Geographic Comparison of Dietary Intake and Quality in Manitoba Adolescents

Purpose: The Food and Nutrition for Manitoba Youth (FANS) study examined dietary intakes, food behaviours, food security status, health indicators, and body mass index of a cohort of grade 9 students. This paper describes regional differences and similarities in dietary intake (food and nutrients) and quality of youth participants in the FANS study.Methods: Grade 9 students completed a web-based survey on dietary intakes (24-hour recall), food behaviours, self-reported health indicators, and sociodemographic variables. Nutrient intakes were compared with national guidelines and diet quality was assessed using a modified Healthy Eating Index.Results: A total of 1587 students participated from northern, rural, and urban regions in Manitoba. Northern and rural students had higher intakes of sugar, sodium, and saturated fat compared with urban. Northern students consumed fewer grain products compared to urban, and more servings of "other" foods compared with rural and urban. While most participants were classified into the "needs improvement" or "poor" Healthy Eating Index categories, significantly more northern participants were in the "poor" category.Conclusions: Most adolescents in the study are at nutritional risk; however, there are additional vulnerabilities for those in rural and northern communities. Dietitians can use results to advocate for and plan interventions to improve adolescent nutrition.

[Supporting families in the management of gastroesophageal reflux disease in children]

Gastroesophageal reflux disease (GERD) in children is a frequent reason for medical consultation. It is defined as the involuntary passage of gastric contents into the esophagus, with or without regurgitation and vomiting. It can become pathological if it leads to embarrassing symptoms and complications. Often confronted with this pathology, nursery nurses sometimes find themselves at a loss when it comes to treating the symptoms of pathological GERD in a toddler, as well as in supporting the parents. In order to give them some ideas, a review of the literature on the benefits of non-medicinal strategies on regurgitation in full-term infants with pathological GERD was conducted.

Perceptions and Experiences of Nutrition Interventions in Individuals with Amyotrophic Lateral Sclerosis (ALS) and their Caregivers

Nutrition concerns are prevalent in individuals with Amyotrophic Lateral Sclerosis (ALS). Despite the prevalence of nutrition concerns, few data are available on perceptions and experiences of nutrition interventions in individuals with ALS and their caregivers; this study aimed to collect this information. An online survey was developed and hosted on Survey Monkey^®. Individuals with ALS and their caregivers from Saskatchewan, Canada, were invited to complete the survey through email to attendees of the ALS Clinic (Saskatoon, Canada), and via the ALS Society of Saskatchewan Facebook page in February-March, 2021. Quantitative data were analyzed using descriptive statistics. Twelve eligible respondents completed the survey (n = 10 individuals with ALS; n = 2 caregivers). The present study found nutrition was important to respondents and there was interest in trying diets and supplements for ALS management; of note, many respondents were interested in exploring the ketogenic diet. Six (50%) respondents had weight loss concerns. All respondents would recommend consulting with a dietitian upon being diagnosed with ALS. Many respondents reported a predefined negative perception of tube feeding. The results of this study suggest that increasing the accessibility of dietitians could positively impact ALS-related care. The findings also provide guidance for dietitians to enhance nutrition care for individuals with ALS.

The effect of flunixin meglumine on eating and rumination variables in cows after omentopexy for correction of left displaced abomasum

INTRODUCTION

Eating and rumination variables were recorded using a pressure sensor integrated into the noseband of a halter in 60 cows with left displaced abomasum (LDA) before and after postoperative administration of flunixin meglumine (FM). Group 1 comprised 9 healthy control cows that were used to establish reference intervals. Group 2 included 60 cows with LDA that received one of the following three treatments: intravenous saline solution (2A, n=20), 1.1 mg/kg FM (2B, n=20) or 2.2 mg/kg FM (2C, n=20) once daily for 3 days after right-flank omentopexy. Median eating times on the day before surgery were 93 (2A), 80 (2B) and 114 (2C) min, which were below the reference interval (246 to 381 min). On the day after surgery, eating times had increased significantly to 201 (2A), 172 (2B) and 216 (2C) min, after which time they continued to increase. Eating and rumination times, numbers of regurgitated feed boluses per day and chewing cycles per bolus did not differ among treated groups. Postoperative administration of FM did not affect eating and rumination variables in this study, and normalisation of these variables was attributable to surgical correction of LDA.

[Advocacy for food and wine in palliative care]

In the palliative care unit, the care and treatment provided are aimed at optimizing the quality of life and not the quantity of life. Food is adjusted to the patient's condition and is primarily oriented towards pleasure food.

Immunodietica: interrogating the role of diet in autoimmune disease

Diet is an environmental factor in autoimmune disorders, where the immune system erroneously destroys one's own tissues. Yet, interactions between diet and autoimmunity remain largely unexplored, particularly the impact of immunogenetics, one's human leukocyte antigen (HLA) allele make-up, in this interplay. Here, we interrogated animals and plants for the presence of epitopes implicated in human autoimmune diseases. We mapped autoimmune epitope distribution across organisms and determined their tissue expression pattern. Interestingly, diet-derived epitopes implicated in a disease were more likely to bind to HLA alleles associated with that disease than to protective alleles, with visible differences between organisms with similar autoimmune epitope content. We then analyzed an individual's HLA haplotype, generating a personalized heatmap of potential dietary autoimmune triggers. Our work uncovered differences in autoimmunogenic potential across food sources and revealed differential binding of diet-derived epitopes to autoimmune disease-associated HLA alleles, shedding light on the impact of diet on autoimmunity.

[A socio-anthropological look at food, from identity to care]

Long relegated to the background of modern medicine, food is now a major public health issue echoing to the old idea that what we eat is potentially a cure, or a poison. But, beyond its nutritional dimension, food takes on a set of facets that make up our unique identities that should not be overlooked in the context of care.

Changes in Adolescents' Dietary Intake Following the Initiation of an 8-Week Exercise Program

Purpose: To assess changes in dietary intake of adolescents following an 8-week aerobic exercise program.Methods: Twenty-six adolescents (14-18 years) participated in an 8-week aerobic exercise program on cycle ergometer at their high school in Quebec, Canada. Twenty-four hour recalls were collected pre- and post-intervention. A two-way repeated measures ANOVA and paired sample t-tests were used to assess differences in energy and dietary intake parameters (food quantity, diet quality, eating patterns) between pre- and postintervention.Results: A decrease in total daily energy intake (-287.8 kcal, P = 0.007), in meal size at lunch (-110.1 g, P = 0.02) and dinner (-143.7 g, P = 0.03), in food density at breakfast (-1.8 kcal/g, P = 0.04), in daily carbohydrate intake (-56.1 g, P = 0.005), and in percentage of energy intake consumed at school (-5.1%, P = 0.04) were observed following initiation of an aerobic exercise program. No change in healthy eating index scores or percentage of energy from processed foods was observed.Conclusions: Changes in energy intake, food quantity, and eating pattern but not diet quality (Healthy Eating Index or food processing scores) were observed following the initiation of an aerobic exercise program. Nutrition interventions may be needed, in addition to an exercise program, to target diet quality and promote healthy eating habits in adolescents.

Diet and physical activity in Greenland: genetic interactions and associations with obesity and diabetes

The Inuit in Greenland have gone through dramatic lifestyle changes during the last half century. More time is spent being sedentary and imported foods replaces traditional foods like seal and whale. The population has also experienced a rapid growth in obesity and metabolic disturbances and diabetes is today common despite being almost unknown few decades ago. In this paper, we describe and discuss the role of lifestyle changes and genetics for Inuit metabolic health. Novelty: Cardiometabolic disease risk has increased in Greenland. Lifestyle changes and possibly gene-lifestyle interactions play a role.

[Orthorexis: Psychopathological profiles and life trajectories]

At the crossroads of social influences and the psychopathology of everyday life, orthorexis is a little-known concept. This obsession with a healthy diet with deleterious consequences raises questions of differential clinical evaluation. Case studies and clinical illustrations provide a better understanding of what some orthorexic people think, feel, do and experience in having these restrictive and deviant relationships to food.

[Orthorexia: News and treatment of a modern-day pathology]

Contrary to the objective sought by orthorexics, orthorexia ends up affecting health more or less seriously. For these subjects, who are often asocial eaters in search of the perfect food, the obsession with healthy eating becomes unhealthy. Between psychopathology and certain modern eating incentives, this still relatively unknown disorder must be detected, evaluated and treated in order to prevent its harmful consequences.

A Review on the Triggers of Pediatric Migraine with the Aim of Improving Headache Education

Although migraines are common in children and adolescents, they have a robustly negative impact on the quality of life of individuals and their families. The current treatment guidelines outline the behavioral and lifestyle interventions to correct common causative factors, such as negative emotional states, lack of exercise and sleep, and obesity; however, the evidence of their effectiveness is insufficient. To create a plan for disseminating optimal pediatric headache education, we reviewed the current evidence for factors correlated with migraine. We assessed three triggers or risk factors for migraines in children and adolescents: stress, sleep poverty, and alimentation (including diet and obesity). While there is a gradual uptick in research supporting the association between migraine, stress, and sleep, the evidence for diet-related migraines is very limited. Unless obvious dietary triggers are defined, clinicians should counsel patients to eat a balanced diet and avoid skipping meals rather than randomly limiting certain foods. We concluded that there is not enough evidence to establish a headache education plan regarding behavioral and lifestyle interventions. Clinicians should advise patients to avoid certain triggers, such as stress and sleep disorders, and make a few conservative dietary changes.

Effect of aging and obesity on GLUT12 expression in small intestine, adipose tissue, muscle, and kidney and its regulation by docosahexaenoic acid and exercise in mice

Obesity is characterized by excessive fat accumulation and inflammation. Aging has also been characterized as an inflammatory condition, frequently accompanied by accumulation of visceral fat. Beneficial effects of exercise and n-3 long-chain polyunsaturated fatty acids in metabolic disorders have been described. Glucose transporter 12 (GLUT12) is one of the less investigated members of the GLUT family. Glucose, insulin, and tumor necrosis factor alpha (TNF-α) induce GLUT12 translocation to the membrane in muscle, adipose tissue, and intestine. We aimed to investigate GLUT12 expression in obesity and aging, and under diet supplementation with docosahexaenoic acid (DHA) alone or in combination with physical exercise in mice. Aging increased GLUT12 expression in intestine, kidney, and adipose tissue, whereas obesity reduced it. No changes on the transporter occurred in skeletal muscle. In obese 18-month-old mice, DHA further decreased GLUT12 in the 4 organs. Aerobic exercise alone did not modify GLUT12, but the changes triggered by exercise were able to prevent the DHA-diminishing effect, and almost restored GLUT12 basal levels. In conclusion, the downregulation of metabolism in aging would be a stimulus to upregulate GLUT12 expression. Contrary, obesity, an excessive energy condition, would induce GLUT12 downregulation. The combination of exercise and DHA would contribute to restore basal function of GLUT12. Novelty In small intestine, kidney and adipose tissue aging increases GLUT12 protein expression whereas obesity reduces it. Dietary DHA decreases GLUT12 in small intestine, kidney, adipose tissue and skeletal muscle. Exercise alone does not modify GLUT12 expression, nevertheless exercise prevents the DHA-diminishing effect on GLUT12.

Dietary flaxseed: what we know and don't know about its effects on cardiovascular disease

Flaxseed (Linum usitatissimum) is composed of a unique combination of bioactive components that appear to generate, through either an isolated or a synergistic action, a significant beneficial effect on the cardiovascular system. With a significant increase in the generation of data on the dietary impact of flaxseed on the cardiovascular system, a review of where we stand - what we know and what we still need to understand about these effects on the heart and the vasculature - was thought to be of value and the rationale for this paper. For example, although we now know how to deliver the bioactives most efficiently (oil versus ground seed versus whole seed), we do not know how different foods can influence that delivery. Further, we know flaxseed has anti-arrhythmic, anti-atherogenic, anti-hypertensive, and cholesterol-lowering actions in animal studies and some selected human trials but much more needs to be learned, particularly in human trials. These results have justified further commitment of resources to the initiation of human trials. Because of the impact of nutrition on many chronic diseases, this may not only be true for the effects of flaxseed on cardiovascular disease but may be just as relevant for many other disease conditions.

Somatic growth and the risks of bronchopulmonary dysplasia and pulmonary hypertension: connecting epidemiology and physiology 1

In the premature infant, poor growth in utero (fetal growth restriction) and in the first weeks of life (postnatal growth restriction) are associated with increased risk for bronchopulmonary dysplasia and pulmonary hypertension. In this review, we summarize the epidemiologic data supporting these associations, present a novel rodent model of postnatal growth restriction, and review 5 promising mechanisms by which poor nutrition may affect the developing lung. These observations support the hypothesis that nutritional and (or) pharmacologic interventions early in life may be able to decrease risk of the pulmonary complications of extreme prematurity.

[The relational issues surrounding food in obese teenagers and their family]

Several qualitative studies have been carried out into the relational issues in families where a teenager is suffering from obesity. Power struggles, issues related to love, relational distance and family organisation must be taken into account in the care of these teenagers. Work on the intrafamily relational aspects can help to improve the effectiveness of standard treatments.

The effectiveness of voluntary policies and commitments in restricting unhealthy food marketing to Canadian children on food company websites

Marketing unhealthy foods and beverages to children (M2K) fosters poor dietary patterns, increasing obesity and noncommunicable disease risk. Federal restrictions on M2K have been under development in Canada since 2016; however, at present, M2K is mostly self-regulated by food companies. This study aimed to compare M2K on Canadian websites of food companies with and without voluntary policies or commitments in this area. A systematic content analysis of company websites was conducted in spring/summer 2017 for major packaged food (n = 16), beverage (n = 12), and restaurant chain (n = 13) companies in Canada. M2K policies were sourced from company websites and published corporate documents. Sixteen companies (43%) reported national and/or global M2K policies, while 21 companies (57%) had no published policies. The websites of Canadian companies (n = 154) were scanned for child-directed products and marketing; type and frequency of marketing techniques were recorded. Child-directed marketing appeared on 19 websites of 12 companies (32%), including 9 companies with M2K policies. Websites featured products with unconventional flavours, colours, shapes, or child-oriented packaging, and used promotional characters, contests, games, activities, or lettering and graphics appealing to children. The nutritional quality of products marketed to children was evaluated using a nutrient profile model developed by Health Canada for proposed M2K regulations. Of the 217 products marketed to children, 97% exceeded Health Canada's proposed ∼5% Daily Value threshold for saturated fat, sodium, and/or sugars, 73% of which were products from 9 companies with policies. These findings highlight the limitations of self-regulation in restricting M2K on food company websites, reinforcing the need for government regulations.

[Nutritional requirements of the elderly]

The nutritional status of patients is based on knowledge of their specific needs and tools enabling them to be evaluated. The needs are qualitative and quantitative and must be adapted in certain situations such as the existence of an inflammatory syndrome. A systematic assessment of the nutritional status is an essential part of an elderly person's care in order to initiate preventive or corrective measures.

[Food and nutrition liaison committees in healthcare facilities]

Since 2002, all healthcare facilities must have a food and nutrition liaison committee. The aim is to improve the management of food and nutrition related issues in hospital. The players concerned undertake a global and cross-disciplinary approach to ensure better food, notably for elderly patients at risk of protein-energy malnutrition.

[Women's dietary habits during pregnancy and breastfeeding in Amoron'i Mania region, Madagascar: a qualitative study]

Introduction

Women's dietary habits are very important due to the specific nutritional requirements for reproduction. This study aimed to describe women's dietary habits during pregnancy and breastfeeding and to identify factors influencing these habits.

Methods

We conducted a qualitative study of pregnant and breastfeeding women living in Amoron'i Mania region, Madagascar. Eight focus groups (6-10 women per group) and 23 individual interviews were carried out to collect data. Thematic analysis was used and focused on the description of women's dietary habits on the basis of dietary behaviours as well as of sociocultural and economic determinants of the described habits.

Results

During pregnancy and breastfeeding, women's dietary habits did not vary considerably except at the very beginning of breastfeeding. They had a little diversified and monotonous diet, poor in fruit and vegetables and poor in proteins. At the very beginning of breastfeeding, during the practice of "mifana " tradition, women had a diet more rich than usual. These dietary habits were influenced by the type of agricultural products in the region and by their availability during the year (self-consumption)as well as by purchasing power (in case of shortage) and tradition.

Conclusion

Mothers' dietary habits appear to be inadequate. This study highlights the importance of improving knowledge of the determinants of mothers' dietary behaviours.

Effectiveness of a school-based program focusing on diet and health habits taught through physical exercise

The global rate of obesity in childhood is becoming an epidemic and many authors have established a significant association between childhood obesity and overweight in adulthood. It is therefore necessary to seek effective strategies to reduce these levels of obesity. The aim of this study was to evaluate the impact of the Healthy Habits Program (HHP). The participants comprised 158 children from the fifth and sixth grades (intervention group, n = 82; control group, n = 76). The HHP is a school-based physical activity program focusing on promoting a healthy lifestyle. It lasted for 8 months, and measurements were taken at the beginning and end of the program. Physiological variables (total cholesterol, triglycerides, blood glucose, blood pressure, and maximal oxygen consumption), anthropometric variables (body mass index (BMI)) and behavioral variables (breakfast, quality of diet, meal frequency, physical activity, sedentary behavior, sleep, and perceived health) were evaluated. Repeated-measures ANOVA showed significant improvements (p < 0.05) after the intervention for the intervention group in triglycerides, blood glucose and maximal oxygen consumption. Significant improvements were also observed in breakfast habits and quality of diet. Finally, a significant improvement in prevalence of normal levels was observed for total cholesterol, blood pressure, and BMI. It can therefore be stated that the HHP is an innovative and useful school-based program that can help to improve diet and health in childhood.

Meta-Analysis of Aedes aegypti Expression Datasets: Comparing Virus Infection and Blood-Fed Transcriptomes to Identify Markers of Virus Presence

The mosquito Aedes aegypti (L.) is vector of several arboviruses including dengue, yellow fever, chikungunya, and more recently zika. Previous transcriptomic studies have been performed to elucidate altered pathways in response to viral infection. However, the intrinsic coupling between alimentation and infection were unappreciated in these studies. Feeding is required for the initial mosquito contact with the virus and these events are highly dependent. Addressing this relationship, we reinterrogated datasets of virus-infected mosquitoes with two different diet schemes (fed and unfed mosquitoes), evaluating the metabolic cross-talk during both processes. We constructed coexpression networks with the differentially expressed genes of these comparison: virus-infected versus blood-fed mosquitoes and virus-infected versus unfed mosquitoes. Our analysis identified one module with 110 genes that correlated with infection status (representing ~0.7% of the A. aegypti genome). Furthermore, we performed a machine-learning approach and summarized the infection status using only four genes (AAEL012128, AAEL014210, AAEL002477, and AAEL005350). While three of the four genes were annotated as hypothetical proteins, AAEL012128 gene is a membrane amino acid transporter correlated with viral envelope binding. This gene alone is able to discriminate all infected samples and thus should have a key role to discriminate viral infection in the A. aegypti mosquito. Moreover, validation using external datasets found this gene as differentially expressed in four transcriptomic experiments. Therefore, these genes may serve as a proxy of viral infection in the mosquito and the others 106 identified genes provides a framework to future studies.

Minimal alteration in muscle lipid genes following stabilized weight loss

Variations in skeletal muscle peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α), carntine palmitoyltransferase-1 (CPT-1), perilipin protein 2 (PLIN2), and adipose tissue triglyceride lipase (ATGL), and comparative gene identification-58 (CGI-58) have been described as playing important roles in the metabolic regulation of lipid oxidation, and may influence intramyocellular lipid (IMCL) and muscle lipid droplet size (LDS). While acute changes in caloric balance and/or aerobic capacity may affect lipid metabolism, the influence of sustained weight loss derived from caloric restriction with weight loss (CWL) compared with exercise training with weight loss (EWL) on the abovementioned parameters has not been fully elucidated. Using a combination of metabolic feeding and/or supervised exercise training, we evaluated the influence of stabilized weight loss elicited by CWL compared with EWL without the confounding influence of acute alterations in caloric balance on molecular markers of mitochondrial metabolism and lipid droplet size in middle-aged overweight individuals with impaired glucose tolerance. There were no significant changes in PGC-1α, CPT-1, PLIN2, ATGL and, CGI-58 messenger RNA (mRNA) in CWL and EWL. While there were no changes in ATGL mRNA in CWL, there was a strong trend (P = 0.05) for the ΔATGL mRNA in EWL with stabilized weight loss. There were no significant changes in IMCL or LDS within skeletal muscle in CWL or EWL, respectively. In conclusion, under the conditions of chronic caloric balance following dietary or exercise-based interventions, mediators of mitochondrial function, IMCL and LDS, were largely unaffected. Future studies should focus on intervention-based changes in protein expression and/or phosphorylation and the relationship to physiological endpoints.

[The nutritional education of patients with diabetes]

The nutritional education of patients with diabetes, in the hospital setting or in the community, is essential for ensuring good glycaemic control. It helps to combat preconceived ideas about diet and reinforces patients' autonomy in the management of their disease.

Dietary inflammatory index and odds of colorectal cancer in a case-control study from Jordan

Dietary components that promote inflammation of the colon have been suggested to be risk factors in the development of colorectal cancer (CRC). The possible link between inflammatory potential of diet and CRC has been investigated in several developed or Western countries. Despite the fact that dietary choices in the Middle East differ markedly from those in the West, results have not been reported from any study conducted in a Middle-Eastern population. We examined the association between dietary inflammatory index (DII) scores and CRC in a case-control study conducted in Jordan. This study included 153 histopathologically confirmed CRC cases and 202 disease-free control subjects' frequency matched on age, sex, and occupation. Data were collected between January 2010 and December 2012, using interviewer-administered questionnaires. DII scores were computed from dietary data reported using a food frequency questionnaire. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) adjusted for age, sex, education, physical activity, body mass index, smoking, and family history of CRC. Subjects with higher DII scores were at increased odds of CRC, with the DII being used both as a continuous variable (OR_continuous = 1.45, 95% CI: 1.13-1.85; 1-unit increase corresponding to ≈20% of its range in the current study) and as a categorical variable (OR_{tertile 3 vs tertile 1} = 2.13, 95%CI: 1.23-3.72). Our results, based on a Jordanian population, add to the growing literature indicating that a pro-inflammatory diet is associated with increased odds of CRC.

[Physiopathology, causes and complications of obesity]

Obesity is a chronic disease associated with respiratory, mechanical, cardiovascular, metabolic as well as psychological and social comorbidities. It has become increasingly prevalent over the last thirty years. The causes are multiple and interwoven, related to diet, sedentary lifestyles, psychological factors, genetics, the socio-economic context and biological factors. Management strategies must be adapted to the clinical situations and treatment must be individualised.

Dietary assessment is a critical element of health research - Perspective from the Partnership for Advancing Nutritional and Dietary Assessment in Canada

Challenges and complexities associated with assessing dietary intakes are numerous, but not insurmountable. This opinion paper from Canadian researchers draws attention to the importance of building capacity and providing funding opportunities for research in dietary assessment methods in Canada and elsewhere. Such strategies would contribute to a better understanding of the roles played by diet in human health and better translation of this information into the most meaningful and effective dietary guidelines, policies, and interventions.

Dietary Patterns and Type 2 Diabetes Mellitus in a First Nations Community

BACKGROUND

Type 2 diabetes mellitus is a growing concern worldwide, particularly in Indigenous communities, which have undergone a marked nutrition transition characterized by reduced intakes of traditional foods and increased intakes of market foods. Few studies have assessed the relationships between differing dietary patterns and risk for type 2 diabetes in Indigenous communities in Canada. The objective of the study was to characterize dietary patterns using factor analysis (FA) and to relate these patterns to the incidence of type 2 diabetes after 10 years of follow up in a First Nations community in Ontario, Canada.

METHODS

We conducted a prospective analysis of 492 participants in the SLHDP who did not have diabetes at baseline (1993 to 1995) and were followed for 10 years. A food-frequency questionnaire was administered, and FA was used to identify patterns of food consumption. Multivariate logistic regression analyses determined associations of food patterns with incident type 2 diabetes, adjusting for sociodemographic and lifestyle confounders.

RESULTS

At follow up, 86 participants had developed incident type 2 diabetes. FA revealed 3 prominent dietary patterns: Balanced Market Foods, Beef and Processed Foods and Traditional Foods. After adjustment for age, sex, waist circumference, interleukin-6 and adiponectin, the Beef and Processed Foods pattern was associated with increased risk for incident type 2 diabetes (OR=1.38; 95% CI 1.02, 1.86). In contrast, the Balanced Market Foods and Traditional Foods Patterns were not significantly associated with type 2 diabetes.

CONCLUSIONS

Dietary interventions should encourage reduced consumption of unhealthful market foods, in combination with improvements in local food environments so as to increase access to healthful foods and reduce food insecurity in Indigenous communities.

[Type 2 diabetes, obesity and nutrition, a paradigm shift]

Obesity and type 2 diabetes are two complex and multifactorial chronic diseases. Nutritional management is based on an educational and bio-psycho-sensory approach centred on the patient using cognitive-behavioural and emotionally-focused therapy tools.

[Can diet prevent the reoccurrence of an intestinal obstruction?]

Mechanical obstructions are mainly linked to old age which can favour constipation and faecal impaction, to abdominal surgery, to chronic inflammatory diseases of the intestine or to digestive tract malignant tumours. In addition to monitoring the patient and ensuring their compliance with prescribed treatments, educating the patient with the aim of restoring a good nutritional status is essential.

[The diet of the elderly person undergoing dialysis]

The elderly patient undergoing dialysis is often at risk of undernutrition. The condition may already be present at the pre-dialysis stage and can worsen once dialysis starts. Aside from the impact on the patient's quality of life and general health status, undernutrition exposes them to serious risk of complications and can be life-threatening. It is therefore essential that it is diagnosed early.

[Preventing swallowing disorders in neurological patients]

Swallowing disorders in neurological rehabilitation are common and important as they can have harmful consequences. A multi-disciplinary hospital team was created to study ways of preventing their occurrence. This article presents the areas to focus on and the main orientations of patient management.

Relation entre la mastication et la qualité de l'alimentation des aînés de l'Étude longitudinale québécoise sur la nutrition et le vieillissement (NuAge)

The objective of this study was to assess the relationship between the quality of mastication and dietary intake among community-dwelling older adults (67-84 years). A secondary analysis of data collected upon entry of participants in the NuAge study was effected. Perceived masticatory efficiency (n=1793) was measured using a questionnaire inspired by the Oral Health Impact Profile. Direct assessment of masticatory efficiency was carried out in a subsample (n=94), using a validated clinical test (Swallowing Threshold Test Index, 0-100%). Dietary intake was calculated from three non-consecutive 24h recalls. Mean scores indicate good perceived masticatory efficiency (Men:26.22±0.19/28;Women:25.81±0.21/28), but weak assessed efficiency (Men:60.8% [CI(57.3-64.2)]; Women:61.2% [CI(57.7-64.7)]). Multivariate regression analysis, adjusting for confounding variables (age, sex, schooling, living alone, income, smoking, chronic conditions, functional autonomy), showed that masticatory efficiency (measured or perceived) was not associated with intake of fruits/vegetables, protein, vitamin C or folic acid.

ANALYSIS OF FOOD TOLERANCE IN PATIENTS SUBMITTED TO BARIATRIC SURGERY USING THE QUESTIONNAIRE QUALITY OF ALIMENTATION

BACKGROUND

Due to the increased prevalence of obesity in many countries, the number of bariatric surgeries is increasing. They are considered the most effective treatment for obesity. In the postoperative there may be difficulties with the quality of alimentation, tolerance to various types of food, as well as vomiting and regurgitation. Few surveys are available to assess these difficulties in the postoperative.

AIM

To perform a systematic literature review about food tolerance in patients undergoing bariatric surgery using the questionnaire "Quality of Alimentation", and compare the results between different techniques.

METHOD

A descriptive-exploratory study where the portals Medline and Scielo were used. The following headings were used in english, spanish and portuguese: quality of alimentation, bariatric surgery and food tolerance. A total of 88 references were found, 14 used the questionnaire "Quality of Alimentation" and were selected.

RESULTS

In total, 2745 patients were interviewed of which 371 underwent to gastric banding, 1006 to sleeve gastrectomy, 1113 to Roux-en-Y gastric bypass, 14 to biliopancreatic diversion associated with duodenal switch, 83 were non-operated obese, and 158 non-obese patients. The questionnaire showed good acceptability. The biliopancreatic diversion with duodenal switch had the best food tolerance in the postoperative when compared to other techniques, but it was evaluated in a single article with a small sample. The longer the time after the operation, the better is the food tolerance. Comparing the sleeve gastrectomy and the Roux-en-Y gastric bypass, there are still controversial results in the literature. The gastric banding had the worst score of food tolerance among all the techniques evaluated.

CONCLUSION

The questionnaire is easy and fast to assess the food tolerance in patients after bariatric surgery. Biliopancreatic diversion with duodenal switch had the best food tolerance in the postoperative when compared to sleeve gastrectomy and the Roux-en-Y gastric bypass. Gastric banding still remains in controversy, due it presented the worst score.

"A Wholesome Article of Food": Rhetoric of Health and Nation in Canada's Oleomargarine Debates, 1917-1924

This article examines the rhetoric employed in the 1917-1924 debates over oleomargarine's legalization in Canada, noting that health, extending from the individual to the collective body, emerged as a key battle cry. Oleomargarine was at once a tool of citizenship and a nexus for new theories of food science, anxieties about race and otherness, women's emerging political influence, and contention about the roles of both industry and government in dictating food choices. As both sides promulgated their respective products' contributions to personal and national welfare, health and citizenship stood as entwined ideals, inviolable but not uncontested.

Patates, pain, et lard salé valaient-ils mieux que céréales, bacon et bœuf haché? La diète quotidienne et la santé au Québec, 1861-1941

Cet article expose certains facteurs qui permettent l’amélioration de la diète et identifie des conditions qui nuisent à l’obtention d’une alimentation abondante et variée pour les ouvriers urbains et les paysans du Québec entre 1861 et 1941. Il décrit d’abord quelques défis méthodologiques qui rendent difficile la description de grandes tendances dans l’évolution de la diète et de la santé. Ensuite, il compare les aliments consommés dans trois ménages, selon les données fournies par deux enquêtes sociographiques menées dans Charlevoix en 1861 et à Québec en 1903, et par un article décrivant le travail d’une nutritionniste auprès d’une famille pauvre de Montréal, en 1941. Cette comparaison révèle que les conditions matérielles d’existence et les revenus déterminent grandement la diète quotidienne durant cette période marquée par l’industrialisation et l’urbanisation.

Nutritional controls of food reward

The propensity to select and consume palatable nutrients is strongly influenced by the rewarding effects of food. Neural processes integrating reward, emotional states and decision-making can supersede satiety signals to promote excessive caloric intake and weight gain. While nutritional habits are influenced by reward-based neural mechanisms, nutrition and its impact on energy metabolism, in turn, plays an important role in the control of food reward. Feeding modulates the release of metabolic hormones that have an important influence on central controls of appetite. Nutrients themselves are also an essential source of energy fuel, while serving as key metabolites and acting as signalling molecules in the neural pathways that control feeding and food reward. Along these lines, this review discusses the impact of nutritionally regulated hormones and select macronutrients on the behavioural and neural processes underlying the rewarding effects of food.

Evaluation of the infertile male - modern approach in the Procreation Medical Assistance (P.M.A.)

The infertility of the couple represents a constant preoccupation of the modern society; the supervision of the fertility of the population has become a necessity today, as a result of the behaviour and habitat modifications, which the modern life has generated. Today the PMA (Assisted Human Reproduction) techniques allow the palliative solving of the medical problems, as far as the somatic plan is concerned, the incapacity of procreation of the couple. However, beyond the attempt of practically solving infertility, at the world level, the specialists in the field of reproduction have projected evaluation and supervising couple fertility programs, trying to delineate the responsible factors of this reality.

[Dietary recommendations with practical examples of menus for people living with HIV/AIDS in sub-Saharan Africa]

L’infection par le VIH (Virus de l’Immunodéficience Humaine) est une infection chronique incurable. L’infection au VIH cause jusqu’à présent des millions de morts et entrave l’économie des pays sous développés ou en voie de développement, en l’occurrence les pays d’Afrique subsaharienne. Le but principal de la thérapie nutritionnelle en cas d’infection par le VIH est d’assurer au patient un poids normal et une alimentation appropriée couvrant ses besoins nutritionnels pendant les différentes phases de l’infection. Nous proposons des recommandations alimentaires détaillées quant aux apports recommandés en nutriments (macro- et micronutriments) pour les personnes vivant avec le VIH/SIDA. La nutrition joue en général un rôle très important dans le fonctionnement optimal du système immunitaire. Puisque l’infection par le VIH/SIDA est une maladie du système immunitaire, elle influence de plusieurs manières l’état nutritionnel du patient. Une nutrition hyper calorifique et hyper protéinée saine, variée et adaptée aux besoins de l’organisme est une condition indispensable pour rester longtemps en forme en cas d’infection par le VIH/SIDA. Elle permet en outre de garder un poids normal pendant la phase asymptomatique de l’infection et d’augmenter son poids pendant la phase symptomatique. Ceci a pour but de freiner l’évolution de l’infection vers le stade SIDA. Les personnes atteintes par le VIH/SIDA devraient en plus avoir une bonne hygiène de vie et exercer régulièrement une activité sportive modérée. Elles devraient mettre l’accent sur leur protection contre toute intoxication alimentaire et sur le renforcement de leur système immunitaire. Il est en outre important en plus du besoin en nutriments des personnes atteintes par le VIH/SIDA, de tenir compte de leur situation financière et culturelle, car en Afrique il existe sur ce point une très grande différence dans la population. C’est pourquoi, aussi à cause des différentes causes de la perte involontaire de poids et des différents goûts alimentaires des personnes, il est recommandé que les conseils et le suivi nutritionnel du patient soient adaptés à l’individu.