Adherence to Vitamin D Supplementation Recommendations for Breastfed Infants and Young Children: An Analysis of Canadian Community Health Survey Data Cycles From 2015 to 2018.

BACKGROUND: In Canada, nutrition policy, as outlined in the Nutrition for Healthy Term Infants recommendations, includes a daily vitamin D supplement of 10 µg (400 IU) for breastfed infants and young children to support adequate vitamin D status. OBJECTIVES: This study aimed to report on adherence to vitamin D supplementation recommendations for breastfed infants (≤12 months); and for children breastfed >12 mo. METHODS: Canadian Community Health Survey (paired-cycles 2015/2016 and 2017/2018) maternal experiences data for infants born 2012-2018 who received any breastmilk formed the sample (n = 7079). Whether the infant was given a vitamin D supplement (yes/no) and the frequency (daily/almost every day, 1-2/wk, or <1/wk) were surveyed. Weighted data (95% CI) were summarized according to breastfeeding history (exclusive to 6 mo and continuing; partial to 6 mo and continuing; and stopped ≤6 mo). Correlates of supplement adherence were explored using logistic regression. RESULTS: Overall, 87.1% (95% CI: 85.9%, 88.3%) of participants reported giving their infant (≤12 mo) a vitamin D supplement, and of these, 83.3% (95% CI: 81.9%, 84.7%) did so daily/almost every day, 12.4% (95% CI: 11.1%, 13.7%) did so 1-2/wk, and 4.3% (95% CI: 3.6%, 5.0%) did so <1/wk. Lower adjusted odds of adherence were observed among participants reporting: stopped breastfeeding ≤6 mo, lower education or income, recent immigration, and overweight prepregnancy body mass index; higher odds of adherence were observed in the western provinces. Regarding mothers of children >12 mo and breastfed (n = 2312), 58.0% (95% CI: 54.9%, 61.1%) gave a vitamin D supplement daily/almost every day. CONCLUSIONS: Adherence to providing a vitamin D supplement to breastfed infants is high in Canada. Nonetheless, we estimate that ∼27% of mothers are nonadherent to daily/almost every day administration of a vitamin D supplement and that adherence declines in children breastfed >12 mo. Further promotion to support uptake of the current guidance may be necessary, particularly for parents of recent immigration or lower socioeconomic status.

Caffeinated energy drinks in the Canadian context: health risk assessment with a focus on cardiovascular effects.

In Canada, caffeinated energy drinks (CEDs) currently sold under Temporary Marketing Authorizations must meet strict eligibility criteria. These criteria, which include compositional and labelling requirements, were developed based on the outcome of a health risk assessment conducted by Health Canada (HC) in 2013. HC updated its assessment by reviewing new information with the focus on potential cardiovascular effects associated with the consumption of CEDs available for sale in Canada. Due to limited data on CED consumption among Canadians to derive accurate exposure information, the composition of a typical CED was characterized to assess the potential effects of single ingredients and synergistic interactions between ingredients on the cardiovascular system. Surveillance data on potential adverse effects related to CED consumption was also analyzed. After extensive review, HC's updated assessment confirms the current risk management approach for CEDs is health protective for Canadian consumers, including the potential for cardiovascular effects. The available evidence supports that moderate consumption (up to 500 mL per day) of a typical CED authorized for sale in Canada is safe for the general population of healthy adults and adolescents. It also re-confirms that vulnerable sub-populations (i.e., children, pregnant and/or breastfeeding women, and caffeine-sensitive individuals) should not consume CEDs. Novelty: Consumption up to 500 mL per day of a typical CED is not associated with an increased risk of cardiovascular effects. Children, pregnant and/or breastfeeding women, and caffeine-sensitive individuals should not consume CEDs.

A novel toxicokinetic modeling of cypermethrin and permethrin and their metabolites in humans for dose reconstruction from biomarker data.

To assess exposure to pyrethroids in the general population, one of most widely used method nowadays consists of measuring urinary metabolites. Unfortunately, interpretation of data is limited by the unspecified relation between dose and levels in biological tissues and excreta. The objective of this study was to develop a common multi-compartment toxicokinetic model to predict the time courses of two mainly used pyrethroid pesticides, permethrin and cypermethrin, and their metabolites (cis-DCCA, trans-DCCA and 3-PBA) in the human body and in accessible biological matrices following different exposure scenarios. Toxicokinetics was described mathematically by systems of differential equations to yield the time courses of these pyrethroids and their metabolites in the different compartments. Unknown transfer rate values between compartments were determined from best fits to available human data on the urinary excretion time courses of metabolites following an oral and dermal exposure to cypermethrin in volunteers. Since values for these coefficients have not yet been determined, a mathematical routine was programmed in MathCad to establish the possible range of values on the basis of physiological and mathematical considerations. The best combination of parameter values was then selected using a statistic measure (reliability factor) along with a statistically acceptable range of values for each parameter. With this approach, simulations provided a close approximation to published time course data. This model allows to predict urinary time courses of trans-DCCA, cis-DCCA and 3-PBA, whatever the exposure route. It can also serve to reconstruct absorbed doses of permethrin or cypermethrin in the population using measured biomarker data.

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.

Determination of biological reference values for chlorpyrifos metabolites in human urine using a toxicokinetic approach.

Urinary biomarkers of chlorpyrifos (CPF) exposure are often measured in field studies, although biological reference values (BRVs) are not yet available to assess health risks. This study aimed at proposing BRVs for CPF metabolites in workers' urine based on a toxicokinetic approach. As a first step, a toxicokinetic model was developed, using published human kinetic data, to link the absorbed dose of CPF under a variety of exposure routes and temporal scenarios to the urinary excretion of its major metabolites, 3,5,6-trichloro-2-pyridinol (3,5,6-TCP) and alkyl phosphates (AP). The model was then used to propose BRVs for CPF metabolites in urine below which workers should not experience adverse health effects. This was achieved by linking (1) a literature-reported, repeated CPF no-observed-effect level (NOEL) daily exposure dose for the inhibition of red-blood-cell acetylcholinesterase activity to a corresponding absorbed daily dose, and (2) this absorbed daily dose to the urinary excretion of CPF metabolites. Model simulations under a variety of exposure scenarios showed that the safest BRVs are obtained from a dermal exposure scenario with the slowest absorption rate compatible with available literature data rather than from respiratory or oral exposure scenarios. Also, model simulations showed that, for a given total absorbed dose, absorption over 8 hours results in smaller 3,5,6-TCP and AP urinary excretion rates than those obtained from the same dose absorbed over shorter durations. From these considerations, BRVs were derived by simulating an 8-hour dermal CPF exposure such that the total absorbed daily dose corresponds to the absorbed NOEL. The reference values are proposed in the form of total amounts of 3,5,6-TCP and AP metabolites excreted in urine over chosen time periods (24 and 48 hours).

Observations and Interpretations from the Canadian Fine Particle Monitoring Program.

Canadian particle monitoring programs examining PM10, PM2.5, and particle composition have been in operation for over 10 years. Until recently, the measurements were manual/filter-based with 24-hr sample collection varying in frequency from daily to every sixth day, using GrasebyAnderson dichotomous samplers. In the past few years, these monitoring activities have been expanded to include hourly measurements using tapered element oscillating microbalances (TEOMs). This continuous monitoring program started operation focusing on PM10, but now emphasizes PM2.5 through the addition of more TEOMs and switching of the inlets of some of the existing units. The data from all of these measurement activities show that there are broad geographical differences and also local- to regional-scale spatial differences in mass and composition of PM2.5. Due to variations in sources, significantly different PM2.5 concentrations are not uncommon within the same city. Comparison of nearby urban and rural sites indicates that 30 and 40% of the PM2.5 is from local urban sources in Montreal and Toronto, respectively. Hourly PM2.5 measurements in Toronto suggest that vehicular emissions are an important contributor to urban PM2.5. There has been a decreasing trend in urban PM2.5, with annual average concentrations between the 1987-1990 and 1993-1995 periods decreasing by 11 to 39%, depending upon the site. The largest declines were in Montreal and Halifax, and the smallest decline was in Toronto. Comparison of 24-hr TEOM and manual dichotomous sampler PM2.5 measurements from a site in Toronto indicates that the TEOM results in lower concentrations. The magnitude of this difference is relatively small in the warmer months, averaging about 12%. During the colder months the difference averages about 23%, but can be as large as 50%.