Joyce Slater

Vitamin D in a Northern Canadian First Nation Population: Dietary Intake, Serum Concentrations and Functional Gene Polymorphisms

The wide spectrum of vitamin D activity has focused attention on its potential role in the elevated burden of disease in a northern Canadian First Nations (Dené) cohort. Vitamin D insufficiency, and gene polymorphisms in the vitamin D receptor (VDR) and vitamin D binding protein (VDBP) have been implicated in susceptibility to infectious and chronic diseases. The objectives of this study were to determine the contribution of vitamin D from food, and measure the serum concentrations of 25-hydroxyvitamin D3 (25-OHD3) and VDBP in Dené participants. Single nucleotide polymorphisms (SNPs) associated with the dysregulation of the innate immune response were typed and counted. Potential correlations between the SNPs and serum concentrations of 25-OHD3 and VDBP were evaluated. Venous blood was collected in summer and winter over a one-year period and analyzed for 25-OHD3 and VDBP concentrations (N = 46). A questionnaire was administered to determine the amount of dietary vitamin D consumed. Sixty-one percent and 30% of the participants had 25-OHD3 serum concentrations <75 nmol/L in the winter and summer respectively. Mean vitamin D binding protein concentrations were within the normal range in the winter but below normal in the summer. VDBP and VDR gene polymorphisms affect the bioavailability and regulation of 25-OHD3. The Dené had a high frequency of the VDBP D432E-G allele (71%) and the Gc1 genotype (90%), associated with high concentrations of VDBP and a high binding affinity to 25-OHD3. The Dené had a high frequency of VDR Fok1-f allele (82%), which has been associated with a down-regulated Th1 immune response. VDBP and VDR polymorphisms, and low winter 25-OHD3 serum concentrations may be risk factors for infectious diseases and chronic conditions related to the dysregulation of the vitamin D pathway.

The growing Canadian energy gap: more the can than the couch?

OBJECTIVE The present study describes the trajectory of the energy gap (energy imbalance) in the Canadian population from 1976 to 2003, its temporal relationship to adult obesity, and estimates the relative contribution of energy availability and expenditure to the energy gap. It also assesses which foods contributed the most to changes in available energy over the study period. DESIGN Annual estimates of the energy gap were derived by subtracting population-adjusted per capita daily estimated energy requirements (derived from Dietary Reference Intakes) from per capita daily estimated energy available (obtained from food balance sheets). Food balance sheets were used to assess which foods contributed to changes in energy availability. Adult obesity rates were derived from six national surveys. The relationship to the energy gap was assessed through regression analysis. RESULTS Between 1976 and 2003, per capita daily estimated energy availability increased by 18 % (1744 kJ), and increased energy availability was the major driver of the increased energy gap. Salad oils, wheat flour, soft drinks and shortening accounted for the majority of the net increase in energy availability. Adult obesity was significantly correlated with the energy gap over the study period. CONCLUSIONS The widening energy gap is being driven primarily by increased energy availability. The food commodities driving the widening energy gap are major ingredients in many energy-dense convenience foods, which are being consumed with increasing frequency in Canada. Policies to address population obesity must have a strong nutritional focus with the objective of decreasing energy consumption at the population level.

Dietary intake of vitamin D in a northern Canadian Dene´ First Nation community

Background Increased awareness of the wide spectrum of activity of vitamin D has focused interest on its role in the health of Canadas Aboriginal peoples, who bear a high burden of both infectious and chronic disease. Cutaneous vitamin D synthesis is limited at northern latitudes, and the transition from nutrient-dense traditional to nutrient-poor market foods has left many Canadian Aboriginal populations food insecure and nutritionally vulnerable. Objective The study was undertaken to determine the level of dietary vitamin D in a northern Canadian Aboriginal (Dené) community and to determine the primary food sources of vitamin D. Design Cross-sectional study. Methods Dietary vitamin D intakes of 46 adult Dené men and women were assessed using a food frequency questionnaire and compared across age, gender, season and body mass index. The adequacy of dietary vitamin D intake was assessed using the 2007 Adequate Intake (AI) and the 2011 Recommended Dietary Allowance (RDA) values for Dietary Reference Intake (DRI). Results Mean daily vitamin D intake was 271.4 IU in winter and 298.3 IU in summer. Forty percent and 47.8% of participants met the vitamin D 1997 AI values in winter and summer, respectively; this dropped to 11.1 and 13.0% in winter and summer using 2011 RDA values. Supplements, milk, and local fish were positively associated with adequate vitamin D intake. Milk and local fish were the major dietary sources of vitamin D. Conclusions Dietary intake of vitamin D in the study population was low. Only 2 food sources, fluid milk and fish, provided the majority of dietary vitamin D. Addressing low vitamin D intake in this population requires action aimed at food insecurity present in northern Aboriginal populations.

Serological Survey of the Novel Influenza A H1N1 in Inner City Winnipeg, Manitoba, 2009

INTRODUCTION Little is known about the determinants of pandemic H1N1 (pH1N1) infection in Canada among low-income, inner city populations. To inform future influenza planning, the seroprevalence of pH1N1 antibodies among inner city clinic attendees in Winnipeg (Manitoba) according to sociodemographic and risk factor characteristics were estimated and vaccination rates were explored. METHODS Adults presenting to three inner city community clinics in Winnipeg from October 2009 to December 2009 were recruited as study participants (n=458). A questionnaire was administered to collect demographic, risk factor and symptom information, and a venous blood sample was collected for hemagglutination inhibition assay testing to detect the presence of antibodies against pH1N1. RESULTS Approximately one-half (53%) of the study participants reported an annual household income of <

Sustainable Livelihoods for Food and Nutrition Security in Canada: A Conceptual Framework for Public Health Research, Policy, and Practice

10,000/year, and 65% identified as Aboriginal. pH1N1 positivity was 5.7% among those enrolled early in the study and 15.5% among those enrolled later in the study. Positivity was higher among participants who were female, Aboriginal and in contact with children ≤5 years of age. The overall pH1N1 vaccination rate was 28%. DISCUSSION pH1N1 positivity was high among low-income adults accessing clinics in Winnipegs inner city compared with the general population. Of further concern were the low rates of uptake of both seasonal and pH1N1 influenza vaccinations. When planning for future influenza outbreaks, it is important to incorporate strategies for the prevention, control, and care of influenza among low-income and inner city adults.

Nurturing Future Generations: Household Food Practices of Canadian Children and Family Meal Participation

Current definitions of food insecurity center around the dominant themes of (1) individual and household food insecurity, stemming from a lack of access to resources needed to obtain adequate food; and (2) community food insecurity, which occurs when dominant food systems falls short in terms of social, economic, and environmental sustainability. These definitions do not sufficiently incorporate the concept of nutrition security or adequate nutritional status in terms of macro- and micronutrients, a state not achieved by most Canadians. We propose the Sustainable Livelihoods for Food and Nutrition Security Framework, which integrates food security and nutrition security to achieve public health nutrition goals.

Vitamin D, serum 25(OH)D, LL-37 and polymorphisms in a Canadian First Nation population with endemic tuberculosis

PURPOSE Food knowledge and skills appear to have declined in the general population over recent decades and may be contributing to negative outcomes and poor nutritional health. It is pertinent to observe the food skills and habits of Canadians, particularly Canadian youth. METHODS Data from the Canadian Community Health Survey 2013 Rapid Response on Food Skills (n = 10 098) were used to examine the involvement of children in food preparation processes by identifying and describing the role of children in meal preparation as well as the practice of family meals. Variables were examined to assess differentiations between socio-demographic groupings (marital status, education, and income). RESULTS Results indicate a moderate to high level of child participation in Canadian household food-related activities, with two-thirds of households with children having children involved in choosing meals and grocery shopping and one-third of children helping with meal preparation. Some differences were observed between region, education level, and Aboriginal and immigration status. Seventy-five percent of respondents participated in family meals. CONCLUSIONS Data from this study contribute to the current discussion regarding loss of food skills and the significance of family meals on social and health indicators. Results suggest a range of interventions for dietitians including improving the quality of foods prepared at home and campaigns to promote family meals.

Exploring the nutritional vulnerability of homeless men in a Canadian urban setting

Background Canadian First Nation populations have experienced endemic and epidemic tuberculosis (TB) for decades. Vitamin D–mediated induction of the host defence peptide LL-37 is known to enhance control of pathogens such as Mycobacterium tuberculosis. Objective Evaluate associations between serum levels of 25-hydroxy vitamin D (25(OH)D) and LL-37, in adult Dene First Nation participants (N = 34) and assess correlations with single nucleotide polymorphisms (SNPs) in the vitamin D receptor (VDR) and vitamin D binding protein (VDBP). Design Venous blood was collected from all participants at baseline (winter and summer) and in conjunction with taking vitamin D supplements (1,000 IU/day) (winter and summer). Samples were analysed using ELISA for concentrations of vitamin D and LL-37, and SNPs in the VDR and VDBP regions were genotyped. Results Circulating levels of 25(OH)D were not altered by vitamin D supplementation, but LL-37 levels were significantly decreased. VDBP and VDR SNPs did not correlate with serum concentrations of 25(OH)D, but LL-37 levels significantly decreased in individuals with VDBP D432E T/G and T/T, and with VDR SNP Bsm1 T/T genotypes. Conclusions Our findings suggest that vitamin D supplementation may not be beneficial as an intervention to boost innate immune resistance to M. tuberculosis in the Dene population.Background Canadian First Nation populations have experienced endemic and epidemic tuberculosis (TB) for decades. Vitamin D-mediated induction of the host defence peptide LL-37 is known to enhance control of pathogens such as Mycobacterium tuberculosis. Objective Evaluate associations between serum levels of 25-hydroxy vitamin D (25(OH)D) and LL-37, in adult Dene First Nation participants (N = 34) and assess correlations with single nucleotide polymorphisms (SNPs) in the vitamin D receptor (VDR) and vitamin D binding protein (VDBP). Design Venous blood was collected from all participants at baseline (winter and summer) and in conjunction with taking vitamin D supplements (1,000 IU/day) (winter and summer). Samples were analysed using ELISA for concentrations of vitamin D and LL-37, and SNPs in the VDR and VDBP regions were genotyped. Results Circulating levels of 25(OH)D were not altered by vitamin D supplementation, but LL-37 levels were significantly decreased. VDBP and VDR SNPs did not correlate with serum concentrations of 25(OH)D, but LL-37 levels significantly decreased in individuals with VDBP D432E T/G and T/T, and with VDR SNP Bsm1 T/T genotypes. Conclusions Our findings suggest that vitamin D supplementation may not be beneficial as an intervention to boost innate immune resistance to M. tuberculosis in the Dene population.

Are we really “eating well with Canada’s food guide”?

Abstract Homelessness, Aboriginal ethnicity, and nutritional vulnerability are key determinants of health. Substance abuse further compounds health risk. This study explored the nutritional vulnerability of homeless men, some of who were solvent-users, to assess nutrition-related chronic disease risk factors. Anthropometric data were used to calculate disease risk using body mass index. Diet was assessed using a 24-hr food recall and data were compared to Canada’s Food Guide recommendations. A significant proportion of participants had low intakes of vegetables and fruit and milk and alternatives. More than half of the participants met the intake recommendations for grain servings and meat and alternatives. Solvent-using participants consumed significantly higher intakes of vegetables and fruit, grain products, and other foods and beverages, than non-solvent using men. More than half of the participants were classified as overweight or obese. Healthy food consumption was influenced by lack of stable housing, reliance on charitable food, and substance abuse.

Exploring food and healthy eating with newcomers in Winnipeg’s North End

BackgroundCanada’s Food Guide (CFG) has been an important health promotion tool for over seventy years. The most recent version was released in 2007. This study examined Canadians’ exposure to, knowledge, and use of CFG.MethodsData came from the Canadian Community Health Survey’s Rapid Response on the Awareness and Usage of Canada’s Food Guide, which included 10,098 Canadians ≥12 y in all ten provinces. Questions were asked on familiarity, awareness and usage of CFG and Canada’s Food Guide for First Nations, Inuit and Métis, as well as healthy eating principles and behaviours. Descriptive statistics and logistic regression were used to observe counts and differences among key demographic variables.ResultsMore than 80% of Canadians have heard of CFG however significantly more women than men were aware of the Guide. Most knew that ‘Vegetables and Fruit’ had the most recommended servings and that dark green vegetables should be consumed daily; however fewer than half knew this of orange vegetables. Just under one third had a copy in their homes, and the most common sources for obtaining CFG were child’s school and health professional/trainer. Those who consulted CFG recently were more likely to consume the recommended servings of vegetables and fruits, and to state that their eating habits were ‘much better’ than one year previously.ConclusionsCFG has “brand recognition” among Canadians however there are gaps between awareness and eating behaviours. The new Food Guide could consider additional dissemination tools including social media, videos and workbooks tailored to various age groups, demographic groups and settings.