Human health risk assessment on the consumption of fruits and vegetables containing residual pesticides: A cancer and non-cancer risk/benefit perspective.

Pesticide residues in food is a public health concern. This study aimed to evaluate health risk and benefit associated with chronic consumption of fruits and vegetables (F&V) containing residual pesticides in the province of Quebec, Canada. Based on a representative sample of Quebecers (n=4727, aged 1-79) enrolled in the Canadian nutrition survey, population's mean chronic dietary exposure through consumption of F&V was evaluated for 169 different pesticide active ingredients (PAI), including 135 for which toxicological reference values (TRV) were available in the literature. Total lifetime cancer risk was estimated to be 3.3×10-4 considering the 28 substances for which an oral slope factor was also available. Non-cancer risk quotients greater than 1 were obtained at the 95th percentile of children's exposure for 10 of the 135 PAIs, and considering the most severe pesticide-specific TRV. Dithiocarbamates and imazalil are the authorized PAI that contribute the most to cancer and non cancer risk; they are therefore identified as "priority" PAI. For each estimated case of cancer triggered by PAI exposure, at least 88 cases were deemed prevented by the consumed F&V, based on the population's etiological fraction of the cancer risk that F&V prevent. Concluding, chronic health risks investigated are low and health benefits of F&V consumption by far outweigh the PAI-related risk. However, risk estimates are not negligeable and uncertainties remain. Thus, reducing PAI exposure through F&V consumption with a particular focus on "priority" PAI mentionned above, while maintaining an abundant and varied F&V diet, is desirable.

Relation between dietary acrylamide exposure and biomarkers of internal dose in Canadian teenagers.

Acrylamide (AA) is a probable human carcinogen found in several foods. Little information is available regarding exposure of adolescents, a subgroup potentially consuming more AA-rich foods. We investigated the relationship between dietary AA intake and levels of biomarkers of exposure (urinary metabolites and hemoglobin adducts) in 195 non-smoking teenagers of Montreal Island aged 10-17 years. Dietary habits and personal characteristics were documented by questionnaire. AA and its metabolites were quantified in 12-h urine collections by LC-MS/MS. Hemoglobin adducts from 165 blood samples were also analyzed by LC-MS/MS. Most prevalent urinary metabolites were NACP and NACP-S, with respective geometric mean concentrations of 31.2 and 14.2 µmol/mol creatinine. Geometric mean concentrations of AAVal and GAVal (hemoglobin adducts of AA and glycidamide (GA) with N-terminal valine residues) were 45.4 and 45.6 pmol/g globin, respectively. AA intake during the 2 days before urine collection was a significant predictor of NACP+NACP-S urinary concentrations (P<0.0001). AA intakes during the month before blood collection (P<0.0001) and passive smoking (P<0.05) were associated with adduct levels. Levels of hemoglobin adducts were above biomonitoring equivalent values corresponding to a 1 × 10(-4) excess cancer risk, which may indicate the need to reduce AA exposure in the population.

Dietary exposure to acrylamide in adolescents from a Canadian urban center.

The distribution of acrylamide in food items frequently consumed by Canadian adolescents was determined along with estimates of their contribution to the overall dietary intake of acrylamide. A total of 196 non-smoking adolescents (10-17 years old) were recruited in Montreal Island population, Canada. Participants were invited to fill out a 2-day food diary and a food frequency questionnaire over the last month. 146 samples of foods most frequently consumed by participants were analyzed for acrylamide contents. The highest acrylamide contents were measured in deep-fried french fries and potato chips (mean ± SD: 1053 ± 657 and 524 ± 276 ng/g respectively). On the basis of the 2-day food diary, median total daily intake of acrylamide was estimated at 0.29 µg/kg bw/d, as compared to 0.17 µg/kg bw/d on the basis of the food frequency questionnaire. These values are similar to those reported in comparable populations. Deep-fried french fries consumption contributed the most to daily acrylamide intake (50%) followed by potato chips (10%), oven-baked french fries (8%) and breakfast cereals (8%). Margins of exposure based on genotoxic benchmark dose limits were estimated to be low (≈<100) in high-consumer adolescents, indicating the need to continue efforts to reduce dietary acrylamide exposure.

Prevalence of anemia among Inuit women in Nunavik, Canada.

OBJECTIVES: To assess the prevalence and main types of anemia present among non-pregnant Inuit women of Nunavik using a representative sample. STUDY DESIGN: A cross-sectional population-based study. Methods. Iron status was assessed in 466 women aged 18-74 who participated in the 2004 Nunavik Inuit Health Survey. The presence of different types of anemia has been evaluated based on available biochemical indicators of vitamins and of iron status. The correlation between iron status indicators, vitamin status parameters, inflammation markers and heavy metal concentrations was also assessed. RESULTS: Anemia was present in 43% of the Inuit women in Nunavik and 21% suffered from iron deficiency anemia (IDA). The main type of anemia present among women 18-49 years old was IDA (61% of anemia cases) while anemic women 50 years and over suffered mainly from anemia related to chronic inflammation (ACI) (42%). Over 99% of women had normal values for vitamin A, vitamin B12 and folate. Of interest is that ferritin was positively correlated with blood mercury and lead levels. CONCLUSION: The prevalence of anemia in Nunavik women is similar to levels observed in non-industrialized countries and represents a severe public health problem that should be further investigated. The most prevalent type of anemia in these women shifted from IDA to ACI with age. Vitamin A, vitamin B12 and folate deficiencies do not constitute a widespread problem and their contribution to anemia is probably minimal. Sources of heavy metals are also major sources of iron in the diet of Nunavik women which could explain the positive association found between heavy metals and iron status.

Plasma omega-3 and psychological distress among Nunavik Inuit (Canada).

Marine omega-3 (n-3) fatty acid eicosapentaenoic (EPA) and docosahexaenoic (DHA) acids have been associated with beneficial effects in mental health. Cultural and social changes have been related to a decline in mental health of the Inuit, but the role of diet has received scant attention. We examined the relationship between psychological distress (PD) and plasma n-3 among 368 Nunavik Inuit aged 18-74 years who took part in a survey in 1992. Participants were categorized as high-level PD if they scored over the 80th percentile of the PD Index Santé-Québec Survey (PDISQS-14), and non-distressed subjects were those who scored less than this cutoff. Compared with the non-distressed group, n-3 concentrations in the PD group were significantly lower in women but not in men. Compared with the lowest tertile of EPA + DHA, the odds ratios for high-level PD among women were 0.32 (95% CI: 0.13-0.82) for the second, and 0.30 (95% CI: 0.10-0.90) for the third tertile, after controlling for confounders. In males, there were no significant associations between EPA+DHA and PDISQS-14 scores. Our findings suggest that marine n-3 may play a role in PD among Inuit women. The gender difference observed in our analysis must be examined more carefully in future studies.

Plasma n-3 fatty acids and psychological distress in aboriginal Cree Indians (Canada).

OBJECTIVE: To examine the relationship between psychological distress (PD) and plasma n-3 long-chain (LC) PUFA, i.e. EPA, docosapentaenoic acid (DPAn-3) and DHA. DESIGN: Population-based, cross-sectional Santé-Québec Health Survey (1991). Participants were categorized as high-level PD if they scored over the 80th percentile of the PD Index in the Santé-Québec Survey; non-distressed subjects were those who scored less than this cut-off. Associations between tertiles of n-3 fatty acids (FA) and the risk of high-level PD were expressed as odds ratios, with the lowest tertile as the reference group. SETTING: Québec, Canada. SUBJECTS: Data were analysed from a representative sample of 852 James Bay Cree Indian adults aged 18 years and over. RESULTS: Proportions of n-3 FA were statistically significantly lower in the PD than in the non-distressed group. After adjustment for confounders, EPA was the only individual n-3 FA significantly associated with the risk of high-level PD. Combinations of EPA + DHA or EPA + DPAn-3 + DHA or the sum of n-3 were also associated with the risk of high-level PD. Compared with the lowest tertile of EPA + DHA, the OR for high-level PD was 0.89 (95 % CI 0.59, 1.36) for the second and 0.56 (95 % CI 0.32, 0.98) for the third tertile, after controlling for confounders. CONCLUSIONS: In the present retrospective, cross-sectional study, we found that proportions of n-3 LC PUFA in plasma phospholipids, markers of n-3 LC PUFA consumption from fish, were inversely associated with PD.

Fatty acid composition of wild and farmed Atlantic salmon (Salmo salar) and rainbow trout (Oncorhynchus mykiss).

The goal of this study was to examine the FA composition of wild and farmed Atlantic salmon (AS) and rainbow trout (RT). FA profiles were obtained by GC/FID. Results showed that lipid and n-3 highly unsaturated FA contents of farmed and wild AS were similar. Total n-3 and n-6 PUFA were significantly higher in farmed AS than in wild AS. Farmed RT contained more fat and less n-3 PUFA than wild RT. Our results show that farmed salmonids provide high levels of n-3 HUFA to consumers.

Impact of waist circumference on the relationship between blood pressure and insulin: the Quebec Health Survey.

Hyperinsulinemia has been suggested to be involved in the etiology of obesity-associated hypertension. The objective of the present study was to quantify, in a population-based study, the respective contributions of excess adiposity (body mass index [BMI]), waist circumference (WC), fasting insulin levels, and insulin sensitivity to the variation of resting blood pressure. The Quebec Health Survey was used to obtain fasting plasma insulin and glucose levels and resting blood pressure as well as anthropometric measurements in a representative sample of 907 men and 937 women. When the sample was divided into tertiles of BMI and further stratified on the basis of the 50th percentile of WC (88 cm in men), nonobese men in the first BMI tertile (<23.2 kg/m2) but with abdominal obesity were characterized by an increased systolic blood pressure (SBP) compared with nonobese men with low WC (130+/-18 versus 120+/-11 mm Hg; mean+/-SD; P=0.075). The SBP was comparable to SBP values measured among men in the top BMI tertile (129+/-14 mm Hg for BMI > or =26.6 kg/m2). When subjects were classified into tertiles of fasting insulin and WC, no association between insulin levels and blood pressure was noted, once the variation in WC was considered. Insulin sensitivity (estimated with homeostasis model assessment [HOMA]) did not explain variation in blood pressure in men, whereas the contribution of HOMA in women was of marginal clinical significance (R2 of <1.3%; P<0.0001). These results suggest that the documented association between obesity, fasting insulin, insulin sensitivity, and blood pressure is largely explained by concomitant variation in WC.

Vitamin A concentration in umbilical cord blood of infants from three separate regions of the province of Québec (Canada).

BACKGROUND: Inuit women from Northern Québec have been shown to consume inadequate quantities of vitamin A. This study was conducted to evaluate the prevalence of blood vitamin A deficiency in newborns from 3 distinct populations of the province of Québec. METHODS: 594 newborns were included in this study (375 Inuit newborns from northern Québec (Nunavik), 107 Caucasian and Native newborns from the Lower Northern Shore of the Saint-Lawrence River (LNS) and 112 newborns from Southern Québec where clinical vitamin A deficiency is uncommon). Mothers were recruited at delivery and vitamin A (retinol) was analyzed from umbilical cord blood samples by reversed-phase high-pressure liquid chromatography. RESULTS: Nunavik and LNS newborns had significantly lower mean vitamin A concentrations in cord blood compared to Southern Québec participants (15.7 microg/dL, 16.8 microg/dL and 20.4 microg/dL respectively). The differences observed were similar when adjusted for sex and birthweight. Results also showed that 8.5% of Nunavik newborns and 12.2% of LNS newborns were below 10.0 microg/dL, a level thought to be indicative of blood vitamin A deficiency in neonates. CONCLUSION: These data suggest that a carefully planned vitamin A supplementation program during pregnancy in Nunavik and LNS might be indicated to promote healthy infant development.

Fish consumption and blood lipids in three ethnic groups of Québec (Canada).

The purpose of this study was to compare fish intake and plasma phospholipid concentrations of n-3 fatty acids, in particular of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), among representative population samples of Québecers, James Bay Cree, and Inuit of Nunavik (Canada). The relationships between these concentrations and cardiovascular disease (CVD) risk factors were also investigated and compared in the three populations. In 1990-1992, the study subjects had participated in the extensive Santé Québec health surveys conducted in southern Québec, James Bay, and Nunavik. Significant differences in levels of CVD risk factors were found among these three populations. Globally, Inuit showed the lowest risk status for CVD compared with Cree and Québecers, despite the high prevalence of cigarette smoking and obesity. Daily fish intakes varied significantly among the three groups, averaging 13, 60, and 131 g for Québecers, Cree, and Inuit, respectively. Concentrations of EPA + DHA in plasma phospholipids were highest among Inuit (8.0%), second-highest among Cree (3.9%), and lowest among Québecers (1.8%). When the three populations were grouped together, there was a positive association between concentrations of EPA + DHA stratified into quartiles and HDL cholesterol, with a significant relation in quartile 4 (EPA + DHA > or = 4.04%). An inverse relation was also found between EPA + DHA and triacylglycerols in quartile 4. Our results indicate that increased consumption of fish as a source of n-3 fatty acids is beneficially associated with levels of HDL cholesterol and triacylglycerols.

Fat, fishing patterns, and health among the Bardi people of north Western Australia.

Research into the resource use strategies of the Bardi Aboriginal People of One Arm Point, Western Australia, found that they maximize the consumption of specific beneficial marine FA. The Bardi assess the relative fatness of fish and animal species in their environment, procuring fish and marine species only when they are considered to be at their fattest stage: during specific seasons; at specific physiological life stages, or through on-site evaluation. In June 1999 and September 2000, samples of fish, dugong, oyster, and turtle were collected by Bardi fishermen, focusing specifically on species considered to be high in fat content and very popular among the Bardi. Nine species were analyzed for total lipids and FA profile, which were determined by capillary GLC. Comparative lipid analysis established that the Bardi hunters' selection process between species and within species and the selection of specific fish fat deposits increase the levels of beneficial F made available to the community. Bardi fishing and hunting patterns meet a demand for fat within the community and may protect many species of fish whose spawning season is inversely related to the accumulation of the specific gut fat deposits sought by the Bardi. These fat deposits make up for the relatively low levels of fat in the flesh of tropical fish. The Bardi model provides important insights into the nature of human-environment interaction and expands our understanding of the role that warmer-water fisheries can play in human health.

Blood pressure among the Inuit (Eskimo) populations in the Arctic.

AIMS: Studies of blood pressure among various Inuit (Eskimo) populations in the Arctic have given inconsistent results. Most studies reported lower blood pressure among the Inuit as compared with the predominantly white national populations. This has been attributed to traditional subsistence practices and lifestyle. This study compared the blood pressure among the major Inuit population groups with other populations and examined the associations with factors like age, gender, obesity and smoking. METHODS: The study comprised four Inuit populations from Alaska, Canada, and Greenland with participation rates ranging from 51% to 73%. In a cross-sectional design, 2,509 randomly selected adults from 31 villages were examined. Blood pressure, anthropometric measurements, smoking, and medication were recorded. RESULTS: Mean systolic blood pressures ranged from 116 to 124 mm Hg among men and 110 to 118 among women in the four populations. Mean diastolic blood pressures ranged from 75 to 78 mm Hg among men and from 71 to 73 among women. Systolic blood pressure increased with age. Male gender, obesity, being a non-smoker, and being on anti-hypertensive treatment were associated with high systolic and diastolic blood pressure. Adjusted for age, body mass index, smoking, and anti-hypertensive treatment, blood pressure differed among the populations (p

Prevalence of metabolic alterations predictive of cardiovascular disease risk in the Québec population.

BACKGROUND: It is well established that cardiovascular diseases (CVD) are the most important cause of morbidity and mortality in North America and in industrialized countries. Furthermore, the presence of CVD risk factors is widespread in Canada, and two-thirds of adult Canadians present at least one traditional risk factor for CVD. OBJECTIVE: To quantify the prevalence of metabolic alterations predictive of an increased risk of CVD in a representative sample of the Québec population. METHODS: A representative sample of the Québec population was obtained through the Québec Health Survey 1990. The cohort of 1844 subjects (907 men and 937 women), aged from 18 to 74 years, completed the evaluation, which consisted of interviews, validated questionnaires for personal and family history of CVD risk factors, and a physical examination. Anthropometric measurements, blood pressure, fasting plasma lipoprotein-lipid levels as well as fasting glucose and insulin concentrations were obtained. RESULTS: Thirty one per cent of the Québec population had a normal body weight defined by body mass index (BMI) less than 25 kg/m2 with a healthy metabolic profile (glycemia less than 6.1 mmol/L, total cholesterol less than 5.2 mmol/L, low density lipoprotein-cholesterol less than 3.4 mmol/L, triglycerides less than 2.3 mmol/L and high density lipoprotein-cholesterol greater than 0.90 mmol/L). On the other hand, 28% of the population was treated for known metabolic chronic diseases (CVD, diabetes, dyslipidemias and hypertension), whereas the remaining 33% of the Québec population (BMI greater than 25 kg/m2) were characterized by an altered metabolic profile predictive of an increased CVD risk. Furthermore, 75% of men and 70% of women with an altered metabolic profile presented at least two CVD risk factors. Overall, women tended to display a significantly healthier metabolic risk profile than men (P<0.05). CONCLUSIONS: According to our results, only 31% of the Québec population is nonobese without major alterations in their metabolic risk profile. Indeed, 61% of Quebecers are either characterized by chronic diseases or by an altered metabolic profile increasing their risk for the development of CVD and type 2 diabetes. Such a high prevalence should be a source of concern justifying the development of simple screening tools for early identification of the asymptomatic carriers of this cluster of metabolic abnormalities.

Prevalence of 'hypertriglyceridemic waist' in men who participated in the Quebec Health Survey: association with atherogenic and diabetogenic metabolic risk factors.

BACKGROUND: A triad of metabolic markers (high insulin and apolipoprotein B levels, and small, dense, low density lipoprotein particles) is associated with a substantially increased risk of coronary artery disease (CAD) in men. Also, the simultaneous presence of an elevated waist circumference (90 cm or greater) and moderate hypertriglyceridemia (triglyceride concentration 2.0 mmol/L or higher) in men has been shown to be associated with this atherogenic metabolic triad, with a probability of more than 80%. OBJECTIVES: To quantify the prevalence of the 'hypertriglyceridemic waist' phenotype in a sample of adult men and to compare the metabolic risk profile of nondiabetic men with hypertriglyceridemic waist with the CAD risk profile of patients with type 2 diabetes. METHODS: The sample of people who participated in the Quebec Health Survey was used to obtain representative data on the prevalence and distribution of cardiovascular disease risk factors in the Quebec population. Fasting plasma lipoprotein-lipid, insulin and glucose concentrations were measured, and anthropometric measurements were taken in a sample of 907 men. RESULTS: Among men who participated in the Quebec Health Survey, 19% had an elevated waist circumference (90 cm or greater) plus elevated triglyceride levels (2.0 mmol/L or higher). Men with this hypertriglyceridemic waist phenotype were characterized by the highest values for fasting plasma insulin, and the highest total cholesterol to high density lipoprotein cholesterol ratios. They also displayed a metabolic risk profile that was deteriorated to the same extent as that of men with diabetes who had participated in the survey. CONCLUSIONS: The results of the the present study of men who participated in the Quebec Health Survey provide further evidence that the simultaneous measurement and interpretation of waist circumference and fasting triglyceride concentrations may improve the physician's ability to identify abdominally obese men with atherogenic and diabetogenic profiles. Furthermore, this high risk clinical phenotype is highly prevalent (about 20%) among adult men.

Cardiovascular disease risk factors and n-3 fatty acid status in the adult population of James Bay Cree.

BACKGROUND: Canadian native populations, which traditionally consume large amounts of fish, have lower rates of mortality from heart disease than do Canadian nonnative populations, which have low fish intakes. Fish oils rich in n-3 fatty acids may have a protective effect against cardiovascular disease (CVD) risk factors. OBJECTIVES: The purposes were to examine the profile of plasma phospholipid concentrations of the n-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) among James Bay Cree and to verify the relation between these concentrations and CVD risk factors. DESIGN: The study population consisted of 917 subjects aged 18-74 y who participated in the 1991 Santé Québec Health Survey. Data were obtained through home interviews and clinic visits. Plasma samples were analyzed for phospholipid fatty acid composition. RESULTS: The mean fish consumption on the day before the survey was 60 g among the adult Cree population. Expressed as a percentage of total fatty acids, relative concentrations of EPA and DHA were 0.65% and 2.80%, respectively. n-3 Fatty acids were higher among coastal residents than among inland residents. A positive association was observed between plasma HDL and n-3 fatty acids. EPA and EPA+DHA were inversely associated with triacylglycerols. Among subjects aged 50-74 y, an inverse association between EPA and EPA:AA and total:HDL cholesterol was observed. CONCLUSIONS: n-3 Fatty acids may favorably influence some CVD risk factors. The Cree population must be encouraged to maintain their traditional fish-based diet, which may be one of the factors protecting them against mortality from CVD.

Contribution of Selected Traditional and Market Foods to the Diet of Nunavik Inuit Women.

Food composition data were determined for food consumed by 226 Inuit women in Nunavik, estimating the relative contribution of traditional and market food for energy, protein, lipid, carbohydrate, vitamin A, vitamin D, iron, calcium, magnesium, phosphorus, selenium, zinc, and eicosapentaenoic and docosahexaenoic acids. Traditional Inuit food was an important source of protein, vitamin D, iron, selenium, and phosphorus, as well as the main source of eicosapentaenoic and docosahexaenoic acids. The mean contribution of traditional and market food to energy and nutrients was analyzed according to age groups (18-39 and 40-74). Analysis of Inuit women's nutrient intake showed that the contribution of traditional food was greater in the older group than in the younger group, for whom the contribution of market food was greater. Market food contributed the most to Inuit women's energy intake, while 40% of the intake of several nutrients, including protein, vitamin D, iron, phosphorus, and zinc, was derived from traditional food. Inuit women had low vitamin A and calcium intakes. Traditional food had low calcium and vitamin A concentrations, and the Inuit infrequently consumed market food such as milk, dairy products, and yellow and green vegetables. Thus, even though the present study showed that traditional food was the major source of many nutrients in the Inuit diet, market food was also important for the nutritional status of this population, particularly young women. In promoting safe nutritional habits among the Inuit, dietitians must help them maintain traditional food use, which has provided some health advantages (e.g., a lower incidence of cardiovascular disease); encourage consumption of nutritious market foods; and consider the societal values reflected in the traditional diet.