Are the 2019 Canada's Food Guide Recommendations on Healthy Food Choices Consistent with the EAT-Lancet Reference Diet from Sustainable Food Systems?

BACKGROUND: The diet proposed by the EAT-Lancet Commission, which supports both health and environmental sustainability, provides an opportunity to assess the sustainability of food-based dietary guidelines. OBJECTIVES: The primary objective was to assess the alignment of the 2019 Canada's Food Guide (CFG) with the EAT-Lancet diet. To do so, an index assessing adherence to the EAT-Lancet diet was developed and evaluated. METHODS: Data from 1147 adults were used from the cross-sectional PRÉDicteurs Individuals, Sociaux et Environnementaux (PREDISE) study conducted between 2015 and 2017 in the province of Québec. The EAT-Lancet Dietary Index (EAT-I) was developed to evaluate adherence to the EAT-Lancet diet. Adherence to the 2019 CFG was assessed using the Healthy Eating Food Index (HEFI)-2019. Associations between the HEFI-2019 score and component scores and the EAT-I score were examined using linear regression models. RESULTS: The mean EAT-I score (/80) in this population was 33.4 points [95% confidence interval (CI): 32.2, 34.6]. EAT-I scores were consistent with expected differences in diet quality between females and males (+6.9 points, 95% CI: 4.8, 9.0) and between adults aged 50-65 y and 18-34 y (+4.3 points, 95% CI: 1.6, 7.0). The mean HEFI-2019 (/80) score was 44.9 points (95% CI: 44.1, 45.7). The HEFI-2019 was strongly associated with the EAT-I (ß = 0.76, 95% CI: 0.72, 0.80). Among the 10 components of the HEFI-2019, components such as the whole-grain foods (ß =4.01, 95% CI: 3.49, 4.52), grain foods ratio (ß =3.65, 95% CI: 3.24, 4.07), plant-based protein foods (ß =2.41, 95% CI: 2.03, 2.78), and fatty acids ratio (ß =3.12, 95% CI: 2.72, 3.51) showed the strongest associations with the EAT-I. CONCLUSIONS: These results suggest that recommendations in the 2019 CFG are largely coherent with the EAT-Lancet diet underscoring the complementarity and compatibility of the 2019 CFG for sustainability and health promotion purposes.

Assessing the relative validity of a web-based self-administered 24-hour dietary recall in a Canadian adolescent's population.

BACKGROUND: Healthy eating habits at a young age are crucial to support growth and development and good general health. In this context, monitoring youth dietary intakes adequately with valid tools is important to develop efficient interventions and identify groups that are more at risk of inadequate intakes. This study aimed to assess the relative validity of the self-administered web-based 24-h dietary recall (R24W) for evaluating energy and nutrient intakes among active adolescents. METHODS: Participants were invited to complete one interviewer-administered 24-h dietary dietary recall and the R24W on up to three occasions within one month. A total of 272 French-speaking active adolescents aged 12 to 17 years from the province of Québec were invited to complete three R24W and one interview-administered 24-h recall. Student's t-test and correlations were conducted on sex-adjusted data. Percent differences, cross-classification (percentage of agreement), weighted Kappa and Bland-Altman plots were calculated. RESULTS: Mean (SD) energy intake from the R24W was 8.8% higher than from the interview-administered 24-h dietary recall (2558 kcal ± 1128 vs. 2444 kcal ± 998, p < 0.05). Significant differences in mean nutrient intake between the R24W and the interview-administered 24-h dietary recall ranged from 6.5% for % E from fat (p < 0.05) to 25.2% for saturated fat (p < 0.001), i.e., higher values with R24W. Sex-adjusted correlations were significant for all nutrients except for % E from proteins and thiamin (range: 0.24 to 0.52, p < 0.01). Cross-classification demonstrated that 36.6% of the participants were classified in the same fourth with both methods, 39.6% in the adjacent fourth, and 5.7% misclassified. Bland-Atman plots revealed proportional bias between the two methods for 7/25 nutrients. Completing at least two recalls with the R24W increased the precision of intake estimates. CONCLUSION: These data suggest that the R24W presents an acceptable relative validity compared to a standard interview-administered 24-h recall for estimating energy and most nutrients in a cohort of French-speaking adolescents from the province of Québec.

Higher Than Recommended Folic Acid Intakes is Associated with High Folate Status Throughout Pregnancy in a Prospective French-Canadian Cohort.

BACKGROUND: Folate and vitamin B12 status during pregnancy are important for maternal and neonatal health. Maternal intake and prepregnancy body mass index (ppBMI) can influence biomarker status. OBJECTIVES: This study aimed to, throughout pregnancy; 1) assess folate and B12 status including serum total folate, plasma total vitamin B12, and homocysteine (tHcy); 2) examine how these biomarkers are associated with intakes of folate and B12 and with ppBMI; and 3) determine predictors of serum total folate and plasma total vitamin B12. METHODS: In each trimester (T1, T2, and T3), food and supplement intakes of 79 French-Canadian pregnant individuals were assessed by 3 dietary recalls (R24W) and a supplement use questionnaire. Fasting blood samples were collected. Serum total folate and plasma total vitamin B12 and tHcy were assessed by immunoassay (Siemens ADVIA Centaur XP). RESULTS: Participants were 32.1 ± 3.7 y and had a mean ppBMI of 25.7 ± 5.8 kg/m2. Serum total folate concentrations were high (>45.3 nmol/L, T1: 75.4 ± 55.1, T2: 69.1 ± 44.8, T3: 72.1 ± 52.1, P = 0.48). Mean plasma total vitamin B12 concentrations were >220 pmol/L (T1: 428 ± 175, T2: 321 ± 116, T3: 336 ± 128, P < 0.0001). Mean tHcy concentrations were <11 µmol/L across trimesters. Most participants (79.6%-86.1%) had a total folic acid intake above the Tolerable Upper Intake Level (UL, >1000 µg/d). Supplement use accounted for 71.9%-76.1% and 35.3%-41.8% of total folic acid and vitamin B12 intakes, respectively. The ppBMI was not correlated with serum total folate (P > 0.1) but was weakly correlated with and predicted lower plasma total vitamin B12 in T3 (r = -0.23, P = 0.04; r2 = 0.08, standardized beta [sß] = -0.24, P = 0.01). Higher folic acid intakes from supplements predicted higher serum total folate (T1: r2 = 0.05, sß = 0.15, P = 0.04, T2: r2 = 0.28, sß = 0.56, P = 0.01, T3: r2 = 0.19, sß = 0.44, P < 0.0001). CONCLUSIONS: Most pregnant individuals had elevated serum total folate concentrations, reflecting total folic acid intakes above the UL driven by supplement use. Vitamin B12 concentrations were generally adequate and differed by ppBMI and pregnancy stage.

First-trimester diet quality in association with maternal subcutaneous and visceral adipose tissue thicknesses and glucose homeostasis during pregnancy.

We aimed to characterise the associations between first-trimester diet quality, adiposity, and glucose homeostasis measurements throughout pregnancy in a sample of 104 healthy pregnant women. Three Web-based 24-h recalls were completed, from which the Alternate Healthy Eating Index (AHEI) was calculated. At each trimester (12.5 ± 0.7, 22.8 ± 1.0, and 33.6 ± 1.3 weeks of gestation), fasting glucose and insulin were measured to compute an insulin resistance index (HOMA-IR). Subcutaneous and visceral adipose tissue thicknesses were estimated by ultrasound at the end of the first trimester. Inverse associations were observed between the first-trimester AHEI and first-trimester fasting insulin (r = 0.24; p < 0.05), and HOMA-IR (r = -0.22; p < 0.05), as well as third-trimester fasting insulin (r = -0.20; p < 0.05). A trend was also observed between first-trimester AHEI and first-trimester SAT thickness (r = -0.17; p < 0.1). Pre- and early-pregnancy adiposity measurements were identified as high predictors fasting insulin concentrations throughout pregnancy. Higher early-pregnancy diet quality is associated with more favourable metabolic measurements during pregnancy.

Towards regulation of Endocrine Disrupting chemicals (EDCs) in water resources using bioassays - A guide to developing a testing strategy.

Endocrine disrupting chemicals (EDCs) are found in every environmental medium and are chemically diverse. Their presence in water resources can negatively impact the health of both human and wildlife. Currently, there are no mandatory screening mandates or regulations for EDC levels in complex water samples globally. Bioassays, which allow quantifying in vivo or in vitro biological effects of chemicals are used commonly to assess acute toxicity in water. The existing OECD framework to identify single-compound EDCs offers a set of bioassays that are validated for the Estrogen-, Androgen-, and Thyroid hormones, and for Steroidogenesis pathways (EATS). In this review, we discussed bioassays that could be potentially used to screen EDCs in water resources, including in vivo and in vitro bioassays using invertebrates, fish, amphibians, and/or mammalians species. Strengths and weaknesses of samples preparation for complex water samples are discussed. We also review how to calculate the Effect-Based Trigger values, which could serve as thresholds to determine if a given water sample poses a risk based on existing quality standards. This work aims to assist governments and regulatory agencies in developing a testing strategy towards regulation of EDCs in water resources worldwide. The main recommendations include 1) opting for internationally validated cell reporter in vitro bioassays to reduce animal use & cost; 2) testing for cell viability (a critical parameter) when using in vitro bioassays; and 3) evaluating the recovery of the water sample preparation method selected. This review also highlights future research avenues for the EDC screening revolution (e.g., 3D tissue culture, transgenic animals, OMICs, and Adverse Outcome Pathways (AOPs)).

Associations of Intake of Free and Naturally Occurring Sugars from Solid Foods and Drinks with Cardiometabolic Risk Factors in a Quebec Adult Population: The PREDISE (PRÉDicteurs Individuels, Sociaux et Environnementaux) Study.

BACKGROUND: Associations between sugar consumption and cardiometabolic health, taking into account the physical form of sugar-containing foods (liquid vs. solid) and the type of sugars consumed [free sugars (FSs) vs. naturally occurring sugars (NOSs)], remain to be thoroughly documented. OBJECTIVE: The objective was to examine whether FS and NOS intakes from drinks and solid foods are associated with cardiometabolic risk factors in a sample of French-speaking adults from the province of Quebec, Canada. METHODS: Data were collected as part of the cross-sectional PREDISE (PRÉDicteurs Individuels, Sociaux et Environnementaux) study (n = 1019, 18-65 y old; 50% women). FS and NOS intakes were assessed by three 24-h dietary recalls using a self-administered, web-based application. Diet quality was assessed using the Alternative Healthy Eating Index-2010. Participants underwent on-site clinical assessment of cardiometabolic risk factors, including blood pressure, waist circumference, BMI, and fasting blood sampling (glucose, insulin, C-reactive protein, blood lipids). Multivariable linear regression models were performed to examine the associations between sugar intake and cardiometabolic risk factors with sociodemographic characteristics, lifestyle variables, and diet quality entered as covariates. RESULTS: In fully adjusted models, FS intake from drinks was associated with fasting insulin (1.06%; 95% CI: 0.30%, 1.84%; P = 0.006) and with insulin resistance as estimated using the HOMA model (1.01%; 95% CI: 0.19%, 1.84%; P = 0.02). All metabolic variables that were significantly associated with NOS intake from solid foods in minimally adjusted models were no longer significant after entering sociodemographic and lifestyle variables (e.g., educational and income levels, smoking, physical activity, daily energy intake) and diet quality in the models. CONCLUSIONS: Our data from an adult sample showed that unfavorable and favorable associations with cardiometabolic risk factors observed, respectively, for FS intake from drinks and NOS intake from foods are mostly explained by sociodemographic and lifestyle variables, as well as by diet quality.

Factors influencing engagement and dietary behaviour change of mothers and their children in a blog-delivered healthy eating intervention: a process evaluation of a randomised controlled trial.

OBJECTIVE: A randomised controlled trial found no evidence of an impact of a blog written by a registered dietitian (RD) on vegetables and fruit and milk and alternatives (e.g. soya-based beverages, yogurt and cheese) consumption - two food groups included in the 2007 version of the Canadian Food Guide - in mothers and their children compared with a control condition. To investigate these null findings, the current study explored participants' perceptions of engagement with the blog and its influence on their dietary behaviours. DESIGN: Mixed methods process evaluation using a post-intervention satisfaction questionnaire and a content analysis of mothers' comments on the blog (n 213 comments). SETTING: French-speaking adult mothers living in Quebec City, Quebec, Canada (n 26; response rate = 61·9 % of the total sample randomised to exposure to the blog). RESULTS: Most mothers (n 20/26; 76·9 %) perceived the blog useful to improve their dietary habits - with the most appreciated blog features being nutritional information and healthy recipes and interactions with fellow participants and the RD. Mothers reported several facilitators (e.g. meal planning and involving children in household food activities) and few barriers (e.g. lack of time and children's food preferences) to maternal and child consumption of vegetables and fruit and milk and alternatives. Lack of time was the principal reported barrier affecting blog engagement. CONCLUSIONS: The findings from the current study suggest that blogs written by an RD may be an acceptable format of intervention delivery among mothers, but may not alleviate all the barriers to healthy eating and engagement in a dietary intervention.

Individuals with self-determined motivation for eating have better overall diet quality: Results from the PREDISE study.

The study aimed at documenting motivational orientations for the regulation of eating as defined by self-determination theory and their association with sociodemographic characteristics and overall diet quality. As part of the PREDISE study, French-speaking women (n = 550) and men (n = 547), aged 18-65 years, living in the Province of Québec, Canada, completed online validated questionnaires. The Regulation of Eating Behavior Scale, based on the self-determination theory, assessed self-determined and non-self-determined motivation to regulate one's eating behavior. Three web-based 24-h food recalls were completed and used to compute the Canadian Healthy Eating Index 2007 (C-HEI), an indicator of the overall adherence to Canadian guidelines for healthy eating. Multiple linear regressions were performed to assess how regulation styles are associated with the C-HEI. Model 1 included no covariate, model 2 included sociodemographic covariates, and fully adjusted model 3 included as covariates sociodemographic variables as well as variables that were previously associated with diet quality, namely nutrition knowledge and social support for healthy eating. Women (p < 0.0001), older individuals (p = 0.0002), those with a higher education level (p < 0.0001), and non-smokers (p < 0.0001) reported higher self-determined motivation score than their counterparts. Self-determined motivation was positively (model 1: B = 4.67, p < 0.0001; model 2: B = 3.82, p < 0.0001; model 3: B = 3.61, p < 0.0001) and non-self-determined motivation was negatively (model 1: B = -1.62, p = 0.0009; model 2: B = -1.63, p = 0.0006; model 2: B = -1.49, p = 0.0022) associated with C-HEI. The present study suggests that some subgroups of the general adult population show more self-determined motivation for eating, which is associated with a better diet quality independently of individual characteristics and other individual and social determinants of healthy eating. Strategies to help individuals internalize the regulation of eating should be further investigated.

Trimester-Specific and Total Gestational Weight Gain in Two Consecutive Pregnancies.

OBJECTIVE: This retrospective study aimed to characterize trimester-specific and total gestational weight gain (GWG) over the course of two consecutive pregnancies, as well as maternal determinants associated with interpregnancy weight change (IPWC) and excessive GWG in the second pregnancy. METHODS: We analyzed the electronic medical records of women who delivered their first two consecutive infants at term between 2001 and 2017. RESULTS: Weight gain trajectories differed between the first and second pregnancy for the 1497 women included in this study, with lower second- and third-trimester weight gain in the second pregnancy. Respectively, 53% and 41% of women had excessive GWG in the first and second pregnancies, with a higher proportion of excessive GWG found in women with a higher body mass index (BMI). Most women (55%) experienced interpregnancy weight gain. Maternal determinants of IPWC were BMI before first pregnancy, first-trimester and total GWG in the first pregnancy, and interpregnancy interval (P < 0.0001). Maternal risk factors associated with excessive GWG in the second pregnancy were excessive total GWG in the first pregnancy (OR 6.23; 95% CI 4.67-8.32), interpregnancy weight gain (OR 1.58; 95% CI 1.19-2.09), and interpregnancy interval (OR 1.18; 95% CI 1.07-1.29) as well as BMI before the second pregnancy (OR 1.04, 95% CI 1.02-1.07). CONCLUSION: Weight gain trajectories differ between consecutive pregnancies. GWG in the first pregnancy is a key determinant for IPWC and GWG in the second pregnancy.

Positive attitudes toward weight gain in late pregnancy are associated with healthy eating behaviours.

PURPOSE: This cross-sectional study examined the associations between 3rd trimester attitudes toward weight gain and (1) pre-pregnancy BMI, (2) gestational weight gain (GWG) and (3) eating behaviours assessed in the 3rd trimester. METHODS: Seventy-nine (79) pregnant women completed the French version of the Pregnancy Weight Gain Attitude Scale (PWGAS), the Three-Factor Eating Questionnaire (TFEQ) and the Intuitive Eating Scale-2 (IES-2) in their 3rd trimester. Total GWG was calculated as the difference between the weight recorded before delivery and self-reported pre-pregnancy weight. RESULTS: Most (55.6%) women gained weight above the Institute of Medicine's (IOM) recommendations, but there was no association between PWGAS scores and total or 3rd trimester GWG. Women with obesity had lower PWGAS total scores compared to women with overweight (3.48 ± 0.6 vs. 3.99 ± 0.3, p = 0.005), indicating more negative attitudes in women with obesity vs. overweight. Higher total PWGAS scores were positively correlated with intuitive eating scores (r = 0.28, p < 0.05), and inversely associated with unfavourable eating behaviours such as dietary restraint (r = - 0.42, p < 0.01). CONCLUSION: Women with positive attitudes toward weight gain reported healthier eating behaviours in late pregnancy, which remains to be confirmed in prospective studies. Interventions addressing body image issues during pregnancy may positively influence pregnant women's health, including eating behaviours. LEVEL OF EVIDENCE: Level III, case-control analytic study.

Consequences of steroid-5α-reductase deficiency and inhibition in vertebrates.

In 1974, a lack of 5α-dihydrotestosterone (5α-DHT), the most potent androgen across species except for fish, was shown to be the origin of a type of pseudohermaphrodism in which boys have female-like external genitalia. This human intersex condition is linked to a mutation in the steroid-5α-reductase type 2 (SRD5α2) gene, which usually produces an important enzyme capable of reducing the Δ4-ene of steroid C-19 and C-21 into a 5α-stereoisomer. Seeing the potential of SRD5α2 as a target for androgen synthesis, pharmaceutical companies developed 5α-reductase inhibitors (5ARIs), such as finasteride (FIN) and dutasteride (DUT) to target SRD5α2 in benign prostatic hyperplasia and androgenic alopecia. In addition to human treatment, the development of 5ARIs also enabled further research of SRD5α functions. Therefore, this review details the morphological, physiological, and molecular effects of the lack of SRD5α activity induced by both SRD5α mutations and inhibitor exposures across species. More specifically, data highlights 1) the role of 5α-DHT in the development of male secondary sexual organs in vertebrates and sex determination in non-mammalian vertebrates, 2) the role of SRD5α1 in the synthesis of the neurosteroid allopregnanolone (ALLO) and 5α-androstane-3α,17ß-diol (3α-diol), which are involved in anxiety and sexual behavior, respectively, and 3) the role of SRD5α3 in N-glycosylation. This review also features the lesser known functions of SRD5αs in steroid degradation in the uterus during pregnancy and glucocorticoid clearance in the liver. Additionally, the review describes the regulation of SRD5αs by the receptors of androgens, progesterone, estrogen, and thyroid hormones, as well as their differential DNA methylation. Factors known to be involved in their differential methylation are age, inflammation, and mental stimulation. Overall, this review helps shed light on the various essential functions of SRD5αs across species.

The sequence features that define efficient and specific hAGO2-dependent miRNA silencing guides.

MicroRNAs (miRNAs) are ribonucleic acids (RNAs) of ∼21 nucleotides that interfere with the translation of messenger RNAs (mRNAs) and play significant roles in development and diseases. In bilaterian animals, the specificity of miRNA targeting is determined by sequence complementarity involving the seed. However, the role of the remaining nucleotides (non-seed) is only vaguely defined, impacting negatively on our ability to efficiently use miRNAs exogenously to control gene expression. Here, using reporter assays, we deciphered the role of the base pairs formed between the non-seed region and target mRNA. We used molecular modeling to reveal that this mechanism corresponds to the formation of base pairs mediated by ordered motions of the miRNA-induced silencing complex. Subsequently, we developed an algorithm based on this distinctive recognition to predict from sequence the levels of mRNA downregulation with high accuracy (r2 > 0.5, P-value < 10-12). Overall, our discovery improves the design of miRNA-guide sequences used to simultaneously downregulate the expression of multiple predetermined target genes.

Changes in Eating Behaviours Throughout Pregnancy: Associations with Gestational Weight Gain and Pre-pregnancy Body Mass Index.

OBJECTIVE: Most pregnant women gain weight above recommended levels, and this weight gain affects mothers' and children's health. Factors influencing gestational weight gain (GWG) are numerous and include eating behaviours. The objective of this study was to evaluate the association between eating behaviours and GWG while considering pre-pregnancy body mass index (BMI). METHODS: Fifty-three (n = 53) women were recruited at 9.4 ± 0.6 gestational weeks. At each trimester, they completed the Three-Factor Eating Questionnaire, which evaluates disinhibition, dietary restraint, and susceptibility to hunger. Using a weight gain curve, trimester-specific GWG was calculated with interpolated weights. Total GWG was calculated as the difference between maternal weight before delivery and self-reported pre-pregnancy weight (Canadian Task Force Classification II-2). RESULTS: Women were aged 31.5 ± 3.5, and 81.1% had a university degree. The proportion of women who gained weight within recommendations was 21%, 28%, and 26%, at each trimester, respectively, and 38% for total pregnancy. Overall, dietary restraint score was lower in the third trimester in comparison with the first (6.1 ± 4.1 vs. 7.2 ± 4.6; P = 0.049), whereas no difference was observed for disinhibition or susceptibility to hunger. Our data suggest that variations in eating behaviours throughout pregnancy were similar among women who exhibited total GWG below, within, or above recommendations (Ptrim × GWG = NS) (NS: not significant; trim: trimester). Similar observations were reported when women were compared according to their pre-pregnancy BMI (Ptrim × BMI = NS). CONCLUSION: Maintaining high levels of restraint may be challenging considering the increase in hunger, which could explain the decrease observed in dietary restraint scores. Changes in eating behaviours were not associated with total GWG or pre-pregnancy BMI.

Do pregnant women eat healthier than non-pregnant women of childbearing age?

We aimed to compare the dietary quality and intake of pregnant women, women planning to conceive and women of childbearing age. Fifty-five pregnant women were matched for age and pre-pregnancy body mass index with 55 women planning to conceive and 55 women of childbearing age. Three Web-based 24-h recalls were completed, from which the Canadian Healthy Eating Index was calculated. Pregnant women had greater overall diet quality scores (66.8 ± 10.7, 60.3 ± 14.1 and 61.4 ± 12.8, in pregnant vs. planning to conceive and childbearing age women, p = .009), explained by a higher intake in fruits, vegetables and grain products and lower intake of foods that are high in fat, sugar or salt. Energy intake was significantly higher in pregnant versus planning to conceive women only (2283 ± 518 vs. 2062 ± 430 kcal, p = .03). Diet quality was greater among pregnant women, but diet quality scores were low in all groups, indicating that healthier dietary behaviours should be encouraged for all childbearing age women.

Long-term effects of a healthy eating blog in mothers and children.

In the context of low consumption of vegetables and fruits and milk and alternatives among Canadian mothers and children, novel strategies are needed to improve maternal and child nutrition. This study evaluated the long-term effects of an evidence-informed healthy eating blog on dietary intakes and food-related behaviours of mothers and their child. The study presents a secondary outcome analysis of a randomised controlled trial in which 84 mothers (mean age of 37.6 ± 6.7 years) of 2- to 12-year-old children living in Quebec City, Canada, were randomly assigned to a dietary intervention delivered through a healthy eating blog written by a registered dietitian (RD; n = 42) or a control group (n = 42) during a period of 6 months. Dietary intakes, maternal eating behaviours, food parenting practices, and body weight were measured at baseline, 3 months, at the end of the intervention (6 months), and 6-month post-intervention (12 months). Differences between groups were assessed with mixed linear models. Globally, this study found no evidence of long-term differences in mean dietary intakes in mothers exposed to the blog and their children as well as other food-related outcomes and body weight compared with the control condition. Potential predictors of adherence to dietary recommendations in mothers and children (e.g., involvement of children in household food activities) were identified. In conclusion, a healthy eating blog written by an RD did not result in evidence of any long-term differences in dietary intakes and food-related behaviours in mothers and their children compared with the control condition.

Associations between fruit and vegetables intake and abnormal glucose tolerance among women with prior gestational diabetes mellitus.

PURPOSE: Women with prior gestational diabetes mellitus (GDM) are at higher risk of type 2 diabetes (T2D). The aim of this study was to investigate the association between fruit and vegetables (FV) intake and abnormal glucose tolerance (AGT) among women with prior GDM. METHODS: A total of 281 women with prior GDM have been recruited a mean of 6 years after their pregnancy in this cohort study. FV intake was obtained with a validated food frequency questionnaire (FFQ). Anthropometric and glycemic components were measured during their clinical visit and women were stratified according to normal glucose tolerance (NGT) or AGT. RESULTS: A cross-sectional analysis showed that a total of 155 women had NGT and 126 AGT. Women with AGT had significantly lower FV (6.5 ± 0.2) and vegetables servings (3.9 ± 0.2) and tended to have lower fruit servings (2.6 ± 0.2) than women with NGT (7.4 ± 0.2, 4.5 ± 0.2 and 3.0 ± 0.1, respectively) (p = 0.001, p = 0.04 and p = 0.10, respectively, adjusted for age and BMI). FV intake, per one serving increase, was associated with a reduced likelihood of having AGT [OR = 0.88 (0.81-0.97) after adjustment for age and BMI]. Vegetables or fruit intake tended to be associated with a reduced likelihood of having AGT [OR = 0.88 (0.78-1.00) and OR = 0.88 (0.76-1.02), respectively, after adjustment for age and BMI]. CONCLUSIONS: Higher intake of FV may be associated with a lower likelihood of AGT among women with prior GDM. Further studies are needed to confirm these results in this high-risk population.

Consumption of low nutritive value foods and cardiometabolic risk factors among French-speaking adults from Quebec, Canada: the PREDISE study.

BACKGROUND: There is very limited knowledge on the magnitude to which foods with low nutritive value constitute the diet of adults from the province of Quebec. The extent to which these foods impact cardiometabolic risk is also poorly documented. The objective was to assess the contribution of low nutritive value foods to total energy intake (E) and to examine associations with cardiometabolic risk factors among French-speaking adults from 5 administrative regions of the Province of Quebec. METHODS: As part of the cross-sectional PREDISE Study, 1147 adults (50.2% women; mean [SD] age, 43.2 [4.6] years) participated in a web-based investigation. Dietary intake data were obtained using a validated web-based self-administered 24-h recall, the R24W, completed on three occasions. Foods with low nutritive value were defined as foods exceeding predetermined thresholds for the following nutrients: saturated fat, sugar or sodium as well as beverages and ingredients not recommended in Canada's Food Guide 2019. A total of 1019 participants underwent on-site clinical assessment of cardiometabolic risk factors. RESULTS: Participants consumed on average 29.0%E (95%CI, 28.2-29.7) as low nutritive value foods, to which pastries (18%), alcohol (15%), sweets (13%), chips/popcorn (6%) and sugar-sweetened beverages (6%) contributed the most. Low nutritive value foods contributed more to total E in men than in women (30.7%E vs. 27.5%E, respectively; P < 0.0001). In fully-adjusted linear regression models, increments of 250 kcal/d from low nutritive value foods were associated with higher body mass index (+ 1.7 kg/m2; 95%CI 1.2 to 2.2), higher waist circumference (+ 0.6 cm; 95%CI, 0.1 to 1.1), cholesterol: HDL cholesterol ratio (+ 0.12 mmol/L; 95%CI, 0.01 to 0.24 and triglycerides (+ 7.8%; 95%CI, 3.0 to 12.8). CONCLUSIONS: Low nutritive value foods contribute near 30% of total daily energy intake of French-speaking adults of the Province of Quebec and are associated with increased waist circumference and an unfavourable lipid profile. Addressing consumption of low nutritive value foods at the population level is a potential strategy to attenuate the burden of chronic diseases.

Association between early introduction of fruit juice during infancy and childhood consumption of sweet-tasting foods and beverages among children exposed and unexposed to gestational diabetes mellitus in utero.

BACKGROUND: Children exposed to gestational diabetes mellitus (GDM) in utero are at high-risk of obesity. Given that nutritional habits can track from infancy to childhood, the aim of this study was to evaluate the association between the timing of fruit juice introduction in infancy and later consumption of sweet-tasting foods and beverages among children exposed (GDM+) and unexposed (GDM-) to GDM. METHODS: A total of 107 GDM+ and 59 GDM- participated in the project. Data on the timing of fruit juice introduction during infancy were retrospectively collected for 62 GDM+ and 32 GDM- children. Current dietary intakes were collected with two 24-hour dietary recall questionnaires. Children were divided into groups according to the median timing of juice introduction (9 months). RESULTS: Mean age of children was 6.3 ± 2.6 and 7.6 ± 3.7 years for GDM+ and GDM- children, respectively (p = 0.08). Mean age of fruit juice introduction was similar between groups (p > 0.05). Consuming >1 serving of fruit juice per day was 2.72 times more prevalent among GDM+ children introduced to fruit juice <9 months, compared to GDM+ children introduced ≥9 months (CI: 1.19-6.20). This association was not observed in the GDM- group. The timing of fruit juice introduction was not associated with later consumption of sweets, desserts and sweet-tasting beverages when adjustment for children's age was made among GDM+ and GDM- children. CONCLUSION: Early introduction of fruit juice in infant diet is associated with higher prevalence of consumption of >1 serving of fruit juice per day in GDM+ children.

Validation of a self-administered web-based 24-hour dietary recall among pregnant women.

BACKGROUND: The use of valid dietary assessment methods is crucial to analyse adherence to dietary recommendations among pregnant women. This study aims to assess the relative validity of a self-administered Web-based 24-h dietary recall, the R24W, against a pen-paper 3-day food record (FR) among pregnant women. METHODS: Sixty (60) pregnant women recruited at 9.3 ± 0.7 weeks of pregnancy in Quebec City completed, at each trimester, 3 R24W and a 3-day FR. Mean energy and nutrient intakes reported by both tools were compared using paired Student T-Tests. Pearson correlations were used to analyze the association between both methods. Agreement between the two methods was evaluated using cross-classification analyses, weighted kappa coefficients and Bland-Altman analyses. RESULTS: Pearson correlation coefficients were all significant, except for vitamin B12 (r = 0.03; p = 0.83) and ranged from 0.27 to 0.76 (p < 0.05). Differences between mean intakes assessed by the R24W and the FR did not exceed 10% in 19 variables and were not significant for 16 out of 26 variables. In cross-classification analyses, the R24W ranked, on average, 79.1% of participants in the same or adjacent quartiles as the FR. CONCLUSIONS: Compared to a 3-day FR, the R24W is a valid method to assess intakes of energy and most nutrients but may be less accurate in the evaluation of intakes of fat (as a proportion of energy intake), vitamin D, zinc and folic acid. During pregnancy, the R24W was a more accurate tool at a group-level than at an individual-level and should, therefore, be used in an epidemiological rather than a clinical setting. The R24W may be particularly valuable as a tool used in cohort studies to provide valid information on pregnant women's dietary intakes and facilitate evaluation of associations between diet and adverse pregnancy outcomes.

Assessing the relative validity of a new, web-based, self-administered 24 h dietary recall in a French-Canadian population.

OBJECTIVE: To assess the relative validity of a new, web-based, self-administered 24 h dietary recall, the R24W, for assessment of energy and nutrient intakes among French Canadians. DESIGN: Each participant completed a 3d food record (FR) and the R24W on three occasions over a 4-week period. Intakes of energy and of twenty-four selected nutrients assessed by both methods were compared. SETTING: Québec City metropolitan area. SUBJECTS: Fifty-seven women and fifty men (mean (sd) age: 47·2 (13·3) years). RESULTS: Equivalent proportions of under-reporters were found with the R24W (15·0%) and the FR (23·4%). Mean (sd) energy intake from the R24W was 7·2% higher than that from the FR (10 857 (3184) kJ/d (2595 (761) kcal/d) v. 10 075 (2971) kJ/d (2408 (710) kcal/d); P<0·01). Significant differences in mean nutrient intakes between the R24W and the FR ranged from -54·8% (i.e. lower value with R24W) for niacin to +40·0% (i.e. higher value with R24W) for alcohol. Sex- and energy-adjusted deattenuated correlations between the two methods were significant for all nutrients except Zn (range: 0·35-0·72; P<0·01). Cross-classification demonstrated that 40·0% of participants were classified in the same quartile with both methods, while 40·0% were classified in the adjacent quartile and only 3·6% were grossly misclassified (1st v. 4th quartile). Analysis of Bland-Altman plots revealed proportional bias between the two assessment methods for 8/24 nutrients. CONCLUSIONS: These data suggest that the R24W presents an acceptable relative validity as compared with the FR for estimating usual dietary intakes in a cohort of French Canadians.