Nutritional impact of excluding red meat from the Canadian diet.

The objective of the study was to examine differences in nutrient intake between consumers and non-consumers of red meat and to assess nutritional adequacy of consumers relative to Recommended Daily Allowance (RDA) in Canada. Matching estimators were used to identify differences in nutrient intake between the two groups. Statistically significant differences were observed in nutrient intake between red meat consumers and non-consumers, including lower daily intake of protein, riboflavin, niacin, vitamin D, and zinc and a higher daily intake of dietary fiber, folate, and magnesium among Canadians who did not consume red meat. Further, red meat consumers and non-consumers had nutrient intakes below RDA for dietary energy, fiber, and calcium. While individuals who did not consume red meat were at increased risk of calcium, vitamin D, energy, and potassium inadequacy, those who consumed red meat were at increased risk of dietary fiber, vitamin A, and magnesium inadequacy.

Diabetes-related weight change in a Canadian First Nation cohort.

The Canadian First Nations population is disproportionately burdened by diabetes and diabetes complications. Body weight management is purported to be important in the prevention and management of diabetes. In this study, we sought to describe weight change in a First Nation cohort according to diabetes status and management. Study data were from two diabetes screening studies in Sandy Bay First Nation in Manitoba, Canada, collected in 2002/2003 (baseline) and 2011/2012 (follow-up). The cohort was composed of respondents to both screening studies (n=171). Fasting blood samples, anthropometric, health and demographic data were collected. At baseline, 24.8% (n=41) of the cohort members had diabetes. At follow-up, an additional 20.6% (n=34) developed diabetes. Among all participants with diabetes (long-term and incident cases), 66.6% lost weight between the two study periods. Among only participants with long-term diabetes (>8 years), 31.7% lost >10 kg. HbA1c at baseline, positive change in HbA1c over time, and use of metformin were significantly associated with weight loss ≥5%, independent of age, sex, and BMI at baseline. Further research is needed to better understand if and how diabetes-related weight loss contributes to morbidity and mortality in this First Nation population.

Chronic disease and chronic disease risk factors among First Nations, Inuit and Métis populations of northern Canada.

INTRODUCTION: Aboriginal populations in northern Canada are experiencing rapid changes in their environments, which may negatively impact on health status. The purpose of our study was to compare chronic conditions and risk factors in northern Aboriginal populations, including First Nations (FN), Inuit and Métis populations, and northern non-Aboriginal populations. METHODS: Data were from the Canadian Community Health Survey for the period from 2005 to 2008. Weighted multiple logistic regression models tested the association between ethnic groups and health outcomes. Model covariates were age, sex, territory of residence, education and income. Odds ratios (ORs) are reported and a bootstrap method calculated 95% confidence intervals (CIs) and p values. RESULTS: Odds of having at least one chronic condition was significantly lower for the Inuit (OR = 0.59; 95% CI: 0.43-0.81) than for non-Aboriginal population, but similar among FN, Métis and non-Aboriginal populations. Prevalence of many risk factors was significantly different for Inuit, FN and Métis populations. CONCLUSION: Aboriginal populations in Canada's north have heterogeneous health status. Continued chronic disease and risk factor surveillance will be important to monitor changes over time and to evaluate the impact of public health interventions.

TITRE: Maladies chroniques et facteurs de risque chez les membres des Premières Nations, les Inuits et les Métis du Nord canadien. INTRODUCTION: Les populations autochtones du Nord canadien subissent des changements rapides dans leur environnement, ce qui peut avoir des effets nuisibles sur leur état de santé. Nous avons voulu comparer les maladies chroniques et les facteurs de risque des populations autochtones du Nord canadien, à savoir les Premières nations, les Inuits et les Métis, avec les populations non autochtones de la même zone. MÉTHODOLOGIE: Les données sont tirées de l'Enquête sur la santé dans les collectivités canadiennes de 2005 à 2008. Des modèles de régression logistique multiple pondérée ont servi à analyser l'association entre les groupes ethniques et les résultats de santé. Les covariables du modèle étaient l'âge, le sexe, le territoire de résidence, le niveau de scolarité et le revenu. Nous présentons les rapports de cotes (RC) et nous avons utilisé la méthode d'échantillonnage bootstrap pour calculer les intervalles de confiance (IC) à 95% et les valeurs p. RÉSULTATS: La probabilité d'avoir au moins une maladie chronique était significativement plus faible chez les Inuits (RC = 0,59; IC à 95 % : 0,43 à 0,81) que chez les non-Autochtones, mais elle était similaire chez les Premières nations, les Métis et les non-Autochtones. La prévalence de nombreux facteurs de risque était significativement différente chez les Inuits, les membres des Premières nations et les Métis. CONCLUSION: Les Autochtones du Nord canadien ont des états de santé hétérogènes. Le maintien d'une surveillance continue des maladies chroniques et des facteurs de risque va jouer un rôle important dans la mesure des évolutions et dans l'évaluation de l'impact des interventions en santé publique les concernant.

Elevated proinflammatory cytokine expression in affected skin in small fiber neuropathy.

BACKGROUND: Small fiber neuropathy (SFN) is a subtype of sensory neuropathy with acral pain and normal findings in routine nerve conduction studies. METHODS: Twenty-four patients with SFN and matched controls were prospectively studied in this case-control study. Patients were assessed clinically, with standardized pain and depression questionnaires, by neurophysiologic tests, and by quantitative sensory testing. All patients underwent skin punch biopsy in a clinically affected (distal calf) and a nonaffected area (proximal thigh). Blood samples were collected for systemic cytokine gene expression analysis. RESULTS: Patients with SFN had a 2-fold higher gene expression for interleukin (IL)-2 (p < 0.0001), IL-10 (p = 0.01), and transforming growth factor-beta1 (p = 0.001) in peripheral blood. Skin samples from affected areas showed increased IL-6 (7-fold; p = 0.001) and IL-8 (5-fold; p = 0.002) gene expression when compared to healthy controls. In 10/24 patients, SFN was termed length-dependent (LD) because of a > or =5-fold higher intraepidermal nerve fiber density in the proximal than in the distal skin. Patients with LD-SFN had higher gene expression in the affected distal skin than in nonaffected skin for tumor necrosis factor-alpha (2.6-fold; p = 0.04), IL-1beta (2-fold; p = 0.02), IL-6 (>200-fold; p = 0.01), and IL-8 (>500-fold; p = 0.046). Inflammatory cells were present in most SFN samples but their numbers were not correlated with cytokine levels. CONCLUSIONS: Elevated local proinflammatory cytokines may be involved in the pathophysiology of pain in length-dependent small fiber neuropathy. These findings suggest a potential therapeutic role of locally applied cytokine inhibitors.

Obesity and obesity-related comorbidities in a Canadian First Nation population.

INTRODUCTION: Rates of obesity are higher among Canada's Aboriginal First Nations populations than among non-First Nations populations. We studied obesity and obesity-related illness in a Manitoba First Nation community. METHODS: We conducted a screening study of diabetes and diabetes complications in 2003, from which we drew a representative sample of Manitoba First Nation adults (N = 483). We assessed chronic disease and chronic disease risk factors. RESULTS: Prevalence of obesity and associated comorbidities was higher among women than men. By using multivariate analysis, we found that factors significantly associated with obesity among women were diastolic blood pressure, insulin resistance, and employment status. Among men, factors were age, apolipoprotein A1 level, apolipoprotein B level, and insulin resistance. Seventy-five percent of study participants had at least 1 of the following conditions: obesity, dyslipidemia, hypertension, or diabetes. Comorbidity was high even among the youngest age groups; 22% of men and 43% of women aged 18 to 29 had 2 or more chronic conditions. Twenty-two percent of participants had undiagnosed hypertension. Participants with undiagnosed hypertension had significantly more chronic conditions and were more likely to have microalbuminuria than were those without hypertension. The number of chronic conditions was not significantly different for participants with newly diagnosed hypertension than for those with previously diagnosed hypertension. CONCLUSION: The prevalence of obesity and other chronic conditions in the study community is high, especially considering the number of young people. Community-based interventions are being undertaken to reduce the excessive rate of illness.

Cardiovascular risk according to plasma apolipoprotein and lipid profiles in a Canadian First Nation.

INTRODUCTION: Despite high diabetes rates among Canadian First Nations people, little is known about their cardiovascular disease risk. Our aim was to describe the apolipoprotein profile with respect to cardiovascular risk in a Canadian First Nation community. METHODS: In 2003, a representative sample of adult members of a Manitoba First Nation (N = 483) participated in a screening study for diabetes and diabetes complications. We assessed their cardiovascular risk factors. RESULTS: Sixty percent of women were at increased cardiovascular risk because of low apolipoprotein A1 (apoA1) levels, compared with 35% of men. The proportion of women with low apoA1 levels decreased with age, but the proportion with low high-density lipoprotein levels remained stable across age groups. Both apoB and apoA1 were significantly associated with obesity when age, sex, diastolic blood pressure, homocysteine, diabetes, and insulin resistance were controlled for. CONCLUSION: Apolipoprotein and lipid profiles in this First Nation population suggest high cardiovascular risk. Future research should characterize the lipoprotein particle size in this population.

Factors affecting food selection in Canadian population.

OBJECTIVE: To establish health-related reasons behind Canadian food choices, and how variables such as education, income, gender, ethnicity and age may affect food selection. SUBJECTS: Approximately 98 733 Canadians responded to the 12 questions regarding food choices in the Canadian Community Health Survey (CCHS) cycle 2.1, conducted by the Canadian Government in 2003. These included 13 727 adolescents (12-19 years), 19 089 young adults (20-34 years), 31 039 middle-aged adults (35-54 years), 25 338 older adults (55-74 years) and 9580 elderly (75+ years). RESULTS: Approximately 70% of Canadian adolescents in the sample indicated that their food choices were independent of health concerns. Body weight management was a major concern for food selection by adolescents and adults, while the elderly stated heart disease as their main concern. Among all participants, females, and individuals with high levels of education and income reported the highest response to choosing or avoiding foods due to health concerns and food content. CONCLUSIONS: Our data indicate that several factors significantly affect food choices for health-related reasons in the Canadian population. Among them, age- and gender-related gaps, particularly between adolescents and adults, are profound. This observation may urge authorities to implement effective strategies to educate Canadians, especially adolescents, that selection of appropriate foods may prevent chronic diseases.