Jennifer Enns

Variations in Adipokine Genes AdipoQ, Lep, and LepR are Associated with Risk for Obesity-Related Metabolic Disease: The Modulatory Role of Gene-Nutrient Interactions

Obesity rates are rapidly increasing worldwide and facilitate the development of many related disease states, such as cardiovascular disease, the metabolic syndrome, type 2 diabetes mellitus, and various types of cancer. Variation in metabolically important genes can have a great impact on a populations susceptibility to becoming obese and/or developing related complications. The adipokines adiponectin and leptin, as well as the leptin receptor, are major players in the regulation of body energy homeostasis and fat storage. This paper summarizes the findings of single nucleotide polymorphisms in these three genes and their effect on obesity and metabolic disease risk. Additionally, studies of gene-nutrient interactions involving adiponectin, leptin, and the leptin receptor are highlighted to emphasize the critical role of diet in susceptible populations.

Dietary flaxseed oil reduces adipocyte size, adipose monocyte chemoattractant protein-1 levels and T-cell infiltration in obese, insulin-resistant rats

BACKGROUND Adipocyte dysfunction is characterized by an increase in adipocyte size and changes to their adipokine profiles. Immune cell infiltration into adipose tissue is thought to contribute to the metabolic complications of obesity, with local and systemic consequences for the inflammatory status of the obese individual. Dietary interventions with omega-3 fatty acids from marine sources have been successful at reducing inflammation. The aim of this study was to determine whether flaxseed oil containing the plant-based omega-3 fatty acid α-linolenic acid (ALA) is an effective modulator of inflammation and adipocyte dysfunction. METHODS Seventeen-week old male fa/fa and lean Zucker rats were fed a control diet (faCTL, lnCTL) and fa/fa rats were fed an ALA-rich flaxseed oil supplemented diet (faFLAX) for 8 weeks. Adipose tissue and serum were collected and analyzed for cytokine (IL-6, IL-10, IL-18, IL-2, IFN-γ, TNF-α), haptoglobin, monocyte chemoattractant protein-1 (MCP-1) and adipokine (leptin, adiponectin) levels. Splenocytes were isolated and ex vivo mitogen-stimulated cytokine production was measured. Digital images of adipose tissue sections were used to quantify adipocyte area. Macrophage and T-cell infiltration were assessed in adipose tissue by immunohistochemistry. RESULTS faFLAX rats had 17% smaller adipocytes and 5-fold lower MCP-1 levels in adipose tissue than faCTL rats. Adipose tissue levels of IL-10 were 72% lower in the faFLAX group compared to baseline, and TNF-α levels decreased 80% (equal to lnCTL levels) in the faFLAX group compared to faCTL. There were no changes in ex vivo cytokine production by splenocytes between faFLAX and faCTL. Macrophage infiltration was not different among groups; however, faFLAX rats had less T-cell infiltration than faCTL rats. CONCLUSIONS Dietary intervention with ALA-rich flaxseed oil in obese Zucker rats reduced adipocyte hypertrophy, protein levels of inflammatory markers MCP-1 and TNF-α, and T-cell infiltration in adipose tissue. Modest improvements to other parameters of obesity were also observed. The results suggest that, due to its ability to improve adipocyte function, ALA-rich flaxseed oil confers health benefits in obesity.

Modulation of Cardiovascular Function by Adipokines

Cardiovascular disease (CVD) and associated risk factors such as obesity remain at the forefront of health concerns. Adipose tissue has been well established as an endocrine organ that becomes dysfunctional with increased adipose tissue mass. The secretion of several adipokines is altered in subjects with abdominal adiposity and these changes to the endocrine balance may contribute to increased CVD risk. The identification and characterization of disease-specific proteins within the adipose tissue offers a novel therapeutic target for prevention or treatment of cardiovascular complications. This review will discuss the latest developments on therapeutic targets within the context of adipokines, such as adiponectin, C1q/ tumor necrosis factor (TNF) related proteins (CTRPs), visfatin, vaspin, chemerin and omentin, and their involvement in obesity-related cardiovascular complications.

Mapping interventions that promote mental health in the general population: A scoping review of reviews.

Health policies and programs promoting mental health or preventing mental illness in the general public are under-recognized facets of primary prevention. Increasing awareness and adoption of such strategies could reduce the burden of mental illness in individuals, families, communities, and society as whole. We conducted a scoping review of reviews of interventions to promote mental health or prevent mental illness. We searched PubMed, PsycINFO, Scopus, Cochrane CENTRAL, CINAHL and ERIC from 2004 to 2014. Reviews were included if the authors indicated a systematic approach in their literature searches, and if they comprised interventions in Westernized countries targeting the general population. We identified 39 reviews that met the inclusion criteria. Mental health intervention approaches and outcomes varied across age groups and settings, and included functional, social, and cognitive measures. Most interventions aimed to prevent a specific mental illness or symptoms (depression, anxiety, burnout, or stress). Cognitive-behavioral therapy and educational components were common. School-based programs focused on outcomes involving social and academic development. Interventions for families, especially for young or disadvantaged parents, taught parenting skills to help improve the well-being of children and their care-givers. In the workplace, the focus was on managing stress, while programs for the elderly emphasized quality of life determinants. This review summarizes a wide variety of interventions to promote mental health or prevent mental illness, but the literature is primarily focused on the individual or family unit. More information is required about interventions at the community and societal levels.

Diets high in monounsaturated and polyunsaturated fatty acids decrease fatty acid synthase protein levels in adipose tissue but do not alter other markers of adipose function and inflammation in diet-induced obese rats

This study investigates the effects of monounsaturated and polyunsaturated fatty acids from different fat sources (High Oleic Canola, Canola, Canola-Flaxseed (3:1 blend), Safflower, or Soybean Oil, or a Lard-based diet) on adipose tissue function and markers of inflammation in Obese Prone rats fed high-fat (55% energy) diets for 12 weeks. Adipose tissue fatty acid composition reflected the dietary fatty acid profiles. Protein levels of fatty acid synthase, but not mRNA levels, were lower in adipose tissue of all groups compared to the Lard group. Adiponectin and fatty acid receptors GPR41 and GPR43 protein levels were also altered, but other metabolic and inflammatory mediators in adipose tissue and serum were unchanged among groups. Overall, rats fed vegetable oil- or lard-based high-fat diets appear to be largely resistant to major phenotypic changes when the dietary fat composition is altered, providing little support for the importance of specific fatty acid profiles in the context of a high-fat diet.

Dietary supplementation of trans-11-vaccenic acid reduces adipocyte size but neither aggravates nor attenuates obesity-mediated metabolic abnormalities in fa/fa Zucker rats.

Conjugated linoleic acid (CLA) present in dairy and ruminant fat has beneficial effects on metabolic syndrome characteristics in humans and some rodent models. Production practices to increase the milk content of CLA are also substantially elevating trans-11-vaccenic acid (VA). Questions are being raised whether VA has the same beneficial actions as CLA or has adverse biological effects similar to industrially produced trans-fatty acids. The present study examined the effects of dietary supplementation of either 0 or 1·5 % (w/w) VA for 8 weeks on lipidaemia, glycaemia, blood pressure, hepatic steatosis, adipocyte size and molecular markers of inflammation and insulin signalling in fa/fa Zucker rats. Dietary supplementation of VA did not alter feed intake, weight gain, blood pressure or organ:body weight (BW) ratios, except the epididymal fat:BW ratio which was lower in the VA group compared with the control group. The total liver lipid concentration as an indicator of hepatic steatosis was not different between the groups. Likewise, there were no changes in fasting lipidaemia, glycaemia or oral glucose tolerance. Although there were no physiological differences observed between the groups, animals supplemented with VA had smaller adipocytes (approximately 7 % smaller than the controls). The VA group also had higher adipophilin and IL-10 protein levels in epididymal adipose tissue (1·7- and 1·4-fold higher than the controls, respectively); however, there were no changes observed in critical nodes of insulin signalling. The present study provides evidence that supplementation with VA, a naturally produced trans-fat, has some positive effects on adipose tissue and did not exacerbate obesity-mediated metabolic abnormalities.

Examining the social determinants of children's developmental health: protocol for building a pan-Canadian population-based monitoring system for early childhood development

Introduction Early childhood is a key period to establish policies and practices that optimise childrens health and development, but Canada lacks nationally representative data on social indicators of childrens well-being. To address this gap, the Early Development Instrument (EDI), a teacher-administered questionnaire completed for kindergarten-age children, has been implemented across most Canadian provinces over the past 10 years. The purpose of this protocol is to describe the Canadian Neighbourhoods and Early Child Development (CanNECD) Study, the aims of which are to create a pan-Canadian EDI database to monitor trends over time in childrens developmental health and to advance research examining the social determinants of health. Methods and analysis Canada-wide EDI records from 2004 to 2014 (representing over 700 000 children) will be linked to Canada Census and Income Taxfiler data. Variables of socioeconomic status derived from these databases will be used to predict neighbourhood-level EDI vulnerability rates by conducting a series of regression analyses and latent variable models at provincial/territorial and national levels. Where data are available, we will measure the neighbourhood-level change in developmental vulnerability rates over time and model the socioeconomic factors associated with those trends. Ethics and dissemination Ethics approval for this study was granted by the Behavioural Research Ethics Board at the University of British Columbia. Study findings will be disseminated to key partners, including provincial and federal ministries, schools and school districts, collaborative community groups and the early childhood development research community. The database created as part of this longitudinal population-level monitoring system will allow researchers to associate practices, programmes and policies at school and community levels with trends in developmental health outcomes. The CanNECD Study will guide future early childhood development action and policies, using the database as a tool for formative programme and policy evaluation.

Canada needs a holistic First Nations health strategy

KEY POINTS Media headlines regularly describe the relatively poor health of First Nation peoples in Canada. Among urban-and rural-dwelling First Nations, abysmal living conditions, poor access to appropriate health care services and a marked lack of employment opportunities engender feelings of

An early intervention for psychosis and its effect on criminal accusations and suicidal behaviour using a matched-cohort design ☆ ☆☆ ★

BACKGROUND Early interventions for psychosis have been shown to reduce psychotic symptoms and hospital use for first-episode patients, but the effect on suicidal and criminal behaviour has not been reliably determined. This study aimed to examine whether an early intervention for psychosis program (EPPIS) reduced criminal behaviour, suicide attempts, and hospital-based service use. METHODS The study utilized administrative data to match clients of EPPIS to historical controls. Regression was used to determine the effect of treatment by EPPIS on inpatient use, emergency department use, suicide attempts/deaths, and criminal accusations. RESULTS A sample of 244 patients was matched to 449 controls. EPPIS patients had lower odds of being accused of a crime both during and after treatment. Suicidal behavior was less frequent among patients, both during treatment (p<0.0001) and after (HR=0.39; 95% CI: 0.17 to 0.94). During treatment there were more emergency department visits for the patients (RR=2.54; 95% CI: 1.56 to 4.58), but no difference in inpatient usage compared to controls. Post-treatment, both emergency department and inpatient usage were higher among patients. CONCLUSIONS EPPIS patients had reduced suicide attempts and criminal accusations. Increased emergency department use could indicate that encouraging treatment during a crisis may increase service use, while reducing suicidal and criminal behaviour.

Pediatric primary care services in Manitoba: Is the health of the next generation of children at risk?

OBJECTIVES Physician resource planning is an important part of health policy, but to date there are no studies measuring the primary care service needs of a particular population. The aim of this study was to project the expected provision of physician services for the pediatric population of one Canadian province for 2020. METHODS A novel standardized measure of physician service provision, the equivalent services measure, was developed using mathematical modeling. Population projections and past use of services were used to calculate the projected service needs for the pediatric population of Manitoba. RESULTS Despite projecting a small increase in the pediatric population (2.8%), our model predicted a decrease of 13.4% in the services that would be provided. CONCLUSIONS The findings of this study indicate that the health of future generations of children may be at risk. Further research is needed to determine the effect of the reduction in pediatric service provision on the health of the pediatric population.