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Marrie RA, Patel R, Schaffer SA. Carotid intima media thickness in multiple sclerosis: A CLSA study. Mult Scler Relat Disord 2024; 87:105660. [PMID: 38754248 DOI: 10.1016/j.msard.2024.105660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 04/07/2024] [Accepted: 04/28/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND People with multiple sclerosis (MS) have an increased incidence of atherosclerotic disease, including ischemic heart disease and stroke, compared to people without MS even after accounting for risk factors such as hypertension, dyslipidemia, diabetes and smoking. We compared carotid intima media thickness (CIMT), a surrogate of atherosclerosis, in people with MS and in two groups of people without MS (rheumatoid arthritis [RA]; all other participants). METHODS We used data from participants in the Canadian Longitudinal Study on Aging (CLSA) who did not have known vascular disease (ischemic heart disease, stroke, transient ischemic attack, peripheral vascular disease) and who underwent carotid ultrasound for assessment of CIMT. We selected participants with MS, RA and controls who did not have MS or RA. Using age and gender-stratified norms for average CIMT in the CLSA, we identified participants in each cohort with a CIMT ≥75th percentile (subclinical atherosclerosis). We also calculated ten-year level of cardiovascular risk using the Framingham Risk Score (FRS). We tested the association between cohort membership (MS, RA, controls) and atherosclerosis using logistic regression, adjusted for FRS, abdominal obesity, excess alcohol intake, education and elevated symptoms of depression. We adjusted all analyses for the stratified sampling design. RESULTS We included 78 participants with MS, 364 participants with RA and 13,891 controls. Overall, the average (SE) CIMT was 0.699 (0.002), and this did not differ between cohorts. Logistic regression analyses revealed that cohort membership was not associated with atherosclerosis based on the average CIMT in unadjusted or adjusted models. However, a 1-point higher FRS was associated with 1.032 (95 %CI: 1.021, 1.043) increased odds of atherosclerosis. CONCLUSION Average CIMT does not differ between people with MS, people with RA and people without these diseases. Subclinical atherosclerosis as defined by a CIMT ≥75 % is not observed in people with MS at an increased rate beyond what FRS would predict. Further evaluation is needed to determine what mechanisms underlie the increased rates of cardiovascular disease and stroke in MS.
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Affiliation(s)
- Ruth Ann Marrie
- Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Can; Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Can.
| | - Ronak Patel
- Department of Clinical Health Psychology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Can
| | - Stephen Allan Schaffer
- Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Can
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Bruneau J, Moralejo D, Parsons K. Evaluating the effectiveness of the cardiovascular assessment screening program with nurse practitioners and patients: results of a cluster randomised controlled trial. BMC PRIMARY CARE 2024; 25:185. [PMID: 38789927 PMCID: PMC11127425 DOI: 10.1186/s12875-024-02432-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 05/13/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND There is inconsistent utilisation of clinical practice guidelines (CPGs) for cardiovascular disease (CVD) screening and management by healthcare professionals to identify CVD risk factors early and to intervene using current recommendations. To address this issue, the Cardiovascular Assessment Screening Program (CASP) was developed, implemented, and evaluated. This manuscript reports on the second phase of an exploratory sequential mixed methods study that tested the effectiveness of the CASP with nurse practitioners (NPs) and patients in Canada. METHODS A two-armed, non-blinded, cluster randomised controlled trial (cRCT) compared the NP-led implementation of CASP with usual care by NPs in community practice clinics across one Canadian province. The NPs were the cluster variable as their screening practices could be affected by their educational training, resources, or other factors. NPs were eligible for inclusion in the study if they were located in different urban and rural community settings and could conduct follow-up visits with patients. NPs recruited and enrolled the patients from their own practices as participants if they were healthy individuals, aged 40-74 years, with no established CVD or vascular disease. Researchers randomly allocated the NPs (n = 10) to the intervention group (IG) or the control group (CG). RESULTS Eight (8) NPs and 167 patients participated in the cRCT study. Patient participant-level data were analysed by the originally assigned groups IG (n = 68) and CG (n = 99). Utilising GLM (generalized linear modeling) more IG patients (90%; n = 61) received comprehensive CVD screening compared to the CG patients (2%; n = 2), RR = 30.2, 95% CI [8.76, 103.9], p < .0001, controlling for the effect of NP and BP category. CONCLUSION NP implementation of CASP was effective for comprehensive screening compared to usual care and led to identifying previously unknown CVD risk factors, calculated FRS, heart health priorities and personalised goal-setting. TRIAL REGISTRATION ClinicalTrial.gov ID#: NCT03170752, date of registration 2017/05/31.
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Affiliation(s)
- Jill Bruneau
- Faculty of Nursing, Memorial University of Newfoundland, 323 Prince Philip Drive, St. John's, NL, A1B 3X8, Canada.
| | - Donna Moralejo
- Faculty of Nursing, Memorial University of Newfoundland, 323 Prince Philip Drive, St. John's, NL, A1B 3X8, Canada
| | - Karen Parsons
- Faculty of Nursing, Memorial University of Newfoundland, 323 Prince Philip Drive, St. John's, NL, A1B 3X8, Canada
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Fernandes C, Campbell-Scherer D, Lofters A, Grunfeld E, Aubrey-Bassler K, Cheung H, Latko K, Tink W, Lewanczuk R, Shea-Budgell M, Heisey R, Wong T, Yang H, Walji S, Wilson M, Holmes E, Lang-Robertson K, DeLonghi C, Manca DP. Harmonization of clinical practice guidelines for primary prevention and screening: actionable recommendations and resources for primary care. BMC PRIMARY CARE 2024; 25:153. [PMID: 38711031 PMCID: PMC11071261 DOI: 10.1186/s12875-024-02388-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 04/12/2024] [Indexed: 05/08/2024]
Abstract
BACKGROUND Clinical practice guidelines (CPGs) synthesize high-quality information to support evidence-based clinical practice. In primary care, numerous CPGs must be integrated to address the needs of patients with multiple risks and conditions. The BETTER program aims to improve prevention and screening for cancer and chronic disease in primary care by synthesizing CPGs into integrated, actionable recommendations. We describe the process used to harmonize high-quality cancer and chronic disease prevention and screening (CCDPS) CPGs to update the BETTER program. METHODS A review of CPG databases, repositories, and grey literature was conducted to identify international and Canadian (national and provincial) CPGs for CCDPS in adults 40-69 years of age across 19 topic areas: cancers, cardiovascular disease, chronic obstructive pulmonary disease, diabetes, hepatitis C, obesity, osteoporosis, depression, and associated risk factors (i.e., diet, physical activity, alcohol, cannabis, drug, tobacco, and vaping/e-cigarette use). CPGs published in English between 2016 and 2021, applicable to adults, and containing CCDPS recommendations were included. Guideline quality was assessed using the Appraisal of Guidelines for Research and Evaluation (AGREE) II tool and a three-step process involving patients, health policy, content experts, primary care providers, and researchers was used to identify and synthesize recommendations. RESULTS We identified 51 international and Canadian CPGs and 22 guidelines developed by provincial organizations that provided relevant CCDPS recommendations. Clinical recommendations were extracted and reviewed for inclusion using the following criteria: 1) pertinence to primary prevention and screening, 2) relevance to adults ages 40-69, and 3) applicability to diverse primary care settings. Recommendations were synthesized and integrated into the BETTER toolkit alongside resources to support shared decision-making and care paths for the BETTER program. CONCLUSIONS Comprehensive care requires the ability to address a person's overall health. An approach to identify high-quality clinical guidance to comprehensively address CCDPS is described. The process used to synthesize and harmonize implementable clinical recommendations may be useful to others wanting to integrate evidence across broad content areas to provide comprehensive care. The BETTER toolkit provides resources that clearly and succinctly present a breadth of clinical evidence that providers can use to assist with implementing CCDPS guidance in primary care.
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Affiliation(s)
- Carolina Fernandes
- Department of Family Medicine, University of Alberta, Edmonton, AB, Canada.
| | - Denise Campbell-Scherer
- Department of Family Medicine, University of Alberta, Edmonton, AB, Canada
- Office of Lifelong Learning and the Physician Learning Program, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Aisha Lofters
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
- Peter Gilgan Centre for Women's Cancers, Women's College Hospital, Toronto, ON, Canada
| | - Eva Grunfeld
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
- Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - Kris Aubrey-Bassler
- Discipline of Family Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
- Newfoundland and Labrador Centre for Health Information, St. John's, NL, Canada
| | - Heidi Cheung
- Department of Family Medicine, University of Alberta, Edmonton, AB, Canada
| | - Katherine Latko
- College of Physicians and Surgeons of Ontario, Toronto, ON, Canada
| | - Wendy Tink
- Department of Family Medicine, University of Calgary, Calgary, AB, Canada
| | - Richard Lewanczuk
- Alberta Health Services, Alberta, AB, Canada
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | | | - Ruth Heisey
- Peter Gilgan Centre for Women's Cancers, Women's College Hospital, Toronto, ON, Canada
- Family and Community Medicine, Women's College Hospital, Toronto, ON, Canada
| | - Tracy Wong
- Strategic Clinical Networks, Alberta Health Services, Calgary, AB, Canada
| | | | - Sakina Walji
- Department of Family Medicine, Mount Sinai Hospital, Sinai Health System, Toronto, ON, Canada
| | - Margo Wilson
- Discipline of Emergency Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | | | | | | | - Donna Patricia Manca
- Department of Family Medicine, University of Alberta, Edmonton, AB, Canada
- Office of Lifelong Learning and the Physician Learning Program, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
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Marrie RA, Patel R, Schaffer SA. Subclinical atherosclerosis in multiple sclerosis. Mult Scler J Exp Transl Clin 2024; 10:20552173241238627. [PMID: 38585500 PMCID: PMC10998495 DOI: 10.1177/20552173241238627] [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] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 02/22/2024] [Indexed: 04/09/2024] Open
Abstract
Background People with multiple sclerosis (MS) have an increased risk of ischemic heart disease as compared to people without MS after accounting for traditional vascular risk factors. Objective We assessed whether subclinical atherosclerosis, an inflammatory disease of arteries, occurs in persons with MS who do not have traditional vascular risk factors, and whether the Framingham Score (FRS) predicted carotid intima media thickness (CIMT) similarly in people with and without MS. Methods We recruited participants with and without MS who did not have vascular disease. Participants completed questionnaires, physical assessments, underwent an ultrasound (CIMT), and provided samples for HbA1c and lipid measurements. We defined subclinical atherosclerosis as an average CIMT ≥75th percentile, and tested the association between MS/not-MS, FRS, and atherosclerosis using logistic regression. Results We recruited 106 participants with MS 101 without MS. The average (SD) CIMT did not differ between the MS (0.60 [0.11]) and non-MS (0.61 [0.12]) cohorts (p = 0.69), nor did the proportion with atherosclerosis (MS: 11.3% vs. non-MS 13.4%, p = 0.58). On regression analysis a 1-point increase in the FRS was associated with 11% increased odds of having atherosclerosis (95%CI: 1.04, 1.19) but MS was not. Conclusion MS was not associated with subclinical atherosclerosis.
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Affiliation(s)
- Ruth Ann Marrie
- Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
- Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Ronak Patel
- Department of Clinical Health Psychology, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Stephen Allan Schaffer
- Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
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Badawy MAEMD, Naing L, Saeed IA, Tuah NAA. Quality Appraisal of Screening Guidelines for Cardiovascular disease Prevention: a scoping review.. [DOI: 10.1101/2023.08.05.23293686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
ABSTRACTObjectiveEach nation develops a guideline for managing and preventing cardiovascular disease (CVD) based on the available literature and the evidence-based consensus in their guideline’s recommendations. The goal of this review is to appraise the quality of many guidelines recommended by several international organizations for the early detection and prevention of CVD.MethodsWe conducted a scoping review using a few guideline-specific databases using Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) as the reporting guideline for this review. We used the Appraisal of Guidelines for Research and Evaluation II (AGREE II) instrument to rate the methodological quality and rigorousness of the included guidelines for CVD prevention and early detection.ResultsOut of the 2,466 guidelines identified by our search, based on our eligibility criteria, we included a total of 20 distinct guidelines globally focused on screening for CVD prevention and early detection. (70%) of these guidelines were classified as "strongly recommended" while only (90%) were classified as just "recommended". The AGREE II appraisal domains with the highest median scores (percentile 25th, 75th) were “Clarity of Presentation”92% (81, 95.5), followed by Applicability88% (73, 93). The Rigour of Development and Editorial Independence were the lowest scores with a median of78% (66.5, 84) and75% (60.5, 92).ConclusionsUsing AGREE II quality appraisal tool, we provided a critical quality appraisal of several international CVD prevention guidelines and reveal opportunities to improve the CVD prevention guidelines’ quality.What is already known in this review?Each community develops a guideline for screening and managing CVD prevention based on the current evidence and evidence-based consensus.AGREE II tool is an internationally standardized instrument to report the rigorousness of development, transparency, and methodological quality of the clinical practice guidelines.What this review addsThis review provided a critical quality appraisal of several international CVD prevention guidelines.The highest AGREE II domain median score was “Clarity of Presentation” while the least domains were “Editorial Independence” and “Rigour of Development”.70%of these guidelines were classified as "strongly recommended".How this review might affect research, practice, or policyThis review provided a critical quality appraisal of many CVD prevention guidelines and revealed opportunities to improve CVD prevention guidelines’ quality.
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Darwesh Badawy MAEM, Naing L, Tuah NAA. Comparison of Screening Guidelines for Cardiovascular disease Prevention and Early Detection: a scoping review.. [DOI: 10.1101/2023.08.05.23293697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
ABSTRACTObjectiveGlobally, cardiovascular disease (CVD) has a significant role in morbidity and early death. This review’s objective is to provide a summary of the strengths and weaknesses in the variety of screening guidelines made by several international organizations for the early identification and prevention of CVD.MethodsAs the reporting guideline for this review, we used Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). We performed a scoping review using a few guideline-specific databases. We tabulated the main key differences between the included screening guidelines for CVD prevention and early detection from different perspectives.ResultsWe included a total of 20 unique guidelines that were developed by various organizations throughout the world and focused on screening for CVD prevention and early detection out of the 2,466 guidelines discovered by our search based on our eligibility criteria. We concluded that the target populations, CVD risk assessment techniques, outcomes, and categories of the chosen CVD prevention guidelines widely varied. Additionally, some guidelines adopted no grading scheme for their evidence, while others did not advocate the use of any imaging screening tools in their evaluation of the CVD risk.ConclusionsThis scoping review highlights the areas of each guideline’s strengths and weaknesses and conducts a systematic comparison of a number of worldwide guidelines for CVD prevention and early diagnosis.What is already known in this review?Based on the most recent evidence and consensus among experts, each nation creates its own set of guidelines for the early detection and prevention of CVD.What this review addsThis review conducted a systematic comparison and summarized the strengths and weaknesses of the various screening guidelines made by numerous international organizations for the early detection and prevention of CVD.• How this review might affect research, practice or policyThis review provided opportunities to improve the future development of the clinical practice guidelines for CVD prevention and early detection.
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Maclagan LC, Croxford R, Chu A, Sin DD, Udell JA, Lee DS, Austin PC, Gershon AS. Quantifying COPD as a risk factor for cardiac disease in a primary prevention cohort. Eur Respir J 2023; 62:2202364. [PMID: 37385658 DOI: 10.1183/13993003.02364-2022] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 06/15/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND Despite COPD being a risk factor for cardiovascular disease (CVD) and knowing that risk stratification for CVD primary prevention is important, little is known about the real-world risk of CVD among people with COPD with no history of CVD. This knowledge would inform CVD management for people with COPD. The current study aimed to examine the risk of major adverse cardiovascular events (MACE) (including acute myocardial infarction, stroke or cardiovascular death) in a large, complete real-world population with COPD without previous CVD. METHODS We conducted a retrospective population cohort study using health administrative, medication, laboratory, electronic medical record and other data from Ontario, Canada. People without a history of CVD with and without physician-diagnosed COPD were followed between 2008 and 2016, and cardiac risk factors and comorbidities compared. Sequential cause-specific hazard models adjusting for these factors determined the risk of MACE in people with COPD. RESULTS Among ∼5.8 million individuals in Ontario aged ≥40 years without CVD, 152 125 had COPD. After adjustment for cardiovascular risk factors, comorbidities and other variables, the rate of MACE was 25% higher in persons with COPD compared with those without COPD (hazard ratio 1.25, 95% CI 1.23-1.27). CONCLUSIONS In a large real-world population without CVD, people with physician-diagnosed COPD were 25% more likely to have a major CVD event, after adjustment for CVD risk and other factors. This rate is comparable to the rate in people with diabetes and calls for more aggressive CVD primary prevention in the COPD population.
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Affiliation(s)
| | | | | | - Don D Sin
- Centre for Heart Lung Innovation, St Paul's Hospital and Division of Respiratory Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Jacob A Udell
- ICES, Toronto, ON, Canada
- Cardiovascular Division, Department of Medicine, Women's College Hospital and Women's College Research Institute, Toronto, ON, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
- Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Douglas S Lee
- ICES, Toronto, ON, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
- Peter Munk Cardiac Centre, University Health Network, Toronto, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Peter C Austin
- ICES, Toronto, ON, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Andrea S Gershon
- ICES, Toronto, ON, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Sunnybrook Health Sciences Centre, Toronto, ON, Canada
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Rodrigues MP, Ferreira CB, Santos KAMD, Merello PN, Rossato SL, Fuchs SC, Moreira LB. Efficacy of an Educational Intervention for Sodium Restriction in Patients with Hypertension: A Randomized Controlled Trial. Nutrients 2023; 15:2159. [PMID: 37432286 DOI: 10.3390/nu15092159] [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: 03/03/2023] [Revised: 04/24/2023] [Accepted: 04/27/2023] [Indexed: 07/12/2023] Open
Abstract
There is sound evidence showing the efficacy of non-pharmacological interventions in lowering blood pressure (BP); however, adherence is usually poor. Interventions to induce behavioral changes aim to improve the ability to read labels, choose foods, and eat low-sodium meals, reinforcing adherence to sodium restriction. In this randomized parallel-controlled trial, we assessed the effectiveness of an educational intervention using the Dietary Sodium Restriction Questionnaire (DSRQ) scores. A follow-up period of 6 months was conducted. Participants were randomized into (1) an educational intervention provided by a registered dietitian on individual visits and dietary planning; (2) a control group with the usual care and dietary recommendations. Patients underwent 24-h ambulatory BP monitoring, 12-h fasting blood tests, spot urine collection, and assessment using DSRQ. We randomized 120 participants (67.5% women and 68.3% Caucasians), and 25 participants were lost to follow-up. The 24-h sodium urinary excretion changed in the control (Δ -1610 mg/day; 95% confidence interval [CI] -1800 to -1410) and intervention groups (Δ -1670 mg/day; 95% CI -1800 to -1450) over time. There was no significant difference in the 24-h estimated sodium between groups. In hypertensive patients, DSRQ-based educational intervention is effective for improving the ability to detect and overcome obstacles to a low-sodium restriction diet but is as effective as dietary recommendations for lowering sodium.
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Affiliation(s)
- Marcela P Rodrigues
- Postgraduate Studies Program in Cardiology, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-002, Brazil
| | - Carolina B Ferreira
- Postgraduate Studies Program in Cardiology, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-002, Brazil
| | | | - Paula N Merello
- Medicine School, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-002, Brazil
| | - Sinara L Rossato
- Graduation Course in Collective Health, Institute of Geography, Universidade Federal de Uberlandia (UFU), Uberlandia 38400-902, Brazil
| | - Sandra C Fuchs
- Postgraduate Studies Program in Cardiology, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-002, Brazil
- Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, Brazil
| | - Leila B Moreira
- Postgraduate Studies Program in Cardiology, Universidade Federal do Rio Grande do Sul, Porto Alegre 90035-002, Brazil
- Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, Brazil
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Boisvenue JJ, Oliva CU, Manca DP, Johnson JA, Yeung RO. Identifying Sex-Specific Differences in Young-Onset Metabolic Syndrome Using Primary Care Electronic Medical Record. Metab Syndr Relat Disord 2023; 21:133-140. [PMID: 37098189 DOI: 10.1089/met.2022.0065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
Abstract
Objectives: To apply a case definition to a Northern Alberta-based primary care practice population and to assess the sex-specific characteristics of young-onset metabolic syndrome (MetS). Design: We carried out a cross-sectional study to identify and estimate the prevalence of MetS using electronic medical record (EMR) data and perform descriptive comparative analyses of demographic and clinical characteristics between males and females. Setting: Northern Alberta Primary Care Research Network (NAPCReN) consists of EMR patient data from 77 physicians among 18 clinics. Participants: Patients with one or more clinic visit between 2015 and 2018, between 18 and 40 years old, residing in Northern Alberta. Main Outcome Measures: Comparison of prevalence in MetS between sexes as well as sex-specific distribution of MetS characteristics [body mass index (BMI), fasting blood glucose, glycated hemoglobin, triglycerides, and high-density lipoprotein cholesterol (HDL-C), presence of hypertension, and presence of diabetes]. Results: Of 15,766 patients, 4.4% (n = 700) had young-onset MetS based on recorded data, prevalence was nearly twice as high in males (6.1%, n = 354) compared with females (3.5%, n = 346). The most prevalent risk factor for MetS consisted of having an elevated BMI for both females (90.9%) and males (91.5%). In the presence of MetS, more females had lower HDL-C [68.2% females (F) vs. 52.5% males (M)], and higher prevalence of diabetes (21.4% F vs. 9.0% M), whereas more males had hypertriglyceridemia (60.4% F vs. 79.7% M) and hypertension (12.4% F vs. 15.8% M). Females also had consistently higher percentages of absent laboratory data compared with males when identified as having MetS and BMI ≥25 kg/m2. Conclusions: Males have nearly twice the prevalence of young-onset MetS compared with females, with notable sex-specific differences in the manifestation of MetS, although we suspect that this is partially due to underreporting where the absence of anthropomorphic and laboratory investigations point to a lack of testing. Sex-specific screening for MetS, especially among young females of childbearing years, is important for downstream prevention.
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Affiliation(s)
- Jamie J Boisvenue
- School of Public Health, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
- Alberta Diabetes Institute, Edmonton, Alberta, Canada
| | - Carlo U Oliva
- Department of Computer Science, College of Natural & Applied Sciences, Faculty of Science, University of Alberta, Edmonton, Alberta, Canada
| | - Donna P Manca
- Department of Family Medicine, College of Health Sciences, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
- Northern Alberta Primary Care Research Network, Edmonton, Alberta, Canada
- Alberta Physician Learning Program, University of Alberta, Edmonton, Alberta, Canada
| | - Jeffery A Johnson
- School of Public Health, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
- Alberta Diabetes Institute, Edmonton, Alberta, Canada
| | - Roseanne O Yeung
- School of Public Health, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
- Alberta Diabetes Institute, Edmonton, Alberta, Canada
- Alberta Physician Learning Program, University of Alberta, Edmonton, Alberta, Canada
- Division of Endocrinology & Metabolism, Department of Medicine, College of Health Sciences, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
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Bruneau J, Parsons K, Moralejo D, Donovan C. Development of the Cardiovascular Assessment Screening Program (CASP) using the qualitative findings of a mixed methods study and applying the TDF to address the barriers of and facilitators to comprehensive screening for cardiovascular disease. BMC PRIMARY CARE 2023; 24:65. [PMID: 36882713 PMCID: PMC9990229 DOI: 10.1186/s12875-023-02022-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 02/27/2023] [Indexed: 03/09/2023]
Abstract
BACKGROUND There is inconsistent utilisation of clinical practice guidelines (CPGs) for cardiovascular disease (CVD) screening and management by healthcare professionals to identify CVD risk factors early and to intervene using current recommendations. This manuscript reports on the first phase of an exploratory sequential mixed methods study describing the integration of the qualitative study findings with the Theoretical Domains Framework (TDF) that led to the development of the Cardiovascular Assessment Screening Program (CASP). The main objective of the qualitative study was to inform the development of CASP. METHODS Focus groups (5) and interviews (10) were conducted in rural and urban settings in one Canadian province with target health professionals, managers in health care organizations, and the public to obtain different perspectives to inform the CASP intervention. Three focus groups were held with nurse practitioners and two with members of the public; individual interviews were conducted with target groups as well. Application of the TDF provided a comprehensive approach to determine the main factors influencing clinician behaviour, to assess the implementation process, and to support intervention design. Behaviour change techniques, modes of delivery, and intervention components were selected for the development of the CASP. RESULTS Themes identified such lack of knowledge about comprehensive screening, ambiguity around responsibility for screening, lack of time and commitment to screening were addressed in the components of the CASP intervention that were developed, including a website, education module, decision tools, and a toolkit. CONCLUSION CASP is a theory-informed intervention developed through the integration of the findings from the focus groups and interviews with selected TDF domains, behaviour change techniques, and modes of delivery available in the local context that may be a useful approach for knowledge translation of evidence into practice.
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Affiliation(s)
- Jill Bruneau
- Faculty of Nursing, Memorial University of Newfoundland, 323 Prince Philip Drive, St. John's, NL, A1B 3X8, Canada.
| | - Karen Parsons
- Faculty of Nursing, Memorial University of Newfoundland, 323 Prince Philip Drive, St. John's, NL, A1B 3X8, Canada
| | - Donna Moralejo
- Faculty of Nursing, Memorial University of Newfoundland, 323 Prince Philip Drive, St. John's, NL, A1B 3X8, Canada
| | - Catherine Donovan
- Faculty of Medicine, Memorial University of Newfoundland, 300 Prince Philip Drive, St. John's, NL, A1B 3V6, Canada
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Shimosawa T. Quality is not an act, it is a habit-Aristotle. Hypertens Res 2023; 46:1221-1226. [PMID: 36810621 PMCID: PMC9942021 DOI: 10.1038/s41440-023-01234-w] [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: 01/26/2023] [Accepted: 02/03/2023] [Indexed: 02/24/2023]
Abstract
To measure blood pressure precisely and make the data comparable among facilities, measurement methods and devices must be standardized. Since the Minamata Convention on Mercury, there is no metrological standard for sphygmomanometers. The current validation methods recommended by non-profit organizations in Japan, the US, and European Union countries are not necessarily applicable to the clinical setting, and no protocol for daily or routine performance of quality control has been defined. In addition, recent rapid technological advances have enabled monitoring blood pressure at home with wearable devices or without a cuff by using a smartphone app. A clinically relevant validation method for this recent technology is not available. The importance of out-of-office blood pressure measurement is highlighted by guidelines for the diagnosis and treatment of hypertension, but an appropriate protocol for validating a device is required.
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Affiliation(s)
- Tatsuo Shimosawa
- Faculty of Medicine, Department of Clinical Laboratory, International University of Health and Welfare, Narita, Chiba, Japan.
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Jain R, Stone JA, Agarwal G, Andrade JG, Bacon SL, Bajaj HS, Baker B, Cheng G, Dannenbaum D, Gelfer M, Habert J, Hickey J, Keshavjee K, Kitty D, Lindsay P, L'Abbé MR, Lau DCW, Macle L, McDonald M, Nerenberg K, Pearson GJ, Pham T, Poppe AY, Rabi DM, Sherifali D, Selby P, Smith E, Stern S, Thanassoulis G, Terenzi K, Tu K, Udell J, Virani SA, Ward RA, Warburton DER, Wharton S, Zymantas J, Hua-Stewart D, Liu PP, Tobe SW. Ligne directrice C-CHANGE pour l’harmonisation des lignes directrices nationales de prévention et de prise en charge des maladies cardiovasculaires en contexte de soins primaires au Canada: mise à jour 2022. CMAJ 2023; 195:E21-E42. [PMID: 36623864 PMCID: PMC9829070 DOI: 10.1503/cmaj.220138-f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Affiliation(s)
- Rahul Jain
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - James A Stone
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Gina Agarwal
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Jason G Andrade
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Simon L Bacon
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Harpreet S Bajaj
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Brian Baker
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Gemma Cheng
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - David Dannenbaum
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Mark Gelfer
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Jeffrey Habert
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - John Hickey
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Karim Keshavjee
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Darlene Kitty
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Patrice Lindsay
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Mary R L'Abbé
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - David C W Lau
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Laurent Macle
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Michael McDonald
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Kara Nerenberg
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Glen J Pearson
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Thuy Pham
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Alexandre Y Poppe
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Doreen M Rabi
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Diana Sherifali
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Peter Selby
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Eric Smith
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Sol Stern
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - George Thanassoulis
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Kristin Terenzi
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Karen Tu
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Jacob Udell
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Sean A Virani
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Richard A Ward
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Darren E R Warburton
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Sean Wharton
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Jennifer Zymantas
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Diane Hua-Stewart
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
| | - Peter P Liu
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont.
| | - Sheldon W Tobe
- Département de médecine familiale et communautaire (Jain), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Département des sciences cardiaques, Division de cardiologie (Stone), Faculté de médecine Cumming, Université de Calgary, Institut cardiovasculaire Libin de l'Alberta (Stone), Symphony of Health, Calgary, Alb.; Département de médecine familiale (Agarwal), Université McMaster, Hamilton, Ont.; Département de médecine (Andrade), Université de la Colombie-Britannique, Vancouver, C.-B.; Institut de cardiologie de Montréal (Andrade), Université de Montréal, Montréal, Qc; Bureau de la politique et de la promotion de la nutrition (Aziz), Santé Canada, Ottawa, Ont.; Département de Santé, Kinésiologie et Physiologie appliquée (Bacon), Université Concordia, et Centre de médecine comportementale de Montréal (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Qc; Centre de diabétologie Sinaï (Bajaj), Hôpital du Mont Sinaï; Département de psychiatrie (Baker), Université de Toronto, Toronto, Ont.; Centre de médecine familiale Herzl (Cheng), Hôpital général juif; Département de médecine familiale (Cheng), Université McGill; Hôpital général juif, Département de médecine (Dannenbaum), Université McGill, Montréal, Qc; Département de médecine familiale (Gelfer), Université de la Colombie-Britannique, Vancouver, C.-B.; Université de Toronto (Habert), Toronto, Ont.; Département de médecine familiale (Hickey), Hôpital régional St. Martha, Antigonish, N.-É.; Institut des politiques, de la gestion et de l'évaluation de la santé (Keshavjee), École Dalla Lana de santé publique, Université de Toronto, Toronto, Ont.; Faculté de médecine (Kitty), Université d'Ottawa, Ottawa, Ont.; Fondation canadienne des maladies du cœur et de l'AVC (Lindsay), Toronto, Ont.; Département des sciences de la nutrition (L'Abbé), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de biochimie et de biologie moléculaire (Lau), Université de Calgary, Calgary, Alb.; Institut de cardiologie de Montréal (Macle), Université de Montréal, Montréal, Qc; Division de cardiologie (McDonald), Centre de recherche en cardiologie Ted Rogers, Université de Toronto, Toronto, Ont.; Département de médecine (Nerenberg), Institut cardiovasculaire Libin, Université de Calgary, Calgary, Alb.; Division de cardiologie (Pearson), Institut de cardiologie Mazankowski; Université de l'Alberta, Faculté de médecine et de dentisterie (Pearson), Edmonton, Alb.; Division de néphrologie (Pham), Hôpital Sunnybrook, Université de Toronto, Toronto, Ont.; Division de neurologie (Poppe), Centre Hospitalier de l'Université de Montréal; Département de neurosciences (Poppe), Université de Montréal, Montréal, Qc; Division d'endocrinologie et métabolisme (Rabi), Département de médecine, Université de Calgary, Calgary, Alb.; Faculté des sciences infirmières (Sherifali), Université McMaster, Hamilton, Ont.; Centre pour les dépendances et la santé mentale (Selby); Département de médecine familiale et communautaire (Selby), Faculté de médecine Temerty, Université de Toronto, Toronto, Ont.; Département de neurosciences cliniques et Institut de neurologie Hotchkiss (Smith), Université de Calgary, Calgary, Alb.; Centre médical Argus en santé familiale (Stern), Oakville, Ont.; Services de santé Halton (Stern), Toronto, Ont.; Département de médecine (Thanassoulis), Université McGill, Montréal, Qc; Hôpital Humber River (Terenzi); Hôpital général de North York, Toronto Western Hospital-UHN, Université de Toronto (Tu); Maladies cardiovasculaires, Hôpital Women's College et Centre de cardiologie Peter Munk (Udell), Hôpital général de Toronto, Université de Toronto, Toronto, Ont.; Division de cardiologie (Virani), Université de la Colombie-Britannique; Faculté de l'éducation, programme pour la santé autochtone et l'activité physique (Warburton), Université de la Colombie-Britannique, Vancouver, C.-B.; Faculté de médecine Cumming (Ward), Université de Calgary, Calgary, Alb.; Faculté des sciences de la santé (Wharton), Université McMaster, Hamilton, Ont.; Health Sciences North (Zymantas); Faculté de médecine du Nord de l'Ontario (Zymantas), Sudbury, Ont.; Institut de recherche Sunnybrook (Hua-Stewart), Toronto, Ont.; Faculté de médecine (Liu), Institut de cardiologie de l'Université d'Ottawa, Ottawa, Ont.; Faculté de médecine (Liu), Université de Toronto; Division de néphrologie (Tobe), Centre des sciences de la santé Sunnybrook, Université de Toronto, Toronto, Ont.; Faculté de médecine du Nord de l'Ontario (Tobe), Sudbury, Ont
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13
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Yoshida Y, Fujiki R, Kinoshita M, Sada K, Miyamoto S, Ozeki Y, Mori Y, Matsuda N, Noguchi T, Nakama H, Okamoto M, Gotoh K, Masaki T, Shibata H. Importance of dietary salt restriction for patients with primary aldosteronism during treatment with mineralocorticoid receptor antagonists: The potential importance of post-treatment plasma renin levels. Hypertens Res 2023; 46:100-107. [PMID: 36229529 DOI: 10.1038/s41440-022-01045-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/07/2022] [Accepted: 09/09/2022] [Indexed: 02/03/2023]
Abstract
We measured dietary salt intake in 26 patients with primary aldosteronism treated with mineralocorticoid receptor antagonists and evaluated whether plasma renin levels were affected by dietary salt intake pre-treatment and post 6 months of mineralocorticoid receptor antagonist treatment. The dietary salt intake level was calculated using spot urine sodium and creatinine concentrations, body weight, height, and age. The clinical parameters pre- and post- treatment were compared. The systolic and diastolic blood pressure levels decreased, and the serum potassium and active renin concentration increased significantly. Although the dietary salt intake did not change after treatment, the differences in dietary salt intake and active renin concentration pre- and post- treatment were inversely correlated (r = -0.418, p = 0.03). The 26 patients were divided into two groups with active renin concentration levels ≥5 pg/mL (Group 1) and <5 pg/mL (Group 2) after treatment. The Group parameters did not differ pre- and post- treatment. Group 1 evidenced improvements in systolic and diastolic blood pressures, and the potassium level and active renin concentration over time; Group 2 did not. Group 1 evidenced no significant correlation between the differences in dietary salt intake and active renin concentration levels (r = -0.481, p = 0.11) but Group 2 showed a strong inverse correlation (r = -0.7599, p = 0.01). In conclusion, we found that an active renin concentration level <5 pg/mL post-mineralocorticoid receptor antagonist treatment may indicate that salt sensitivity has not adequately improved, emphasizing the importance of measuring plasma renin levels after such treatment.
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Affiliation(s)
- Yuichi Yoshida
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu, Japan
| | - Rika Fujiki
- Faculty of Medicine, Oita University, Yufu, Japan
| | - Mizuki Kinoshita
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu, Japan
| | - Kentaro Sada
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu, Japan
| | - Shotaro Miyamoto
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu, Japan
| | - Yoshinori Ozeki
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu, Japan
| | - Yumi Mori
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu, Japan
| | - Naoki Matsuda
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu, Japan
| | - Takaaki Noguchi
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu, Japan
| | - Hiroshi Nakama
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu, Japan
| | - Mitsuhiro Okamoto
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu, Japan
| | - Koro Gotoh
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu, Japan
| | - Takayuki Masaki
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu, Japan
| | - Hirotaka Shibata
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu, Japan.
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14
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The prevalence of documented cardiovascular-related pregnancy complications: cross-sectional study in an academic primary care centre. BJGP Open 2022; 6:BJGPO.2022.0070. [PMID: 36229068 PMCID: PMC9904780 DOI: 10.3399/bjgpo.2022.0070] [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: 05/11/2022] [Revised: 08/28/2022] [Accepted: 09/20/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Pregnancy and the postpartum period offer a unique opportunity to identify patients with risk factors leading to premature cardiovascular disease (CVD), which often go unrecognised. AIM This study investigates self-reported prevalence of CVD-related pregnancy complications and its documentation in electronic medical records (EMRs) in an academic family health team (AFHT). DESIGN & SETTING A retrospective cross-sectional survey conducted from 2016 to 2017 in an AFHT. METHOD The survey assessed self-reported pregnancy complications and obstetric histories of adult females. EMRs of responders who provided consent were appraised for documented pregnancy complications, and management of traditional cardiovascular risk factors post-pregnancy. RESULTS Out of 211 responders, 28% (n = 60) had at least one pregnancy complication reported in the survey and/or in the EMR, of which 67% (n = 40) had the complication documented in their EMR. The most prevalent complications were preterm birth (PTB; 12%, n = 25), hypertensive disorders of pregnancy (HDP; 10%, n = 22), and gestational diabetes mellitus (GDM; 7%, n = 14). Twenty-nine per cent (n = 4) of the patients with GDM had a 75 g oral glucose tolerance test result documented post-pregnancy. Of those with HDP, 36% (n = 8) had body mass index and 50% (n = 11) had a blood pressure measurement recorded after delivery. CONCLUSION There has been a significant lack of documentation of pregnancy-related cardiovascular risk factors and subsequent management, introducing a missed opportunity for early cardiovascular intervention. Adequate documentation of pregnancy complications in the EMR and better transitions in care between obstetric and primary care teams could potentially enable clinicians to intervene early and better manage females at increased risk of CVD.
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15
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Saifan AR, Alarabyat IA, Alrimawi I, Al-Nsair N. Utilizing telehealth intervention to support patients with cardiovascular diseases in Jordan: A qualitative study. Appl Nurs Res 2022; 68:151641. [PMID: 36473721 DOI: 10.1016/j.apnr.2022.151641] [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: 03/30/2022] [Revised: 08/11/2022] [Accepted: 11/22/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Telemedicine is one of the new technological solutions used to facilitate treatment and intervention in patients with Cardiovascular Diseases (CVD). Nevertheless, the utilization of telehealth in Jordan is under-researched. PURPOSE To explore the perspectives and experiences of patients with cardiovascular disease (CVD) and healthcare providers on how telehealth can help manage critical and long-term CVD health problems. METHOD A qualitative, descriptive approach was employed, whereby individual interviews were conducted with 12 healthcare providers and 12 cardiac patients from Abdali and Prince Hamzah Hospitals in Jordan. The derived data were analyzed using thematic analysis, according to the method expounded by Braun and Clarke (2014). RESULTS The analysis of collected data revealed that telehealth deployment exhibited several advantages from the participants' perspectives, these can be divided into the following six themes: mitigating associated risks, qualified and friendly staff, streamlined work processes, effective and structured services, accessibility and privacy of patient information, affordable and convenient services. CONCLUSION The current study suggests that telehealth can be helpful and convenient in many aspects of the health care services for patients with CVD, mainly during the crucial times of the COVID pandemic. With this study, stakeholders and Jordanian managers can better understand the telehealth advantages. This will enable them to improve the quality of care in their health organizations in the future.
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Affiliation(s)
| | | | - Intima Alrimawi
- School of Nursing, Georgetown University, 3700 Reservoir Road Northwest, Washington, DC 20057, United States of America.
| | - Nezam Al-Nsair
- College of Nursing, Xavier University, Cincinnati, OH, United States of America.
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Jain R, Stone JA, Agarwal G, Andrade JG, Bacon SL, Bajaj HS, Baker B, Cheng G, Dannenbaum D, Gelfer M, Habert J, Hickey J, Keshavjee K, Kitty D, Lindsay P, L'Abbé MR, Lau DCW, Macle L, McDonald M, Nerenberg K, Pearson GJ, Pham T, Poppe AY, Rabi DM, Sherifali D, Selby P, Smith E, Stern S, Thanassoulis G, Terenzi K, Tu K, Udell J, Virani SA, Ward RA, Warburton DER, Wharton S, Zymantas J, Hua-Stewart D, Liu PP, Tobe SW. Canadian Cardiovascular Harmonized National Guideline Endeavour (C-CHANGE) guideline for the prevention and management of cardiovascular disease in primary care: 2022 update. CMAJ 2022; 194:E1460-E1480. [PMID: 36343954 PMCID: PMC9828999 DOI: 10.1503/cmaj.220138] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Rahul Jain
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - James A Stone
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Gina Agarwal
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Jason G Andrade
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Simon L Bacon
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Harpreet S Bajaj
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Brian Baker
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Gemma Cheng
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - David Dannenbaum
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Mark Gelfer
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Jeffrey Habert
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - John Hickey
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Karim Keshavjee
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Darlene Kitty
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Patrice Lindsay
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Mary R L'Abbé
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - David C W Lau
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Laurent Macle
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Michael McDonald
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Kara Nerenberg
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Glen J Pearson
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Thuy Pham
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Alexandre Y Poppe
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Doreen M Rabi
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Diana Sherifali
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Peter Selby
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont.
| | - Eric Smith
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Sol Stern
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - George Thanassoulis
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Kristin Terenzi
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Karen Tu
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Jacob Udell
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Sean A Virani
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Richard A Ward
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Darren E R Warburton
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Sean Wharton
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Jennifer Zymantas
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Diane Hua-Stewart
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Peter P Liu
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Sheldon W Tobe
- Department of Family and Community Medicine (Jain), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Department of Cardiac Sciences, Division of Cardiology (Stone), Cumming School of Medicine University of Calgary, Libin Cardiovascular Institute of Alberta (Stone), Symphony of Health, Calgary, Alta.; Department of Family Medicine (Agarwal), McMaster University, Hamilton, Ont.; Department of Medicine (Andrade), University of British Columbia, Vancouver, BC; Montréal Heart Institute (Andrade), Université of Montréal, Que.; Office of Nutrition Policy Promotion (Aziz), Health Canada, Ottawa, Ont.; Department of Health, Kinesiology & Applied Physiology (Bacon), Concordia University, and the Montreal Behavioural Medicine Centre (Bacon), Centre intégré universitaire de santé et de services sociaux du Nord-de-l'Île-de-Montréal, Montréal, Que.; Sinai Centre for Diabetes (Bajaj), Mount Sinai Hospital; Department of Psychiatry (Baker), University of Toronto, Toronto, Ont.; Herzl Family Practice Centre (Cheng), Jewish General Hospital; Department of Family Medicine (Cheng), McGill University; Jewish General Hospital, Department of Medicine (Dannenbaum), McGill University, Montréal, Que.; Department of Family Practice (Gelfer), University of British Columbia, Vancouver, BC; University of Toronto (Habert), Toronto, Ont.; Department of Family Medicine (Hickey), St. Martha's Regional Hospital, Antigonish, NS; Institute of Health Policy, Management and Evaluation (Keshavjee), Dalla Lana School of Public Health, University of Toronto, Toronto, Ont.; Faculty of Medicine (Kitty), University of Ottawa, Ottawa, Ont.; Heart and Stroke Foundation of Canada (Lindsay), Toronto, Ont.; Department of Nutritional Sciences (L'Abbé), Temerty Faculty of Medicine, University of Toronto, Toronto, Ont.; Department of Biochemistry and Molecular Biology (Lau), University of Calgary, Calgary, Alta.; Institut de Cardiologie de Montréal (Macle), Université de Montréal, Montréal, Que.; Division of Cardiology (McDonald), Ted Rogers Centre for Heart Research, University of Toronto, Toronto, Ont.; Department of Medicine (Nerenberg), Libin Cardiovascular Institute, University of Calgary, Calgary, Alta.; Division of Cardiology (Pearson), Mazankowski Alberta Heart Institute; University of Alberta, Faculty of Medicine and Dentistry (Pearson), Edmonton, Alta.; Division of Nephrology (Pham), Sunnybrook Hospital, University of Toronto, Toronto, Ont.; Division of Neurology (Poppe), Centre Hospitalier de l'Université de Montréal; Department of Neurosciences (Poppe), Université de Montréal, Montréal, Que.; Division of Endocrinology and Metabolism (Rabi), Department of Medicine, University of Calgary, Calgary, Alta.; School of Nursing (Sherifali), McMaster University, Hamilton, Ont.; Centre for Addiction and Mental Health (Selby), Toronto, Ont.; Department of Family and Community Medicine (Selby), Temerty Faculty of Medicine, University of Toronto, Toront, Ont.; Department of Clinical Neurosciences and Hotchkiss Brain Institute (Smith), University of Calgary, Calgary, Alta.; Argus Medical Centre Family Health Organization (Stern), Oakville, Ont.; Halton Healthcare Services (Stern), Toronto, Ont.; Department of Medicine (Thanassoulis), McGill University, Montréal, Que.; Humber River Hospital (Terenzi), Toronto, Ont.; North York General Hospital, Toronto Western Hospital-UHN, University of Toronto (Tu), Toronto, Ont.; Cardiovascular Disease, Women's College Hospital and Peter Munk Cardiac Centre (Udell), Toronto General Hospital, University of Toronto, Toronto, Ont.; Division of Cardiology (Virani), University of British Columbia; Faculty of Education, Indigenous Health & Physical Activity Program (Warburton), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Ward), University of Calgary, Calgary, Alta.; Faculty of Health Sciences (Wharton), McMaster University, Hamilton, Ont.; Health Sciences North (Zymantas); Northern Ontario School of Medicine (Zymantas), Sudbury, Ont.; Sunnybrook Research Institute (Hua-Stewart), Toronto, Ont.; Faculty of Medicine (Liu), University of Ottawa Heart Institute, Ottawa, Ont.; Faculty of Medicine (Liu), University of Toronto, Toronto, Ont.; Division of Nephrology (Tobe), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
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The Special Issue on “The Nutritional Value of Pulses and Whole Grains”: A Continued Endeavor to Delineate Their Benefits for Today and Addressing the Challenges of the Future. Nutrients 2022; 14:nu14163381. [PMID: 36014887 PMCID: PMC9416299 DOI: 10.3390/nu14163381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 08/05/2022] [Accepted: 08/16/2022] [Indexed: 11/17/2022] Open
Abstract
Dietary patterns are increasingly focusing on the interplay between nutritional adequacy, reduction of chronic disease, and environmental sustainability [...]
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Kokorovic A, So AI, Serag H, French C, Hamilton RJ, Izard JP, Nayak JG, Pouliot F, Saad F, Shayegan B, Aprikian A, Rendon RA. UPDATE - Canadian Urological Association guideline on androgen deprivation therapy: Adverse events and management strategies. Can Urol Assoc J 2022; 16:E416-E431. [PMID: 35905482 PMCID: PMC9343157 DOI: 10.5489/cuaj.8054] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2023]
Affiliation(s)
- Andrea Kokorovic
- Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Alan I So
- Department of Urological Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Hosam Serag
- Department of Urological Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Christopher French
- Department of Surgery, Division of Urology, Memorial University, St. John's, NL, Canada
| | - Robert J Hamilton
- Division of Urology, Department of Surgery, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Jason P Izard
- Department of Urology, Queen's University, Kingston, ON, Canada
| | - Jasmir G Nayak
- Section of Urology, Department of Surgery, University of Manitoba, Winnipeg, MB, Canada
| | | | - Fred Saad
- Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Bobby Shayegan
- Department of Surgery (Urology) and Oncology, McMaster University, Hamilton, ON, Canada
| | | | - Ricardo A Rendon
- Department of Urology, Dalhousie, University, Halifax, NS, Canada
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Talukdar JR, Cooper MA, Lyutvyn L, Zeraatkar D, Ali R, Bierbrier R, Janes S, Ha V, Darling PB, Sievenpiper JL, Jenkins DJA, Banfield L, Mbuagbaw L, de Souza RJ. Effects of inulin-type fructans supplementation on cardiovascular disease risk factors: a protocol for a systematic review and meta-analysis of randomised controlled trials. BMJ Open 2022; 12:e058875. [PMID: 35793918 PMCID: PMC9260802 DOI: 10.1136/bmjopen-2021-058875] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION This review aims to assess the effects of dietary supplementation with inulin-type fructans (ITF) compared with no supplementation on cardiovascular disease risk factors in adults and assess the quality of trial reporting using the Consolidated Standards of Reporting Trials (CONSORT) and CONSORT for abstract (CONSORT-A) checklists. METHODS AND ANALYSIS We will search randomised controlled trials (RCTs) in MEDLINE, EMBASE, CINAHL, Emcare, AMED and the Cochrane Database of Systematic Reviews from inception to 31 March 2022, without any language restrictions. The RCTs need to administer ITF in adults for at least 2 weeks and assess effects on at least one cardiovascular risk factor. We will exclude RCTs that (1) assessed the postprandial effects of ITF; (2) included pregnant or lactating participants; (3) enrolled participants undergoing treatment that might affect the response to ITF. We will assess the study risk of bias (RoB) using V.2 of the Cochrane RoB tool for RCTs (RoB 2) and the certainty of the evidence using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. We will pool data using a random-effects model. We will use the χ2 test to compare compliance of CONSORT and CONSORT-A checklists and Poisson regression to identify factors associated with better reporting. ETHICS AND DISSEMINATION Ethics approval is not required for secondary analysis of already published data. We will publish the reviews in a peer-review journal. PROSPERO REGISTRATION NUMBER CRD42019136745.
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Affiliation(s)
- Jhalok Ronjan Talukdar
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | | | - Lyuba Lyutvyn
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Dena Zeraatkar
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USA
| | - Rahim Ali
- Faculty of Law (Common Law Section), University of Ottawa, Ottawa, Ontario, Canada
| | - Rachel Bierbrier
- Department of Dermatology, McGill University Health Centre, Montreal, Québec, Canada
| | | | - Vanessa Ha
- School of Medicine, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
| | - Pauline B Darling
- School of Nutrition Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - John L Sievenpiper
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - David J A Jenkins
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Clinical Nutrition and Risk Factor Modification centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
- Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Laura Banfield
- Health Sciences Library, McMaster University, Hamilton, Ontario, Canada
| | - Lawrence Mbuagbaw
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada
- Biostatistics Unit, Father Sean O'Sullivan Research Centre, St Joseph's Healthcare, Hamilton, Ontario, Canada
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Centre for Development of Best Practices in Health (CDBPH), Yaoundé Central Hospital, Yaoundé, Cameroon
- Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - Russell J de Souza
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Global Health Graduate Program, McMaster University, Hamilton, Ontario, Canada
- Population Health Research Institute, Hamilton Health Sciences Corporation, Hamilton, Ontario, Canada
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Chu A, Shah BR, Rashid M, Booth GL, Fazli GS, Tu K, Sun LY, Abdel-Qadir H, Yu CH, Shin S, Connelly KA, Tobe S, Liu PP, Lee DS. Trends in glucose testing among individuals without diabetes in Ontario between 2010 and 2017: a population-based cohort study. CMAJ Open 2022; 10:E772-E780. [PMID: 35998927 PMCID: PMC9402266 DOI: 10.9778/cmajo.20210195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Early identification of people with diabetes or prediabetes enables greater opportunities for glycemic control and management strategies to prevent related complications. To identify gaps in screening for these conditions, we examined population trends in receipt of timely glucose testing overall and in specific clinical subgroups. METHODS Using linked administrative databases, we conducted a retrospective cohort study of people aged 40 years and older without diabetes at baseline. Our primary outcome was up-to-date glucose testing, defined as having received testing at least once in the 3 years before each index year from 2010 to 2017, using linked administrative databases of people residing in Ontario, Canada. We calculated rates of up-to-date testing by age group, sex, ethnicity (South Asian, Chinese, general population) and comorbidities (hypertension, hyperlipidemia, cardiovascular disease). RESULTS Over the 8-year study period, up-to-date glucose testing rates were stable at 67% for men and 77% for women (both relative risk 1.00 per year; 95% confidence interval 1.00-1.00). Testing rates were significantly lower in men than in women (all age groups p < 0.001) and lower in younger than older age groups (except those aged ≥ 80 yr). South Asian people had the highest testing rates, although among people aged 70 years or older, testing was highest in the general population (p < 0.001). Among people with hypertension, hyperlipidemia and cardiovascular disease, annual testing rates were also stable, but only 58% overall among people with hypertension. INTERPRETATION We found lower glucose testing rates in younger men and people with hypertension. Our findings reinforce the need for initiatives to increase awareness of glycemic testing.
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Affiliation(s)
- Anna Chu
- ICES Central (Chu, Shah, Rashid, Booth, Sun, Abdel-Qadir, Tobe, Lee); University of Toronto (Chu, Shah, Booth, Fazli, Tu, Abdel-Qadir, Yu, Connelly, Tobe, Lee); Sunnybrook Health Sciences Centre (Shah, Tobe); Unity Health Toronto (Booth, Fazli, Yu, Connelly); University Health Network (Tu, Abdel-Qadir, Lee); North York General Hospital (Tu), Toronto, Ont.; University of Ottawa Heart Institute (Sun, Liu); University of Ottawa (Sun, Shin), Ottawa, Ont.; Woman's College Hospital (Abdel-Qadir); Keenan Research Centre (Connelly), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Baiju R Shah
- ICES Central (Chu, Shah, Rashid, Booth, Sun, Abdel-Qadir, Tobe, Lee); University of Toronto (Chu, Shah, Booth, Fazli, Tu, Abdel-Qadir, Yu, Connelly, Tobe, Lee); Sunnybrook Health Sciences Centre (Shah, Tobe); Unity Health Toronto (Booth, Fazli, Yu, Connelly); University Health Network (Tu, Abdel-Qadir, Lee); North York General Hospital (Tu), Toronto, Ont.; University of Ottawa Heart Institute (Sun, Liu); University of Ottawa (Sun, Shin), Ottawa, Ont.; Woman's College Hospital (Abdel-Qadir); Keenan Research Centre (Connelly), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Mohammed Rashid
- ICES Central (Chu, Shah, Rashid, Booth, Sun, Abdel-Qadir, Tobe, Lee); University of Toronto (Chu, Shah, Booth, Fazli, Tu, Abdel-Qadir, Yu, Connelly, Tobe, Lee); Sunnybrook Health Sciences Centre (Shah, Tobe); Unity Health Toronto (Booth, Fazli, Yu, Connelly); University Health Network (Tu, Abdel-Qadir, Lee); North York General Hospital (Tu), Toronto, Ont.; University of Ottawa Heart Institute (Sun, Liu); University of Ottawa (Sun, Shin), Ottawa, Ont.; Woman's College Hospital (Abdel-Qadir); Keenan Research Centre (Connelly), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Gillian L Booth
- ICES Central (Chu, Shah, Rashid, Booth, Sun, Abdel-Qadir, Tobe, Lee); University of Toronto (Chu, Shah, Booth, Fazli, Tu, Abdel-Qadir, Yu, Connelly, Tobe, Lee); Sunnybrook Health Sciences Centre (Shah, Tobe); Unity Health Toronto (Booth, Fazli, Yu, Connelly); University Health Network (Tu, Abdel-Qadir, Lee); North York General Hospital (Tu), Toronto, Ont.; University of Ottawa Heart Institute (Sun, Liu); University of Ottawa (Sun, Shin), Ottawa, Ont.; Woman's College Hospital (Abdel-Qadir); Keenan Research Centre (Connelly), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Ghazal S Fazli
- ICES Central (Chu, Shah, Rashid, Booth, Sun, Abdel-Qadir, Tobe, Lee); University of Toronto (Chu, Shah, Booth, Fazli, Tu, Abdel-Qadir, Yu, Connelly, Tobe, Lee); Sunnybrook Health Sciences Centre (Shah, Tobe); Unity Health Toronto (Booth, Fazli, Yu, Connelly); University Health Network (Tu, Abdel-Qadir, Lee); North York General Hospital (Tu), Toronto, Ont.; University of Ottawa Heart Institute (Sun, Liu); University of Ottawa (Sun, Shin), Ottawa, Ont.; Woman's College Hospital (Abdel-Qadir); Keenan Research Centre (Connelly), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Karen Tu
- ICES Central (Chu, Shah, Rashid, Booth, Sun, Abdel-Qadir, Tobe, Lee); University of Toronto (Chu, Shah, Booth, Fazli, Tu, Abdel-Qadir, Yu, Connelly, Tobe, Lee); Sunnybrook Health Sciences Centre (Shah, Tobe); Unity Health Toronto (Booth, Fazli, Yu, Connelly); University Health Network (Tu, Abdel-Qadir, Lee); North York General Hospital (Tu), Toronto, Ont.; University of Ottawa Heart Institute (Sun, Liu); University of Ottawa (Sun, Shin), Ottawa, Ont.; Woman's College Hospital (Abdel-Qadir); Keenan Research Centre (Connelly), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Louise Y Sun
- ICES Central (Chu, Shah, Rashid, Booth, Sun, Abdel-Qadir, Tobe, Lee); University of Toronto (Chu, Shah, Booth, Fazli, Tu, Abdel-Qadir, Yu, Connelly, Tobe, Lee); Sunnybrook Health Sciences Centre (Shah, Tobe); Unity Health Toronto (Booth, Fazli, Yu, Connelly); University Health Network (Tu, Abdel-Qadir, Lee); North York General Hospital (Tu), Toronto, Ont.; University of Ottawa Heart Institute (Sun, Liu); University of Ottawa (Sun, Shin), Ottawa, Ont.; Woman's College Hospital (Abdel-Qadir); Keenan Research Centre (Connelly), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Husam Abdel-Qadir
- ICES Central (Chu, Shah, Rashid, Booth, Sun, Abdel-Qadir, Tobe, Lee); University of Toronto (Chu, Shah, Booth, Fazli, Tu, Abdel-Qadir, Yu, Connelly, Tobe, Lee); Sunnybrook Health Sciences Centre (Shah, Tobe); Unity Health Toronto (Booth, Fazli, Yu, Connelly); University Health Network (Tu, Abdel-Qadir, Lee); North York General Hospital (Tu), Toronto, Ont.; University of Ottawa Heart Institute (Sun, Liu); University of Ottawa (Sun, Shin), Ottawa, Ont.; Woman's College Hospital (Abdel-Qadir); Keenan Research Centre (Connelly), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Catherine H Yu
- ICES Central (Chu, Shah, Rashid, Booth, Sun, Abdel-Qadir, Tobe, Lee); University of Toronto (Chu, Shah, Booth, Fazli, Tu, Abdel-Qadir, Yu, Connelly, Tobe, Lee); Sunnybrook Health Sciences Centre (Shah, Tobe); Unity Health Toronto (Booth, Fazli, Yu, Connelly); University Health Network (Tu, Abdel-Qadir, Lee); North York General Hospital (Tu), Toronto, Ont.; University of Ottawa Heart Institute (Sun, Liu); University of Ottawa (Sun, Shin), Ottawa, Ont.; Woman's College Hospital (Abdel-Qadir); Keenan Research Centre (Connelly), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Sheojung Shin
- ICES Central (Chu, Shah, Rashid, Booth, Sun, Abdel-Qadir, Tobe, Lee); University of Toronto (Chu, Shah, Booth, Fazli, Tu, Abdel-Qadir, Yu, Connelly, Tobe, Lee); Sunnybrook Health Sciences Centre (Shah, Tobe); Unity Health Toronto (Booth, Fazli, Yu, Connelly); University Health Network (Tu, Abdel-Qadir, Lee); North York General Hospital (Tu), Toronto, Ont.; University of Ottawa Heart Institute (Sun, Liu); University of Ottawa (Sun, Shin), Ottawa, Ont.; Woman's College Hospital (Abdel-Qadir); Keenan Research Centre (Connelly), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Kim A Connelly
- ICES Central (Chu, Shah, Rashid, Booth, Sun, Abdel-Qadir, Tobe, Lee); University of Toronto (Chu, Shah, Booth, Fazli, Tu, Abdel-Qadir, Yu, Connelly, Tobe, Lee); Sunnybrook Health Sciences Centre (Shah, Tobe); Unity Health Toronto (Booth, Fazli, Yu, Connelly); University Health Network (Tu, Abdel-Qadir, Lee); North York General Hospital (Tu), Toronto, Ont.; University of Ottawa Heart Institute (Sun, Liu); University of Ottawa (Sun, Shin), Ottawa, Ont.; Woman's College Hospital (Abdel-Qadir); Keenan Research Centre (Connelly), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Sheldon Tobe
- ICES Central (Chu, Shah, Rashid, Booth, Sun, Abdel-Qadir, Tobe, Lee); University of Toronto (Chu, Shah, Booth, Fazli, Tu, Abdel-Qadir, Yu, Connelly, Tobe, Lee); Sunnybrook Health Sciences Centre (Shah, Tobe); Unity Health Toronto (Booth, Fazli, Yu, Connelly); University Health Network (Tu, Abdel-Qadir, Lee); North York General Hospital (Tu), Toronto, Ont.; University of Ottawa Heart Institute (Sun, Liu); University of Ottawa (Sun, Shin), Ottawa, Ont.; Woman's College Hospital (Abdel-Qadir); Keenan Research Centre (Connelly), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Peter P Liu
- ICES Central (Chu, Shah, Rashid, Booth, Sun, Abdel-Qadir, Tobe, Lee); University of Toronto (Chu, Shah, Booth, Fazli, Tu, Abdel-Qadir, Yu, Connelly, Tobe, Lee); Sunnybrook Health Sciences Centre (Shah, Tobe); Unity Health Toronto (Booth, Fazli, Yu, Connelly); University Health Network (Tu, Abdel-Qadir, Lee); North York General Hospital (Tu), Toronto, Ont.; University of Ottawa Heart Institute (Sun, Liu); University of Ottawa (Sun, Shin), Ottawa, Ont.; Woman's College Hospital (Abdel-Qadir); Keenan Research Centre (Connelly), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont
| | - Douglas S Lee
- ICES Central (Chu, Shah, Rashid, Booth, Sun, Abdel-Qadir, Tobe, Lee); University of Toronto (Chu, Shah, Booth, Fazli, Tu, Abdel-Qadir, Yu, Connelly, Tobe, Lee); Sunnybrook Health Sciences Centre (Shah, Tobe); Unity Health Toronto (Booth, Fazli, Yu, Connelly); University Health Network (Tu, Abdel-Qadir, Lee); North York General Hospital (Tu), Toronto, Ont.; University of Ottawa Heart Institute (Sun, Liu); University of Ottawa (Sun, Shin), Ottawa, Ont.; Woman's College Hospital (Abdel-Qadir); Keenan Research Centre (Connelly), Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ont.; Northern Ontario School of Medicine (Tobe), Sudbury, Ont.
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Lin E, Gobraeil J, Johnston S, Venables MJ, Archibald D. Consensus-Based Development of an Assessment Tool: A Methodology for Patient Engagement in Primary Care and CPD Research. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2022; 42:153-158. [PMID: 35916890 PMCID: PMC9398503 DOI: 10.1097/ceh.0000000000000440] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
With cardiovascular disease (CVD) posing a significant disease burden in Canada and more broadly, preventative efforts which incorporate best evidence, patient preference, and physician expertise must continue to take place. Primary care providers play a pivotal role in this effort, and a greater understanding of patient perspectives is needed to guide management and inform training. We used a validated consensus method, the nominal group technique (NGT), to identify patient-reported experience measures (PREM) related to CVD prevention deemed most important by both patients and providers. The NGT was used by using structured discussions between patients and providers to bring ideas about PREM CVD outcomes to a consensus. Four patient partners and four primary care providers were selected to participate in an NGT session. Each participant wrote down items/questions they believed important in CVD preventative care. After discussions, all items underwent anonymous ranking on a 5-point scale. Items were included/excluded based on 75% agreement a priori. The panel produced 10 items from a total of 26 after 2 rounds of ranking. The top two items were as follows: "Is your treatment plan tailored to you" and "Was your physician good at giving information about your risk factors?" These results are significantly different compared with existing quality measures because they highlight aspects of patient experience and therapeutic relationship. A questionnaire consisting of prioritized PREM items is valuable in quality improvement and continuous professional development (CPD).
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Brauer P, Royall D, Li A, Rodrigues A, Green J, Macklin S, Craig A, Chan M, Pasanen J, Brunelle L, Dhaliwal R, Klein D, Tremblay A, Rheaume C, Mutch DM, Jeejeebhoy K. Key process features of personalized diet counselling in metabolic syndrome: secondary analysis of feasibility study in primary care. BMC Nutr 2022; 8:45. [PMID: 35534841 PMCID: PMC9081667 DOI: 10.1186/s40795-022-00540-9] [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] [Received: 11/04/2021] [Accepted: 04/29/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Personalized diet counselling, as part of lifestyle change programs for cardiometabolic risk conditions (combinations of prediabetes or type 2 diabetes, hypertension, dyslipidemia and high waist circumference) has been shown to reduce progression to type 2 diabetes overall. To identify key process of care measures that could be linked to changes in diet, we undertook a secondary analysis of a Canadian pre-post study of lifestyle treatment of metabolic syndrome (MetS). Diet counselling process measures were documented and association with diet quality changes after 3 months were assessed. Results of the primary study showed 19% reversal of MetS after 1 year. METHODS Registered dietitians (RDs) reported on contact time, specific food behaviour goals (FBG), behaviour change techniques (BCT; adapted from the Michie CALO-RE taxonomy) and teaching resources at each contact. Diet quality was measured by 2005 Canadian Healthy Eating Index (HEI-C) and assessed for possible associations with individual BCT and FBG. RESULTS Food behaviour goals associated with improved HEI-C at 3 months were: poultry more than red meat, increased plant protein, increased fish, increased olive oil, increased fruits and vegetables, eating breakfast, increased milk and alternatives, healthier fats, healthier snacks and increased nuts, with an adverse association noted for more use (> 2 times/ 3 months) of the balanced meal concept (F test; p < 0.001). Of 16 BCT, goal setting accounted for 15% of all BCT recorded, yet more goal setting (> 3 times/3 months) was associated with poorer HEI-C at 3 months (F test; p = 0.007). Only self-monitoring, feedback on performance and focus on past success were associated with improved HEI-C. CONCLUSIONS These results identify key aspects of process that impact diet quality. Documentation of both FBG and BCT is highly relevant in diet counselling and a summary diet quality score is a promising target for assessing short-term counselling success.
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Affiliation(s)
- Paula Brauer
- Department of Family Relations & Applied Nutrition, University of Guelph, 50 Stone Road East, Guelph, ON N1G 2W1 Canada
| | - Dawna Royall
- Department of Family Relations & Applied Nutrition, University of Guelph, 50 Stone Road East, Guelph, ON N1G 2W1 Canada
| | - Airu Li
- Department of Family Relations & Applied Nutrition, University of Guelph, 50 Stone Road East, Guelph, ON N1G 2W1 Canada
| | - Ariellia Rodrigues
- Department of Family Relations & Applied Nutrition, University of Guelph, 50 Stone Road East, Guelph, ON N1G 2W1 Canada
| | - Jennifer Green
- Department of Family Relations & Applied Nutrition, University of Guelph, 50 Stone Road East, Guelph, ON N1G 2W1 Canada
- Current address: Trillium Health Partners, Mississauga, ON Canada
| | - Sharon Macklin
- Edmonton Oliver Primary Care Network, Edmonton, AB Canada
| | - Alison Craig
- Edmonton Oliver Primary Care Network, Edmonton, AB Canada
| | - Miranda Chan
- Edmonton Oliver Primary Care Network, Edmonton, AB Canada
| | | | - Lucie Brunelle
- Department of Kinesiology, Laval University, Québec, QC Canada
| | - Rupinder Dhaliwal
- Metabolic Syndrome Canada, Kingston, ON Canada
- Current address: Canadian Nutrition Society, Kemptville, ON Canada
| | - Doug Klein
- Department of Family Medicine, University of Alberta, Edmonton, AB Canada
| | - Angelo Tremblay
- Department of Kinesiology, Laval University, Québec, QC Canada
| | - Caroline Rheaume
- Department of Family Medicine and Emergency Medicine, Laval University, Québec, QC Canada
| | - David M. Mutch
- Department of Human Health & Nutritional Sciences, University of Guelph, Guelph, ON Canada
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Brauer P, Desroches S, Dhaliwal R, Li A, Wang Y, Conklin AI, Klein D, Drouin-Chartier JP, Robitaille J, Horne J, Ponta ML, Burns R, Harding SV, Hosseini Z, Santosa S. Modified Delphi Process to Identify Research Priorities and Measures for Adult Lifestyle Programs to Address Type 2 Diabetes and Other Cardiometabolic Risk Conditions. Can J Diabetes 2022; 46:411-418. [DOI: 10.1016/j.jcjd.2022.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 01/05/2022] [Accepted: 01/11/2022] [Indexed: 11/26/2022]
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Kavanagh ME, Chiavaroli L, Glenn AJ, Heijmans G, Grant SM, Chow CM, Josse RG, Malik VS, Watson W, Lofters A, Holmes C, Rackal J, Srichaikul K, Sherifali D, Snelgrove-Clarke E, Udell JA, Juni P, Booth GL, Farkouh ME, Leiter LA, Kendall CWC, Jenkins DJA, Sievenpiper JL. Quality improvement and usability testing of the PortfolioDiet.app, a web-based health application to translate nutrition therapy for cardiovascular risk reduction in primary care (Preprint). JMIR Hum Factors 2021; 9:e34704. [PMID: 35451981 PMCID: PMC9073604 DOI: 10.2196/34704] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 02/04/2022] [Accepted: 02/13/2022] [Indexed: 12/26/2022] Open
Abstract
Background The Portfolio Diet, or Dietary Portfolio, is a therapeutic dietary pattern that combines cholesterol-lowering foods to manage dyslipidemia for the prevention of cardiovascular disease. To translate the Portfolio Diet for primary care, we developed the PortfolioDiet.app as a patient and physician educational and engagement tool for PCs and smartphones. The PortfolioDiet.app is currently being used as an add-on therapy to the standard of care (usual care) for the prevention of cardiovascular disease in primary care. To enhance the adoption of this tool, it is important to ensure that the PortfolioDiet.app meets the needs of its target end users. Objective The main objective of this project is to undertake user testing to inform modifications to the PortfolioDiet.app as part of ongoing engagement in quality improvement (QI). Methods We undertook a 2-phase QI project from February 2021 to September 2021. We recruited users by convenience sampling. Users included patients, family physicians, and dietitians, as well as nutrition and medical students. For both phases, users were asked to use the PortfolioDiet.app daily for 7 days. In phase 1, a mixed-form questionnaire was administered to evaluate the users’ perceived acceptability, knowledge acquisition, and engagement with the PortfolioDiet.app. The questionnaire collected both quantitative and qualitative data, including 2 open-ended questions. The responses were used to inform modifications to the PortfolioDiet.app. In phase 2, the System Usability Scale was used to assess the usability of the updated PortfolioDiet.app, with a score higher than 70 being considered acceptable. Results A total of 30 and 19 users were recruited for phase 1 and phase 2, respectively. In phase 1, the PortfolioDiet.app increased users’ perceived knowledge of the Portfolio Diet and influenced their perceived food choices. Limitations identified by users included challenges navigating to resources and profile settings, limited information on plant sterols, inaccuracies in points, timed-logout frustration, request for step-by-step pop-up windows, and request for a mobile app version; when looking at positive feedback, the recipe section was the most commonly praised feature. Between the project phases, 6 modifications were made to the PortfolioDiet.app to incorporate and address user feedback. At phase 2, the average System Usability Scale score was 85.39 (SD 11.47), with 100 being the best possible. Conclusions By undertaking user testing of the PortfolioDiet.app, its limitations and strengths were able to be identified, informing modifications to the application, which resulted in a clinical tool that better meets users’ needs. The PortfolioDiet.app educates users on the Portfolio Diet and is considered acceptable by users. Although further refinements to the PortfolioDiet.app will continue to be made before its evaluation in a clinical trial, the result of this QI project is an improved clinical tool.
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Affiliation(s)
- Meaghan E Kavanagh
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Laura Chiavaroli
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Andrea J Glenn
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Genevieve Heijmans
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Shannan M Grant
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS, Canada
- Departments of Pediatrics and Obstetrics and Gynaecology, IWK Health, Halifax, NS, Canada
- Department of Obstetrics and Gynaecology, Faulty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Chi-Ming Chow
- Division of Cardiology, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Robert G Josse
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Division of Endocrinology and Metabolism, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Vasanti S Malik
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - William Watson
- Department of Family and Community Medicine, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Aisha Lofters
- Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Family Practice Health Centre, Women's College Hospital, Toronto, ON, Canada
- Peter Gilgan Centre for Women's Cancers, Women's College Hospital, Toronto, ON, Canada
| | - Candice Holmes
- Department of Family and Community Medicine, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Julia Rackal
- Department of Family and Community Medicine, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Kristie Srichaikul
- Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
| | - Diana Sherifali
- School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Erna Snelgrove-Clarke
- School of Nursing, Faculty of Health Sciences, Queen's University, Kingston, ON, Canada
| | - Jacob A Udell
- Women's College Research Institute and Cardiovascular Division, Department of Medicine, Women's College Hospital, University of Toronto, Toronto, ON, Canada
- Applied Health Research Centre, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Department of Medicine, University of Toronto, Toronto, ON, Canada
- Institute for Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- ICES, Toronto, ON, Canada
- Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Peter Munk Cardiac Centre and the Heart and Stroke Richard Lewar Centre, University of Toronto, Toronto, ON, Canada
| | - Peter Juni
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Applied Health Research Centre, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Department of Medicine, University of Toronto, Toronto, ON, Canada
- Institute for Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Gillian L Booth
- Institute for Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- ICES, Toronto, ON, Canada
- Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- MAP Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
| | - Michael E Farkouh
- Peter Munk Cardiac Centre and the Heart and Stroke Richard Lewar Centre, University of Toronto, Toronto, ON, Canada
| | - Lawrence A Leiter
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Division of Endocrinology and Metabolism, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Cyril W C Kendall
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada
| | - David J A Jenkins
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Division of Endocrinology and Metabolism, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - John L Sievenpiper
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Toronto 3D Knowledge Synthesis and Clinical Trials Unit, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Division of Endocrinology and Metabolism, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada
- Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Evaluation of Latent Models Assessing Physical Fitness and the Healthy Eating Index in Community Studies: Time-, Sex-, and Diabetes-Status Invariance. Nutrients 2021; 13:nu13124258. [PMID: 34959810 PMCID: PMC8708138 DOI: 10.3390/nu13124258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 11/19/2021] [Accepted: 11/20/2021] [Indexed: 01/04/2023] Open
Abstract
Accurate measurement requires assessment of measurement equivalence/invariance (ME/I) to demonstrate that the tests/measurements perform equally well and measure the same underlying constructs across groups and over time. Using structural equation modeling, the measurement properties (stability and responsiveness) of intervention measures used in a study of metabolic syndrome (MetS) treatment in primary care offices, were assessed. The primary study (N = 293; mean age = 59 years) had achieved 19% reversal of MetS overall; yet neither diet quality nor aerobic capacity were correlated with declines in cardiovascular disease risk. Factor analytic methods were used to develop measurement models and factorial invariance were tested across three time points (baseline, 3-month, 12-month), sex (male/female), and diabetes status for the Canadian Healthy Eating Index (2005 HEI-C) and several fitness measures combined (percentile VO2 max from submaximal exercise, treadmill speed, curl-ups, push-ups). The model fit for the original HEI-C was poor and could account for the lack of associations in the primary study. A reduced HEI-C and a 4-item fitness model demonstrated excellent model fit and measurement equivalence across time, sex, and diabetes status. Increased use of factor analytic methods increases measurement precision, controls error, and improves ability to link interventions to expected clinical outcomes.
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Dietary Glycaemic Index Labelling: A Global Perspective. Nutrients 2021; 13:nu13093244. [PMID: 34579120 PMCID: PMC8466312 DOI: 10.3390/nu13093244] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/07/2021] [Accepted: 09/14/2021] [Indexed: 11/28/2022] Open
Abstract
The glycaemic index (GI) is a food metric that ranks the acute impact of available (digestible) carbohydrates on blood glucose. At present, few countries regulate the inclusion of GI on food labels even though the information may assist consumers to manage blood glucose levels. Australia and New Zealand regulate GI claims as nutrition content claims and also recognize the GI Foundation’s certified Low GI trademark as an endorsement. The GI Foundation of South Africa endorses foods with low, medium and high GI symbols. In Asia, Singapore’s Healthier Choice Symbol has specific provisions for low GI claims. Low GI claims are also permitted on food labels in India. In China, there are no national regulations specific to GI; however, voluntary claims are permitted. In the USA, GI claims are not specifically regulated but are permitted, as they are deemed to fall under general food-labelling provisions. In Canada and the European Union, GI claims are not legal under current food law. Inconsistences in food regulation around the world undermine consumer and health professional confidence and call for harmonization. Global provisions for GI claims/endorsements in food standard codes would be in the best interests of people with diabetes and those at risk.
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Brauer P, Royall D, Rodrigues A. Use of the Healthy Eating Index in Intervention Studies for Cardiometabolic Risk Conditions: A Systematic Review. Adv Nutr 2021; 12:1317-1331. [PMID: 33460430 PMCID: PMC8321868 DOI: 10.1093/advances/nmaa167] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/17/2020] [Accepted: 12/01/2020] [Indexed: 12/15/2022] Open
Abstract
Researchers and counselors need diet-assessment tools that characterize diet at baseline and over time in diet counseling and coaching interventions. Among possible tools, the Healthy Eating Index (HEI) is of interest in cardiometabolic treatment as it has undergone significant validation and development. The objective of this study was to systematically review relevant intervention studies using the HEI and its adaptations to examine whether diet interventions improve diet quality as measured by the HEI and the magnitude of change in included diet-quality scores following dietary intervention. Two databases [Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PubMed] were searched for articles published from January 1995 to December 2019. The review included intervention studies in adults presenting with overweight/obesity and obesity-related chronic disease (metabolic syndrome, diabetes, prediabetes, hypertension, dyslipidemia) who received education or counseling, and the HEI was evaluated from baseline to follow-up (US or Canadian version) or Alternate HEI. Study quality was assessed using Cochrane risk of bias for randomized controlled trials (RCTs) or Cochrane Risk of Bias for Nonrandomized interventions (ROBINS-I). A total of 25 studies were included: 15 RCTs, 3 quasi-experimental studies, and 7 pre-post studies. Eight different versions of the HEI were used. Results demonstrated that diet quality assessed by HEI and its adaptations improved to a clinically relevant degree, especially in studies where multiple food behaviors/food-behavior goals were the focus and where an intensive, long-term intervention was compared with a no-treatment control group. There was wide variation in magnitude of change in included diet-quality indicators. Use of the HEI and its adaptations and other diet-quality tools is promising for better characterization of diet-counseling interventions and results when multiple food behaviors are a focus. Additional development is encouraged.
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Affiliation(s)
- Paula Brauer
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
| | - Dawna Royall
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
| | - Ariellia Rodrigues
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
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Kokorovic A, So AI, Serag H, French C, Hamilton RJ, Izard JP, Nayak JG, Pouliot F, Saad F, Shayegan B, Aprikian A, Rendon RA. Canadian Urological Association guideline on androgen deprivation therapy: Adverse events and management strategies. Can Urol Assoc J 2021; 15:E307-E322. [PMID: 34127184 DOI: 10.5489/cuaj.7355] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Andrea Kokorovic
- Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Alan I So
- Department of Urological Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Hosam Serag
- Department of Urological Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Christopher French
- Department of Surgery, Division of Urology, Memorial University, St. John's, NL, Canada
| | - Robert J Hamilton
- Division of Urology, Department of Surgery, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Jason P Izard
- Department of Urology, Queen's University, Kingston, ON, Canada
| | - Jasmir G Nayak
- Section of Urology, Department of Surgery, University of Manitoba, Winnipeg, MB, Canada
| | | | - Fred Saad
- Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Bobby Shayegan
- Department of Surgery (Urology) and Oncology, McMaster University, Hamilton, ON, Canada
| | | | - Ricardo A Rendon
- Department of Urology, Dalhousie, University, Halifax, NS, Canada
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Chami N, Mathew S, Weir S, Wright JG, Kantarevic J. Adoption of a laboratory EMR system and inappropriate laboratory testing in Ontario: a cross-sectional observational study. BMC Health Serv Res 2021; 21:307. [PMID: 33823869 PMCID: PMC8025377 DOI: 10.1186/s12913-021-06296-5] [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] [Received: 07/17/2020] [Accepted: 03/19/2021] [Indexed: 11/22/2022] Open
Abstract
Background Electronic medical record (EMR) systems have the potential to facilitate appropriate laboratory testing. We examined three common medical tests in primary care—hemoglobin A1c (HbA1c), lipid, and thyroid stimulating hormone (TSH)— to assess whether adoption of a laboratory EMR system in Ontario had an impact on the rate of inappropriate testing among primary care physicians. Methods We used FY2016–17 population-level laboratory data to estimate the association between adoption of a laboratory EMR system and the rate of inappropriate testing. Inappropriate testing was assessed based on recommendations for screening, monitoring, and follow-up that take into account risk factors related to patient age and certain clinical conditions. To overcome the problem of potential endogeneity of physician choice to use the EMR, the EMR penetration rate in the physician’s geographical area of practice was used as an instrumental variable in an ordinary least squares (OLS) regression. We then simulated the change in the rate of inappropriate testing, by physician payment model, as the EMR penetration rate increased from the baseline percentage. Results The simulation models showed that an increase in the rate of EMR penetration from a baseline average was associated with a statistically significant decrease in inappropriate hbA1c and lipid testing, but a statistically insignificant increase in inappropriate TSH testing. The impact of EMR penetration also varied by payment model. Conclusions This study demonstrated a positive association between availability of an EMR system and appropriate service utilization. Varying impacts of the EMR system availability by primary care payment model may be reflective of different incentives or attributes inherent in payment models. Policies to encourage physicians to increase their use of laboratory EMR systems could improve the quality and continuity of patient care. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06296-5.
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Affiliation(s)
- Nadine Chami
- Ontario Medical Association, Economics, Policy & Research Department, 150 Bloor St. W, Suite 900, Toronto, ON, M5S 3C1, Canada.
| | - Silvy Mathew
- MyFamilyMD, 396 St. Clair Ave. W, Toronto, ON, M5P 3N3, Canada
| | - Sharada Weir
- Ontario Medical Association, Economics, Policy & Research Department, 150 Bloor St. W, Suite 900, Toronto, ON, M5S 3C1, Canada
| | - James G Wright
- Ontario Medical Association, Economics, Policy & Research Department, 150 Bloor St. W, Suite 900, Toronto, ON, M5S 3C1, Canada
| | - Jasmin Kantarevic
- Ontario Medical Association, Economics, Policy & Research Department, 150 Bloor St. W, Suite 900, Toronto, ON, M5S 3C1, Canada
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Teo KK, Rafiq T. Cardiovascular Risk Factors and Prevention: A Perspective From Developing Countries. Can J Cardiol 2021; 37:733-743. [PMID: 33610690 DOI: 10.1016/j.cjca.2021.02.009] [Citation(s) in RCA: 99] [Impact Index Per Article: 33.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 02/12/2021] [Accepted: 02/15/2021] [Indexed: 12/26/2022] Open
Abstract
By the beginning of the 21st century, cardiovascular disease (CVD) had become the leading cause of premature mortality and morbidity worldwide, with 80% originating from less developed lower-income countries in line with societal and economic developments. Extensive research on causes and risk factors have been carried out since the mid-20th century and have established individual factors such as smoking, hypertension, diabetes, and dyslipidemia as CVD risk factors, followed by others. Two recent major case-control studies have summarized the role of common major CVD risk factors in determining the risk of myocardial infarction (INTERHEART study) and stroke (INTERSTROKE study). They showed that 9 and 10 common risk factors accounted for > 90% of the risk of myocardial infarction and stroke, respectively, and established the focus in prevention of these common CVDs. The efficacy of lowering blood pressure, blood glucose, and lipid-lowering therapies has been shown to reduce subsequent morbidity and mortality. Leading international health organizations have published guidelines that are updated regularly to set the standards for providing guidance for implementation and management of risk factors. Interventions can also be costly and long-term adherence, essential to be effective in reducing risks, tends to decrease drastically with time. Dietary recommendations have been incorporated into national and professional guidelines for CVD prevention since the 1960s. On the basis of new research, some existing dietary recommendation might be outdated and should be reviewed, and revised, if necessary. A perspective of CVD prevention and treatment in developing countries is highlighted.
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Affiliation(s)
- Koon K Teo
- Population Health Research Institute, McMaster University, Hamilton Health Sciences, Hamilton, Ontario, Canada.
| | - Talha Rafiq
- Population Health Research Institute, McMaster University, Hamilton Health Sciences, Hamilton, Ontario, Canada
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Garies S, McBrien K, Quan H, Manca D, Drummond N, Williamson T. A data quality assessment to inform hypertension surveillance using primary care electronic medical record data from Alberta, Canada. BMC Public Health 2021; 21:264. [PMID: 33530975 PMCID: PMC7852125 DOI: 10.1186/s12889-021-10295-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 01/20/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Hypertension is a common chronic condition affecting nearly a quarter of Canadians. Hypertension surveillance in Canada typically relies on administrative data and/or national surveys. Routinely-captured data from primary care electronic medical records (EMRs) are a complementary source for chronic disease surveillance, with longitudinal patient-level details such as sociodemographics, blood pressure, weight, prescribed medications, and behavioural risk factors. As EMR data are generated from patient care and administrative tasks, assessing data quality is essential before using for secondary purposes. This study evaluated the quality of primary care EMR data from one province in Canada within the context of hypertension surveillance. METHODS We conducted a cross-sectional, descriptive study using primary care EMR data collected by two practice-based research networks in Alberta, Canada. There were 48,377 adults identified with hypertension from 53 clinics as of June 2018. Summary statistics were used to examine the quality of data elements considered relevant for hypertension surveillance. RESULTS Patient year of birth and sex were complete, but other sociodemographic information (ethnicity, occupation, education) was largely incomplete and highly variable. Height, weight, body mass index and blood pressure were complete for most patients (over 90%), but a small proportion of outlying values indicate data inaccuracies were present. Most patients had a relevant laboratory test present (e.g. blood glucose/glycated hemoglobin, lipid profile), though a very small proportion of values were outside a biologically plausible range. Details of prescribed antihypertensive medication, such as start date, strength, dose, frequency, were mostly complete. Nearly 80% of patients had a smoking status recorded, though only 66% had useful information (i.e. categorized as current, past, or never), and less than half had their alcohol use described; information related to amount, frequency or duration was not available. CONCLUSIONS Blood pressure and prescribed medications in primary care EMR data demonstrated good completeness and plausibility, and contribute valuable information for hypertension epidemiology and surveillance. The use of other clinical, laboratory, and sociodemographic variables should be used carefully due to variable completeness and suspected data errors. Additional strategies to improve these data at the point of entry and after data extraction (e.g. statistical methods) are required.
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Affiliation(s)
- Stephanie Garies
- Department of Family Medicine, University of Calgary, G012 Health Sciences Centre, 3330 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada.
| | - Kerry McBrien
- Department of Family Medicine, University of Calgary, G012 Health Sciences Centre, 3330 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada
- Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada
| | - Hude Quan
- Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada
| | - Donna Manca
- Department of Family Medicine, University of Alberta, 6-10 University Terrace, Edmonton, Alberta, T6G 2T4, Canada
| | - Neil Drummond
- Department of Family Medicine, University of Calgary, G012 Health Sciences Centre, 3330 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada
- Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada
- Department of Family Medicine, University of Alberta, 6-10 University Terrace, Edmonton, Alberta, T6G 2T4, Canada
- School of Public Health, University of Alberta, 3-300 Edmonton Clinic Health Academy, 11405-87 Ave, Edmonton, Alberta, T6G 1C9, Canada
| | - Tyler Williamson
- Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada
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Lee TMH, Tobe SW, Butt DA, Ivers NM, Gershon AS, Barnsley J, Liu PP, Jaakkimainen L, Walker KM, Tu K. Patient- and Physician-Level Factors Associated With Adherence to C-CHANGE Recommendations in Primary Care Settings in Ontario. CJC Open 2020; 2:563-576. [PMID: 33305217 PMCID: PMC7711016 DOI: 10.1016/j.cjco.2020.07.007] [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: 05/11/2020] [Accepted: 07/11/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND We previously found large variation among family physicians in adherence to the Canadian Cardiovascular Harmonization of National Guidelines Endeavour (C-CHANGE). We assessed the role of patient- and physician-level factors in the variation in adherence to recommendations for managing cardiovascular disease risk factors. METHODS We conducted a retrospective study using multilevel logistic regression analyses with the Electronic Medical Record Administrative data Linked Database (EMRALD) housed at ICES in Ontario. Five quality indicators based on C-CHANGE guidelines were modelled. Effects of clustering and between-group variation, patient-level (sociodemographics, comorbidities) and physician-level characteristics (demographic and practice information) were assessed to determine odds ratios of receiving C-CHANGE recommended care. RESULTS In all, 324 Ontario physicians practicing in 41 clinics who provided care to 227,999 adult patients were studied. We found significant variation in quality indicators, with 15% to 39% of the total variation attributable to nonpatient factors. The largest variation was in performing 2-hour plasma glucose testing in prediabetic patients. Patient-level factors most frequently associated with recommendation adherence included sex, age, and multi-comorbidities. Women were more likely than men to have their body mass index measured, and their blood pressure controlled, but less likely to receive antiplatelet medications and liver-enzyme testing if overweight or obese. CONCLUSIONS The majority of variations in adherence were attributable to patient attributes, but a substantial proportion of unexplained variation was due to differences among physicians and clinics. This finding may signal suboptimal processes or structures and warrant further investigation to improve the quality of primary care management of cardiovascular disease in Ontario.
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Affiliation(s)
- Theresa Min-Hyung Lee
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
| | - Sheldon W. Tobe
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Canadian Cardiovascular Harmonization of National Guidelines Endeavour, Ottawa, Ontario, Canada
| | - Debra A. Butt
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Scarborough Health Network, Toronto, Ontario, Canada
| | - Noah M. Ivers
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Women’s College Hospital, Toronto, Ontario, Canada
| | - Andrea S. Gershon
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Hospital for Sick Children, Toronto, Ontario, Canada
| | - Jan Barnsley
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
| | - Peter P. Liu
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Canadian Cardiovascular Harmonization of National Guidelines Endeavour, Ottawa, Ontario, Canada
- University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Liisa Jaakkimainen
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Kimberly M. Walker
- Canadian Cardiovascular Harmonization of National Guidelines Endeavour, Ottawa, Ontario, Canada
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Karen Tu
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- North York General Hospital, Toronto, Ontario, Canada
- Toronto Western Hospital Family Health Team, University Health Network, Toronto, Ontario, Canada
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Butalia S, Lee-Krueger RC, McBrien KA, Leung AA, Anderson TJ, Quan H, Naugler C, Chen G, Campbell DJ. Barriers and Facilitators to Using Statins: A Qualitative Study With Patients and Family Physicians. CJC Open 2020; 2:530-538. [PMID: 33305213 PMCID: PMC7711012 DOI: 10.1016/j.cjco.2020.07.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 07/01/2020] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Despite their proven efficacy to reduce cardiovascular disease, statin medication use remains low in individuals at high risk of cardiovascular disease considering their widespread availability and safety. Our objective was to explore the perspectives of patients and family physicians with regard to the barriers and facilitators of statin use in primary care. METHODS In this qualitative descriptive study, we conducted 2 focus groups with patients (number, n = 8/6) and individual semistructured interviews with family physicians (n = 17) from community settings. Interviewers asked participants about barriers to and facilitators of statin use. Focus groups and interviews were digitally recorded, transcribed, and analyzed in duplicate using conventional content analysis. RESULTS Patients were averse to taking statins for a variety of reasons: medication avoidance and burden; inadequate buy-in for statin therapy; and difficulty remembering to take statins regularly. Family physicians perceived similar barriers and reported other barriers: lack of resources such as inadequate tracking systems; specialist-primary care provider guideline discordance; and lack of continuity and relationship. Patients expressed that key facilitators were patient education and support; splitting tablets to increase cost-effectiveness; and changing to a different statin or lower dose in those with side effects. Family physicians described several similar strategies to facilitate therapy as well as shared decision making and clinical decision support tools as enablers for improvement. CONCLUSIONS We identified several important barriers to and facilitators of statin use at the patient and prescriber level. This information offers insight into strategies to improve statin use and the development of innovative programs and interventions.
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Affiliation(s)
- Sonia Butalia
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- O'Brien Institute for Public Health, Cumming School of Medicine, Calgary, University of Calgary, Calgary, Alberta, Canada
| | - Rachelle C.W. Lee-Krueger
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Innovation in Medical Education, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Kerry A. McBrien
- Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Alexander A.C. Leung
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- O'Brien Institute for Public Health, Cumming School of Medicine, Calgary, University of Calgary, Calgary, Alberta, Canada
| | - Todd J. Anderson
- Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Hude Quan
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- O'Brien Institute for Public Health, Cumming School of Medicine, Calgary, University of Calgary, Calgary, Alberta, Canada
| | - Christopher Naugler
- O'Brien Institute for Public Health, Cumming School of Medicine, Calgary, University of Calgary, Calgary, Alberta, Canada
- Department of Pathology & Laboratory Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Guanmin Chen
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - David J.T. Campbell
- Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- O'Brien Institute for Public Health, Cumming School of Medicine, Calgary, University of Calgary, Calgary, Alberta, Canada
- Department of Cardiac Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Boisvenue JJ, Oliva CU, Manca DP, Johnson JA, Yeung RO. Feasibility of identifying and describing the burden of early-onset metabolic syndrome in primary care electronic medical record data: a cross-sectional analysis. CMAJ Open 2020; 8:E779-E787. [PMID: 33234585 PMCID: PMC7721254 DOI: 10.9778/cmajo.20200007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The prevalence of metabolic syndrome is growing worldwide, yet remains underinvestigated in Canadian young adults. We sought to explore the use of a harmonized case definition specific to early-onset metabolic syndrome and determine its feasibility in assessing the prevalence of metabolic syndrome among electronic medical record (EMR) data of young adults in Northern Alberta. METHODS We conducted a cross-sectional study using a sample of EMR data from young adult patients aged 18-40 years and residing in Northern Alberta, who had an encounter with a participating primary care clinic between June 29, 2015, and June 29, 2018. Physical examination, laboratory investigation and disease diagnosis data were collected. A case definition and algorithm were developed to assess the feasibility of identifying metabolic syndrome, including measures for body mass index (BMI), blood pressure (BP), dysglycemia, hypertriglyceridemia, high-density lipoprotein cholesterol, diabetes and hypertension. RESULTS Among 15 766 young adults, the case definition suggested the prevalence of metabolic syndrome was 4.4%, 95% confidence interval (CI) 4.1%-4.7%. The most frequent 3-factor combination (41.6%, 95% CI 37.9%-45.3%) of metabolic syndrome criteria consisted of being overweight or obese, having elevated BP and hypertriglyceridemia. Half of metabolic syndrome cases (51.3%, 95% CI 47.6%-55.0%) were missing measures for fasting blood glucose, and one-fifth were missing a hemoglobin A1c (HbA1c) level. Notably, most young adults with a BMI of 25 or greater were missing HbA1c (68.7%, 95% CI 67.6%-69.8%), fasting blood glucose (84.0%, 95% CI 83.2%-84.8%) and triglyceride testing (79.0%, 95% CI 78.1%-79.9%). INTERPRETATION We have shown that our case definition is feasible in identifying early-onset metabolic syndrome using EMR data; however, the degree of missing data limits the feasibility in assessing prevalence. Further investigation is required to validate this case definition for metabolic syndrome in the EMR data, which may involve comparing this definition to other validated metabolic syndrome case definitions.
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Affiliation(s)
- Jamie J Boisvenue
- School of Public Health (Boisvenue, Johnson, Yeung), and Department of Computing Science (Oliva), Faculty of Science, and Department of Family Medicine (Manca), Faculty of Medicine & Dentistry, University of Alberta; Northern Alberta Primary Care Research Network (Manca); Division of Endocrinology and Metabolism (Yeung), Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alta.
| | - Carlo U Oliva
- School of Public Health (Boisvenue, Johnson, Yeung), and Department of Computing Science (Oliva), Faculty of Science, and Department of Family Medicine (Manca), Faculty of Medicine & Dentistry, University of Alberta; Northern Alberta Primary Care Research Network (Manca); Division of Endocrinology and Metabolism (Yeung), Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alta
| | - Donna P Manca
- School of Public Health (Boisvenue, Johnson, Yeung), and Department of Computing Science (Oliva), Faculty of Science, and Department of Family Medicine (Manca), Faculty of Medicine & Dentistry, University of Alberta; Northern Alberta Primary Care Research Network (Manca); Division of Endocrinology and Metabolism (Yeung), Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alta
| | - Jeffrey A Johnson
- School of Public Health (Boisvenue, Johnson, Yeung), and Department of Computing Science (Oliva), Faculty of Science, and Department of Family Medicine (Manca), Faculty of Medicine & Dentistry, University of Alberta; Northern Alberta Primary Care Research Network (Manca); Division of Endocrinology and Metabolism (Yeung), Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alta
| | - Roseanne O Yeung
- School of Public Health (Boisvenue, Johnson, Yeung), and Department of Computing Science (Oliva), Faculty of Science, and Department of Family Medicine (Manca), Faculty of Medicine & Dentistry, University of Alberta; Northern Alberta Primary Care Research Network (Manca); Division of Endocrinology and Metabolism (Yeung), Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alta
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Destigmatizing Carbohydrate with Food Labeling: The Use of Non-Mandatory Labelling to Highlight Quality Carbohydrate Foods. Nutrients 2020; 12:nu12061725. [PMID: 32526896 PMCID: PMC7353004 DOI: 10.3390/nu12061725] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 05/28/2020] [Accepted: 06/04/2020] [Indexed: 12/21/2022] Open
Abstract
Dietary carbohydrates are components of healthy foods, but many carbohydrate foods have recently been stigmatized as primary causes of diet-related risk factors for chronic disease. There is an opportunity to enhance efforts within the food landscape to encourage the consumption of higher quality carbohydrate foods. The use of labelling is one strategy that permits consumers to identify healthy carbohydrate foods at the point-of-purchase. This review discusses the regulatory frameworks and examples of associated non-mandatory food labelling claims that are currently employed to highlight healthy carbohydrate foods to consumers. The existing labelling frameworks discussed here align with established measures of carbohydrate quality, such as 1. dietary fibre nutrient content claims and associated dietary fibre-based health claims; 2. the presence of whole carbohydrate foods and ingredients that are intact or reconstituted, such as whole grains; and 3. low glycemic index and glycemic response claims. Standards from Codex Alimentarius, and regulations from Australia and New Zealand, Canada, Europe, and the United States will be used to illustrate the means by which food labelling can be used by consumers to identify quality carbohydrate foods.
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Barry AR, Semchuk WM, Thompson A, LeBras MH, Koshman SL. Use of low-dose acetylsalicylic acid for cardiovascular disease prevention: A practical, stepwise approach for pharmacists. Can Pharm J (Ott) 2020; 153:153-160. [PMID: 32528599 DOI: 10.1177/1715163520909137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Low-dose acetylsalicylic acid (ASA) is recommended in patients with established cardiovascular disease. However, the role of ASA in those without cardiovascular disease (i.e., primary prevention) is less clear, which has led to discordance among Canadian guidelines. In 2018, 3 double-blind, randomized controlled trials were published that evaluated ASA 100 mg daily versus placebo in patients without established cardiovascular disease. In the ASPREE trial, ASA did not reduce the risk of all-cause death, dementia, or persistent physical disability in patients ≥70 years of age but increased the risk of major bleeding. In the ARRIVE trial, ASA failed to lower the risk of a composite of cardiovascular events but increased any gastrointestinal bleeding in patients at intermediate risk of cardiovascular disease. In the ASCEND trial, ASA significantly reduced the primary composite cardiovascular outcome in patients with diabetes for a number needed to treat of 91 over approximately 7.4 years. Yet major bleeding was increased with ASA for a number needed to harm of 112. Therefore, in most situations, ASA should not be recommended for primary cardiovascular prevention. However, there are additional indications for ASA beyond cardiovascular disease. Thus, a sequential algorithm was developed based on contemporary evidence to help pharmacists determine the suitability of ASA in their patients and play an active role in educating their patients about the potential benefits (or lack thereof) and risks of ASA. Can Pharm J (Ott) 2020;153:xx-xx.
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Affiliation(s)
- Arden R Barry
- Chilliwack General Hospital (Barry), University of British Columbia, Vancouver, British Columbia.,Lower Mainland Pharmacy Services, Chilliwack and the Faculty of Pharmaceutical Sciences (Barry), University of British Columbia, Vancouver, British Columbia.,Provincial Pharmacy Services (Semchuk), University of Saskatchewan, Saskatoon, Saskatchewan.,Saskatchewan Health Authority, Regina General Hospital, Regina and the College of Medicine (Semchuk), University of Saskatchewan, Saskatoon, Saskatchewan.,College of Pharmacy and Nutrition (Semchuk, LeBras), University of Saskatchewan, Saskatoon, Saskatchewan.,Faculty of Pharmacy and Pharmaceutical Sciences (Thompson), Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta.,Division of Cardiology (Koshman), Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta
| | - William M Semchuk
- Chilliwack General Hospital (Barry), University of British Columbia, Vancouver, British Columbia.,Lower Mainland Pharmacy Services, Chilliwack and the Faculty of Pharmaceutical Sciences (Barry), University of British Columbia, Vancouver, British Columbia.,Provincial Pharmacy Services (Semchuk), University of Saskatchewan, Saskatoon, Saskatchewan.,Saskatchewan Health Authority, Regina General Hospital, Regina and the College of Medicine (Semchuk), University of Saskatchewan, Saskatoon, Saskatchewan.,College of Pharmacy and Nutrition (Semchuk, LeBras), University of Saskatchewan, Saskatoon, Saskatchewan.,Faculty of Pharmacy and Pharmaceutical Sciences (Thompson), Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta.,Division of Cardiology (Koshman), Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta
| | - Ann Thompson
- Chilliwack General Hospital (Barry), University of British Columbia, Vancouver, British Columbia.,Lower Mainland Pharmacy Services, Chilliwack and the Faculty of Pharmaceutical Sciences (Barry), University of British Columbia, Vancouver, British Columbia.,Provincial Pharmacy Services (Semchuk), University of Saskatchewan, Saskatoon, Saskatchewan.,Saskatchewan Health Authority, Regina General Hospital, Regina and the College of Medicine (Semchuk), University of Saskatchewan, Saskatoon, Saskatchewan.,College of Pharmacy and Nutrition (Semchuk, LeBras), University of Saskatchewan, Saskatoon, Saskatchewan.,Faculty of Pharmacy and Pharmaceutical Sciences (Thompson), Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta.,Division of Cardiology (Koshman), Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta
| | - Marlys H LeBras
- Chilliwack General Hospital (Barry), University of British Columbia, Vancouver, British Columbia.,Lower Mainland Pharmacy Services, Chilliwack and the Faculty of Pharmaceutical Sciences (Barry), University of British Columbia, Vancouver, British Columbia.,Provincial Pharmacy Services (Semchuk), University of Saskatchewan, Saskatoon, Saskatchewan.,Saskatchewan Health Authority, Regina General Hospital, Regina and the College of Medicine (Semchuk), University of Saskatchewan, Saskatoon, Saskatchewan.,College of Pharmacy and Nutrition (Semchuk, LeBras), University of Saskatchewan, Saskatoon, Saskatchewan.,Faculty of Pharmacy and Pharmaceutical Sciences (Thompson), Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta.,Division of Cardiology (Koshman), Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta
| | - Sheri L Koshman
- Chilliwack General Hospital (Barry), University of British Columbia, Vancouver, British Columbia.,Lower Mainland Pharmacy Services, Chilliwack and the Faculty of Pharmaceutical Sciences (Barry), University of British Columbia, Vancouver, British Columbia.,Provincial Pharmacy Services (Semchuk), University of Saskatchewan, Saskatoon, Saskatchewan.,Saskatchewan Health Authority, Regina General Hospital, Regina and the College of Medicine (Semchuk), University of Saskatchewan, Saskatoon, Saskatchewan.,College of Pharmacy and Nutrition (Semchuk, LeBras), University of Saskatchewan, Saskatoon, Saskatchewan.,Faculty of Pharmacy and Pharmaceutical Sciences (Thompson), Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta.,Division of Cardiology (Koshman), Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta
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Garies S, Cummings M, Quan H, McBrien K, Drummond N, Manca D, Williamson T. Methods to improve the quality of smoking records in a primary care EMR database: exploring multiple imputation and pattern-matching algorithms. BMC Med Inform Decis Mak 2020; 20:56. [PMID: 32171301 PMCID: PMC7071570 DOI: 10.1186/s12911-020-1068-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 02/28/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Primary care electronic medical record (EMR) data are emerging as a useful source for secondary uses, such as disease surveillance, health outcomes research, and practice improvement. These data capture clinical details about patients' health status, as well as behavioural risk factors, such as smoking. While the importance of documenting smoking status in a healthcare setting is recognized, the quality of smoking data captured in EMRs is variable. This study was designed to test methods aimed at improving the quality of patient smoking information in a primary care EMR database. METHODS EMR data from community primary care settings extracted by two regional practice-based research networks in Alberta, Canada were used. Patients with at least one encounter in the previous 2 years (2016-2018) and having hypertension according to a validated definition were included (n = 48,377). Multiple imputation was tested under two different assumptions for missing data (smoking status is missing at random and missing not-at-random). A third method tested a novel pattern matching algorithm developed to augment smoking information in the primary care EMR database. External validity was examined by comparing the proportions of smoking categories generated in each method with a general population survey. RESULTS Among those with hypertension, 40.8% (n = 19,743) had either no smoking information recorded or it was not interpretable and considered missing. Those with missing smoking data differed statistically by demographics, clinical features, and type of EMR system used in the clinic. Both multiple imputation methods produced fully complete smoking status information, with the proportion of current smokers estimated at 25.3% (data missing at random) and 12.5% (data missing not-at-random). The pattern-matching algorithm classified 18.2% of patients as current smokers, similar to the population-based survey (18.9%), but still resulted in missing smoking information for 23.6% of patients. The algorithm was estimated to be 93.8% accurate overall, but varied by smoking status category. CONCLUSION Multiple imputation and algorithmic pattern-matching can be used to improve EMR data post-extraction but the recommended method depends on the purpose of secondary use (e.g. practice improvement or epidemiological analyses).
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Affiliation(s)
- Stephanie Garies
- Department of Family Medicine, University of Calgary, G012 Health Sciences Centre, 3330 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada.
- Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada.
| | - Michael Cummings
- Department of Family Medicine, University of Alberta, 6-10 University Terrace, Edmonton, Alberta, T6G 2T4, Canada
| | - Hude Quan
- Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada
| | - Kerry McBrien
- Department of Family Medicine, University of Calgary, G012 Health Sciences Centre, 3330 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada
- Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada
| | - Neil Drummond
- Department of Family Medicine, University of Calgary, G012 Health Sciences Centre, 3330 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada
- Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada
- Department of Family Medicine, University of Alberta, 6-10 University Terrace, Edmonton, Alberta, T6G 2T4, Canada
- School of Public Health, University of Alberta, 3-300 Edmonton Clinic Health Academy, 11405-87 Ave, Edmonton, Alberta, T6G 1C9, Canada
| | - Donna Manca
- Department of Family Medicine, University of Alberta, 6-10 University Terrace, Edmonton, Alberta, T6G 2T4, Canada
| | - Tyler Williamson
- Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada
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Dubrofsky L, Tobe SW. Guideline Alignment in Related Areas. Can J Cardiol 2019; 35:606-610. [DOI: 10.1016/j.cjca.2019.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 12/18/2018] [Accepted: 01/06/2019] [Indexed: 12/01/2022] Open
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Evzel'man MA, Orlova AD, Mityaeva EV, Kamchatnov PR. Meteorological risk factors of ischemic stroke. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 119:35-38. [DOI: 10.17116/jnevro201911908235] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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