alternatives contributed 45.8% of calcium, 39.9% of vitamin D, and 36.0% of vitamin B12 to the diet of the Canadian population in 2015. Milk & Alternatives were among the top sources of vitamin A, phosphorus and riboflavin. Milk & Alternatives food group was a major contributor to saturated fat intake in both 2004 (31.2%) and 2015 (28.6%). In 2015, dietary intakes of calcium and vitamin D among Milk & Alternatives consumers were 137.8, and 59.4% higher, respectively, than those of non-consumers. Conclusion Daily intake of Milk & Alternatives has decreased in the Canadian population over time, which may adversely affect the nutritional profile of the diet.
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Keshavarz P, Shafiee M, Islam N, Whiting SJ, Vatanparast H. Prevalence of vitamin-mineral supplement use and associated factors among Canadians: results from the 2015 Canadian Community Health Survey. Appl Physiol Nutr Metab 2021; 46:1370-1377. [PMID: 34087082 DOI: 10.1139/apnm-2021-0090] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Vitamin/mineral supplements are used for improving micronutrient intake and preventing deficiencies, particularly for shortfall nutrients. We assessed the prevalence of vitamin/mineral supplement use and associated factors among a representative sample of Canadians aged ≥1 y. We used nationally representative data from the 2015 Canadian Community Health Survey (CCHS)-Nutrition. The prevalence of vitamin/mineral supplement use containing shortfall nutrients (Vitamins: A, C, D, B6, B12 and folate; Minerals: calcium, magnesium, and zinc) was examined in this study. Logistic regression models were performed to determine factors associated with vitamin/mineral supplement use among Canadian children (1-18 years) and adults (>19 years). The overall prevalence of vitamin/mineral supplement use was 38% among men and 53% among women. Males aged 14-18 years had the lowest prevalence (26.5%; 95% CI = 21.9-31.0) and females aged ≥71 years had the highest prevalence (67.8%; 95% CI = 64.1-71.5) of vitamin/mineral supplement use. Female gender, older age, higher education level, higher income, living in urban areas, having chronic conditions, having a normal body mass index (BMI), and being non-smoker were independent positive predictors of vitamin/mineral supplement use among adults. Independent positive predictors of vitamin/mineral supplement use among Canadian children included younger age, having a normal BMI, and being food secure. Novelty bullets • The overall prevalence of vitamin/mineral supplement use among Canadian men and women was 38% and 53%, respectively. • Sociodemographic and lifestyle variables were associated with vitamin/mineral supplement use, especially among Canadian adults.
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Affiliation(s)
| | | | - Naorin Islam
- University of Saskatchewan, 7235, Saskatoon, Saskatchewan, Canada;
| | - Susan J Whiting
- University of Saskatchewan, College of Pharmacy and Nutrition, 107 Wiggins Road, Saskatoon, Saskatchewan, Canada, S7N 5E5;
| | - Hassan Vatanparast
- University of Saskatchewan, 7235, Saskatoon, Canada, S7N 5A2.,University of Saskatchewan, 7235, Saskatoon, Canada, S7N 5A2;
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Chávez-Courtois M, Godínez-Martínez E, Muñoz-Manrique C, Negrete-Martínez V, González-Leyva CP, Tolentino-Dolores M, Suárez-Rico B, Estrada-Gutierrez G, Perichart-Perera O. Vitamin D Status and Its Determinants in Mexican Pregnant Women from a Rural and an Urban Area: A Comparative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094571. [PMID: 33925817 PMCID: PMC8123424 DOI: 10.3390/ijerph18094571] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 04/19/2021] [Accepted: 04/21/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND During pregnancy, vitamin D requirements are higher due to fetal growth and development. Vitamin D production occurs mainly through sunlight exposure, which is affected by geographic location and lifestyle factors. METHODS This was a case-control study nested within two cohorts of adult pregnant women (n = 298): urban (Mexico City) and rural (Cuetzalan). To reduce confounding, pairs were selected by age, pregestational body mass index, and pregnancy trimester. Generalized linear models were used to assess the two groups according to their vitamin D status. RESULTS A total of 298 adult women were studied: 149 from a rural area and 149 from an urban area. Vitamin D deficiency and insufficiency were observed in 28% and 38.2% of women, respectively. A trend for higher 25(OH)D concentrations was observed in women from the rural area (27.5 ng/mL vs. 25.8 ng/mL), probably related to the type of job, where women with partial jobs showing less probability of having vitamin D deficiency (OR = 0.26; CI = 0.06-1.16; p = 0.08) and vitamin D insufficiency (OR = 0.24; CI = 0.06-0.99; p = 0.05). Women whose Last Menstrual Period occurred in spring showed lower vitamin D concentration compared to those whose LMP occurred in winter (p < 0.01). CONCLUSIONS A high prevalence of vitamin D deficiency was observed in both rural and urban areas. Women living in rural areas tended to have higher 25(OH)D concentrations, probably related to more sunlight exposure associated with their type of job.
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Affiliation(s)
- Mayra Chávez-Courtois
- Nutrition and Bioprogramming Coordination, Instituto Nacional de Perinatología, Mexico City 11000, Mexico; (M.C.-C.); (E.G.-M.); (C.M.-M.); (V.N.-M.); (C.P.G.-L.); (M.T.-D.)
| | - Estela Godínez-Martínez
- Nutrition and Bioprogramming Coordination, Instituto Nacional de Perinatología, Mexico City 11000, Mexico; (M.C.-C.); (E.G.-M.); (C.M.-M.); (V.N.-M.); (C.P.G.-L.); (M.T.-D.)
| | - Cinthya Muñoz-Manrique
- Nutrition and Bioprogramming Coordination, Instituto Nacional de Perinatología, Mexico City 11000, Mexico; (M.C.-C.); (E.G.-M.); (C.M.-M.); (V.N.-M.); (C.P.G.-L.); (M.T.-D.)
| | - Viviana Negrete-Martínez
- Nutrition and Bioprogramming Coordination, Instituto Nacional de Perinatología, Mexico City 11000, Mexico; (M.C.-C.); (E.G.-M.); (C.M.-M.); (V.N.-M.); (C.P.G.-L.); (M.T.-D.)
| | - Carla Patricia González-Leyva
- Nutrition and Bioprogramming Coordination, Instituto Nacional de Perinatología, Mexico City 11000, Mexico; (M.C.-C.); (E.G.-M.); (C.M.-M.); (V.N.-M.); (C.P.G.-L.); (M.T.-D.)
| | - Maricruz Tolentino-Dolores
- Nutrition and Bioprogramming Coordination, Instituto Nacional de Perinatología, Mexico City 11000, Mexico; (M.C.-C.); (E.G.-M.); (C.M.-M.); (V.N.-M.); (C.P.G.-L.); (M.T.-D.)
| | - Blanca Suárez-Rico
- Community Interventions Research Branch, Instituto Nacional de Perinatología, Mexico City 11000, Mexico;
| | | | - Otilia Perichart-Perera
- Nutrition and Bioprogramming Coordination, Instituto Nacional de Perinatología, Mexico City 11000, Mexico; (M.C.-C.); (E.G.-M.); (C.M.-M.); (V.N.-M.); (C.P.G.-L.); (M.T.-D.)
- Correspondence: ; Tel.: +52-55-5520-9900 (ext. 402/120)
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