Dietary polyphenol intake in the Canadian population: Findings from the 2015 Canadian Community Health Survey-Nutrition.

OBJECTIVES: This study aimed to estimate usual polyphenol intake among Canadians using the nationally representative 2015 Canadian Community Health Survey-Nutrition and to explore the main dietary contributors to polyphenol intake and the sociodemographic and lifestyle factors that may impact polyphenol intake. METHODS: Dietary information was collected from 19,409 respondents using 24-h dietary recalls. The polyphenol content of foods was estimated using the Phenol-Explorer Database (version 3.6). Daily intake values for total polyphenols (adjusted to energy intake), main classes, and subclasses were calculated for each respondent and dietary recall. Usual intake was estimated by age/sex groups and by sociodemographic and lifestyle characteristics independently for adults and children using the National Cancer Institute method. Given-day arithmetic mean polyphenol intakes and mean proportions of main classes contributing to sum total polyphenol intakes were explored. Population proportions were used to determine dietary contributors. RESULTS: Usual total polyphenol intake was 1119.3 mg/1000 kcal/day (95% CI: 1090.5, 1148.1) for adults ≥ 19 years and 473.0 mg/1000 kcal/day (95% CI: 454.9, 491.0) for children 2‒18 years. Generally, total polyphenol intakes differed by age, sex, ethnicity, and household education status and were higher among coffee and tea consumers. Most polyphenols came from flavonoids (40.0%) and phenolic acids (49.8%), with children consuming more flavonoids and other polyphenols and adults more phenolic acids. The top food contributors to polyphenol intake were coffee (26.8%), tea (8.9%), fruit juice (4.2%), banana (4.1%), and apple (3.8%). CONCLUSION: Usual intake of total polyphenols among Canadians differed primarily by age. Non-alcoholic beverages were top contributors to total polyphenol intake.

RéSUMé: OBJECTIFS: Notre étude visait à estimer l'apport habituel en polyphénols des Canadiens et des Canadiennes à l'aide de l'Enquête sur la santé dans les collectivités canadiennes ­ Nutrition 2015 (une enquête nationale représentative) et à explorer les principaux aliments qui contribuent à l'apport en polyphénols, ainsi que les facteurs sociodémographiques et les aspects du mode de vie qui peuvent influencer cet apport. MéTHODE: Les informations relatives à l'alimentation proviennent de 19 409 répondants et ont été obtenues à l'aide de feuilles de rappel des aliments ingérés pendant les 24 dernières heures. Nous avons estimé la teneur en polyphénols des aliments à l'aide de la base de données Phenol-Explorer (version 3.6). Nous avons calculé les valeurs de l'apport quotidien total en polyphénols (ajusté en fonction de l'apport énergétique), les catégories principales et les sous-catégories pour chaque répondant et chaque feuille de rappel. Nous avons estimé l'apport habituel par groupe d'âge et de sexe et selon les caractéristiques sociodémographiques et les aspects du mode de vie, indépendamment pour les adultes et les enfants, à l'aide de la méthode de l'Institut national du cancer. Nous avons également exploré la moyenne arithmétique des apports en polyphénols et les proportions moyennes des principales catégories contribuant au total des apports en polyphénols à une date précise. Les proportions de la population ont servi à déterminer les aliments contribuant aux apports en polyphénols. RéSULTATS: L'apport habituel total en polyphénols était de 1119,3 mg/1000 kcal/jour (IC de 95% : 1090,5, 1148,1) pour les adultes ≥ 19 ans et de 473,0 mg/1000 kcal/jour (IC de 95% : 454,9, 491,0) pour les enfants de 2 à 18 ans. En général, les apports totaux en polyphénols différaient selon l'âge, le sexe, l'ethnicité et le niveau d'instruction du ménage, et ils étaient plus élevés chez les consommateurs de café et de thé. La plupart des polyphénols provenaient des flavonoïdes (40,0 %) et des acides phénoliques (49,8 %); les enfants consommaient davantage de flavonoïdes et d'autres polyphénols, et les adultes, davantage d'acides phénoliques. Les principaux aliments contribuant à l'apport en polyphénols étaient le café (26,8 %), le thé (8,9 %), les jus de fruits (4,2 %), les bananes (4,1 %) et les pommes (3,8 %). CONCLUSION: L'apport habituel total en polyphénols chez les Canadiens et les Canadiennes différait principalement selon l'âge. Les boissons non alcoolisées étaient les principaux aliments contribuant à l'apport total en polyphénols.

Comparative Analysis of Dietary and Supplemental Intake of Calcium and Vitamin D among Canadian Older Adults with Heart Disease and/or Osteoporosis in 2004 and 2015.

Despite the role of calcium and vitamin D in osteoporosis and heart disease, little research has examined changes in the intake of calcium and vitamin D among individuals with these conditions over time. Using data from the 2004 and 2015 Canadian Community Health Surveys, we investigated changes in dietary and supplemental intake of calcium and vitamin D among Canadian older adults aged ≥ 50 years, both with and without heart disease and/or osteoporosis, between 2004 and 2015. Notable declines in dietary calcium intake occurred, particularly among non-supplement users. Surprisingly, individuals with osteoporosis and heart disease, who are at higher nutritional risk, were less likely to use calcium supplements in 2015 compared to 2004. Among calcium supplement users, those with osteoporosis or both conditions experienced significant reductions in their usual calcium intake in 2015, with an increased proportion failing to meet recommended intake levels. Conversely, vitamin D supplement users experienced a substantial rise in vitamin D intake in 2015. In 2015, only a small proportion of supplement users did not meet the recommended vitamin D intake levels. These findings underscore the importance of public health initiatives to facilitate safe increases in calcium and vitamin D intake for older adults, particularly those with heart disease and osteoporosis.

Real-world practices for the care of women with epilepsy during pregnancy: A Canadian perspective.

OBJECTIVE: Approximately 150,000 Canadian women live with epilepsy, a population that presents with unique challenges. Our objective was to capture demographic and real-world practice characteristics of Canadian healthcare professionals providing care for women with epilepsy (WWE) with specific focus on reproductive considerations to identify potential gaps in knowledge and care. METHODS: A questionnaire developed by the Canadian League Against Epilepsy WWE workgroup was distributed to Canadian healthcare professionals from February 2021 to October 2022 to capture participant demographic characteristics and practice patterns in key areas of the reproductive cycle in WWE. RESULTS: A total of 156 participants completed the questionnaire, most being physicians (81.4%), epilepsy specialists (69.0%), and those who cared for adult patients (86.5%), with a significant proportion based at an academic center (65.4%). The majority of participants counselled on folic acid supplementation (89.7%). Participants selected lamotrigine and levetiracetam most frequently for either focal or generalized epilepsies during pregnancy. Additionally, 85.9% performed therapeutic drug monitoring during pregnancy. Almost all practitioners always or often counseled WWE on valproic acid on the benefits of switching to a less teratogenic medication (96.2%). Some geographic variability in practice patterns was noted with valproic acid being one of the top three medications selected for patients with generalized epilepsies in Western regions, although participants in Eastern regions had brivaracetam more commonly included as one of their top three agents for this population. SIGNIFICANCE: This is the first report of real-world Canadian practices in epilepsy care for women in pregnancy. Overall, our study reports that Canadian practice patterns conform well to current evidence and best-practice guidelines. Important variations in antiseizure medication selection across different regions were identified.

Contrasting epistemologies: Biomedicine, narrative medicine and indigenous story medicine.

BACKGROUND: Narrative Medicine (NM) and Indigenous Story Medicine both use narrative to understand and effect health, but their respective conceptualizations of narrative differ. AIMS: I contrast the concept of narrative in NM with that of Indigenous Story Medicine. MATERIALS AND METHODS: The article relies Western narrative theorists as well as Indigenous epistemologists to frame a discussion-by-contrast of the Judeo-Christian creation myth with a Haundenosaunee Creation Story. RESULTS: I demonstrate that the deficiencies of Narrative Medicine exist because the latter's use of narrative is a mere application in an otherwise reductive field, whereas Indigenous epistemologies rely on story as medicine itself. DISCUSSION: OMIT. CONCLUSION: I call for more scholars to take up different narratives to further investigate the ethical space between NM and Indigenous Story Medicine.

Effects of chiropractic use on medical healthcare utilization and costs in adults with back pain in Ontario, Canada from 2003 to 2018: a population-based cohort study.

BACKGROUND: Adults with back pain commonly consult chiropractors, but the impact of chiropractic use on medical utilization and costs within the Canadian health system is unclear. We assessed the association between chiropractic utilization and subsequent medical healthcare utilization and costs in a population-based cohort of Ontario adults with back pain. METHODS: We conducted a population-based cohort study that included Ontario adult respondents of the Canadian Community Health Survey (CCHS) with back pain from 2003 to 2010 (n = 29,475), followed up to 2018. The CCHS data were individually-linked to individual-level health administrative data up to 2018. Chiropractic utilization was self-reported consultation with a chiropractor in the past 12 months. We propensity score-matched adults with and without chiropractic utilization, accounting for confounders. We evaluated back pain-specific and all-cause medical utilization and costs at 1- and 5-year follow-up using negative binomial and linear (log-transformed) regression, respectively. We assessed whether sex and prior specialist consultation in the past 12 months were effect modifiers of the association. RESULTS: There were 6972 matched pairs of CCHS respondents with and without chiropractic utilization. Women with chiropractic utilization had 0.8 times lower rate of cause-specific medical visits at follow-up than those without chiropractic utilization (RR5years = 0.82, 95% CI 0.68-1.00); this association was not found in men (RR5years = 0.96, 95% CI 0.73-1.24). There were no associations between chiropractic utilization and all-cause physician visits, all-cause emergency department visits, all-cause hospitalizations, or costs. Effect modification of the association between chiropractic utilization and cause-specific utilization by prior specialist consultation was found at 1-year but not 5-year follow-up; cause-specific utilization at 1 year was lower in adults without prior specialist consultation only (RR1year = 0.74, 95% CI 0.57-0.97). CONCLUSIONS: Among adults with back pain, chiropractic use is associated with lower rates of back pain-specific utilization in women but not men over a 5-year follow-up period. Findings have implications for guiding allied healthcare delivery in the Ontario health system.

Immobilization in Emergency Medical Service - Are CSR and NEXUS-Criteria Considered? A Matched-Pairs Analysis Between Trauma Patients Treated by Onsite EMS Physicians and Patients Treated by Tele-EMS Physicians.

Background: The NEXUS-low-risk criteria (NEXUS) and Canadian C-spine rule (CSR) are clinical decision tools used for the prehospital spinal clearance in trauma patients, intending to prevent over- as well as under immobilization. Since 2014, a holistic telemedicine system is part of the emergency medical service (EMS) in Aachen (Germany). This study aims to examine whether the decisions to immobilize or not by EMS- and tele-EMS physicians are based on NEXUS and the CSR, as well as the guideline adherence concerning the choice of immobilization device. Methods: A single-site retrospective chart review was undertaken. Inclusion criteria were EMS physician and tele-EMS physician protocols with traumatic diagnoses. Matched pairs were formed, using age, sex and working diagnoses as matching criteria. The primary outcome parameters were the criteria documented as well as the immobilization device used. The evaluation of the decision to immobilize based on the criteria documented was defined as secondary outcome parameter. Results: Of a total of 247 patients, 34% (n = 84) were immobilized in the EMS physician group and 32.79% (n = 81) in the tele-EMS physician group. In both groups, less than 7% NEXUS or CSR criteria were documented completely. The decision to immobilize or not was appropriately implemented in 127 (51%) in the EMS-physician and in 135 (54, 66%) in the tele-EMS physician group. Immobilization without indication was performed significantly more often by tele-EMS physicians (6.88% vs 2.02%). A significantly better guideline adherence was found in the tele-EMS physician group, preferring the vacuum mattress (25, 1% vs 8.9%) over the spineboard. Conclusion: It could be shown that NEXUS and CSR are not applied regularly, and if so, mostly inconsistently with incomplete documentation by both EMS- and tele-EMS physicians. Regarding the choice of the immobilization device a higher guideline adherence was shown among the tele-EMS physicians.

Variation in bone mineral density and fractures over 20 years among Canadians: a comparison of the Canadian Multicenter Osteoporosis Study and the Canadian Longitudinal Study on Aging.

International variations in osteoporosis and fracture rates have been reported, with temporal trends differing between populations. We observed higher BMD and lower fracture prevalence in a recently recruited cohort compared to that of a cohort recruited 20 years ago, even after adjusting for multiple covariates. PURPOSE: We explored sex-specific differences in femoral neck bone mineral density (FN-BMD) and in prevalent major osteoporotic fractures (MOF) using two Canadian cohorts recruited 20 years apart. METHODS: We included men and women aged 50-85 years from the Canadian Multicentre Osteoporosis Study (CaMos, N = 6,479; 1995-1997) and the Canadian Longitudinal Study on Aging (CLSA, N = 19,534; 2012-2015). We created regression models to compare FN-BMD and fracture risk between cohorts, adjusting for important covariates. Among participants with prevalent MOF, we compared anti-osteoporosis medication use. RESULTS: Mean (SD) age in CaMos (65.4 years [8.6]) was higher than in CLSA (63.8 years [9.1]). CaMos participants had lower mean body mass index and higher prevalence of smoking (p < 0.001). Adjusted linear regression models (estimates [95%CI]) demonstrated lower FN-BMD in CaMos women (- 0.017 g/cm2 [- 0.021; - 0.014]) and men (- 0.006 g/cm2 [- 0.011; 0.000]), while adjusted odds ratios (95%CI) for prevalent MOF were higher in CaMos women (1.99 [1.71; 2.30]) and men (2.33 [1.82; 3.00]) compared to CLSA. In women with prevalent MOF, menopausal hormone therapy use was similar in both cohorts (43.3% vs 37.9%, p = 0.076), but supplements (32.0% vs 48.3%, p < 0.001) and bisphosphonate use (5.8% vs 17.3%, p < 0.001) were lower in CaMos. The proportion of men with MOF who received bisphosphonates was below 10% in both cohorts. CONCLUSION: Higher BMD and lower fracture prevalence were noted in the more recently recruited CLSA cohort compared to CaMos, even after adjusting for multiple covariates. We noted an increase in bisphosphonate use in the recent cohort, but it remained very low in men.

A natural history of lower-risk myelodysplastic syndromes with ring sideroblasts: an analysis of the MDS-CAN registry.

Patients with lower-risk (LR) myelodysplastic syndromes (MDS) with ring sideroblasts (RS) have better prognosis than those without RS, but how they fare over time is not fully understood. This study's objective was to assess the natural history of LR MDS with RS ≥5% using MDS-CAN registry individual data. Kaplan-Meier estimates and generalized linear mixed models were used to describe time-to-event outcomes and continuous outcomes, respectively. One hundred and thirty-eight patients were enrolled; median times from diagnosis to enrollment and follow-up were 6.6 and 39.6 months, respectively. Within 5 years of enrollment, 65% of patients had ≥1 red blood cell transfusion dependence episode. Within 5 years of diagnosis, 59% developed iron overload, 38% received iron chelation therapy, 14% progressed to acute myeloid leukemia, and 42% died. Patients exhibited inferior health-related quality of life trends. These first real-world data in LR MDS-RS in Canada indicate a high level of morbidity and mortality over a 5-year period. Clinical Trial Registration: ClinicalTrials.gov Identifier: NCT02537990.

Is Supervised Pastoral Education (SPE) "Substantially Equivalent" to a Recognized Psychotherapy Program in Ontario?

After completing their Supervised Pastoral Education units provided by the Canadian Association for Spiritual Care, two soon-to-be-certified Spiritual Care Practitioners applied to the College of Registered Psychotherapists of Ontario. Both were rejected because their Supervised Pastoral Education program was not deemed to be "substantially equivalent" to a recognized psychotherapy program. This came as a surprise since similarly qualified Canadian Association for Spiritual Care Practitioners in Ontario are also members of the College of Registered Psychotherapists of Ontario through a process called "grandparenting." Using the 10 characteristics of a College of Registered Psychotherapists of Ontario recognized program, this paper examines Canadian Association for Spiritual Care's SPE program in detail, showing how closely it aligns with the College of Registered Psychotherapists of Ontario's description of an equivalent psychotherapy program. I conclude by suggesting the College of Registered Psychotherapists of Ontario should embrace Supervised Pastoral Education as an equivalent program and grant memberships, not just to those grand parented in, but to future Canadian Association for Spiritual Care Practitioners.

Assessing the impact of replacing foods high in saturated fats with foods high in unsaturated fats on dietary fat intake among Canadians.

BACKGROUND: The 2019 Canada's Food Guide (CFG) recommends that foods containing mostly unsaturated fatty acid (UFA) should replace foods that contain mostly SFA to reduce SFA intakes. OBJECTIVES: The objective of this study was to model the theoretical changes in intake of SFA at the population level if all Canadians adhered to that recommendation. METHODS: Dietary intakes from 24-h recalls in the nationally representative 2015 Canadian Community Health Survey-Nutrition were used for these analyses. Foods identified as high in SFA based on Health Canada's criteria [≥2 g SFA per reference amount and/or ≥15% of energy (%E) of the food's content as SFA] were replaced by an equal amount (gram per gram) of substitution foods that were lower in SFA and had a higher UFA to SFA ratio. Distributions of SFA and other nutrients before and after substitutions were estimated using the National Cancer Institute (NCI) method based on dietary intakes data from a 24-h recall repeated in 37% of the population. RESULTS: The mean (95% CI) dietary SFA intake among Canadians 2 y or older would be theoretically reduced from 10.8%E (10.7, 11.0%E) to 5.8%E (5.7, 5.9%E) if all high-SFA foods consumed were replaced by the corresponding low-SFA/high-UFA foods. Modeled usual intake of SFA after substitution was <10%E in 100% of Canadians, irrespective of sex and age. Almost half (44%) of the modeled reduction in SFA intake was attributed to replacement of SFA-rich foods not recommended in the 2019 CFG. CONCLUSIONS: This food-based substitution modeling analysis suggests that consumption of SFA would be below 10%E in Canada if all Canadians adhered to the 2019 CFG recommendation that foods containing mostly UFA should replace foods that contain mostly SFA.

Intimate Partner Violence among Canadian Muslim Women.

An examination of the interaction of pre- and post-migration stressors is critical to understanding Canadian Muslim immigrant women's experience of intimate partner violence (IPV). This study uses a dominant qualitative design, supplemented by quantitative data to understand eight Canadian Muslim immigrant women's experience of IPV from six countries of origin. Five themes were identified: (a) childhood exposure to trauma and violence, (b) iron cage of society, (c) the fusion of love and violence, (d) post-migration challenges and assistance, and (e) toll and consequences of IPV. These themes are described to illustrate the trajectory in the development of IPV and the participants' eventual decision to leave their relationship. Pre-migration experiences included adverse childhood experiences, family history of IPV, and difficulty with help-seeking for IPV. Post-migration challenges of language difficulties, lack of social connections, internalized familial patriarchal values, and sexism influenced women's help-seeking and decision-making. Results from this sample suggested that immigrant Muslim women are likely more affected by IPV in comparison to Canadian-born Muslim women, experienced more stressors, less support, delayed help-seeking process, and more serious mental health consequences. Quantitative measures revealed negative effects of IPV on women's mental and overall health. The roles of ethnic communities, religious institutions, law enforcement, and service providers in supporting Canadian Muslim women with experience of IPV are discussed.

Current Recommendations on Atrial Fibrillation: A Comparison of the Recent European and Canadian Guidelines.

BACKGROUND: Guidelines for the diagnosis and management of atrial fibrillation (AF) are frequently published and updated, reflecting the rapid evolution in AF pathogenesis and treatment modalities. SUMMARY: Recently, 2 important guidelines for the diagnosis and management of atrial AF have been published by the European Society of Cardiology (ESC), and Canadian Cardiovascular Society (CCS). Although the evidence-based recommendations and statements are quite similar, there are some important differences between the ESC and CCS guidelines for AF. Herein, we compared the current recommendations and highlighted the differences from the most recent guidelines for AF. Key Messages: Specifically, key differences can be observed in methods evaluating the recommendations; classifications and the definitions; the symptom score used to guide management decisions, longitudinal patient assessment, and structured characterization; the stroke risk stratification algorithm used to determine indications for oral anticoagulation therapy; the role of acetylsalicylic acid in stroke prevention in AF; the antithrombotic regimens that are employed in the setting of chronic coronary syndromes, acute coronary syndromes, and percutaneous coronary intervention; the target heart rate for rate control; and the algorithms for integrated or holistic management of AF. Differences are observed, particularly when the quality of evidence is moderate or low. More research and randomized controlled studies on major gaps identified in current guidelines will further clarify and modify our future management strategies in AF.

Soil Microbe-Mediated N:P Stoichiometric Effects on Solidago canadensis Performance Depend on Nutrient Levels.

Both soil microbes and soil N:P ratios can affect plant growth, but it is unclear whether they can interact to alter plant growth and whether such an interactive effect depends on nutrient levels. Here, we tested the hypothesis that soil microbes can ameliorate the negative effects of nutrient imbalance caused by low or high N:P ratios on plant growth and that such an ameliorative effect of soil microbes depends on nutrient supply levels. We grew individuals of six populations of the clonal plant Solidago canadensis at three N:P ratios (low (1.7), intermediate (15), and high (135)), under two nutrient levels (low versus high) and in the presence versus absence of soil microbes. The presence of soil microbes significantly increased biomass of S. canadensis at all three N:P ratios and under both nutrient levels. Under the low-nutrient level, biomass, height, and leaf number of S. canadensis did not differ significantly among the three N:P ratio treatments in the absence of soil microbes, but they were higher at the high than at the low and the intermediate N:P ratio in the presence of soil microbes. Under the high-nutrient level, by contrast, biomass, height, and leaf number of S. canadensis were significantly higher at the low than at the high and the intermediate N:P ratio in the absence of soil microbes, but increased with increasing the N:P ratio in the presence of soil microbes. In the presence of soil microbes, number of ramets (asexual individuals) and the accumulation of N and P in plants were significantly higher at the high than at the low and the intermediate N:P ratio under both nutrient levels, whereas in the absence of soil microbes, they did not differ significantly among the three N:P ratio regardless of the nutrient levels. Our results provide empirical evidence that soil microbes can alter effects of N:P ratios on plant performance and that such an effect depends on nutrient availability. Soil microbes may, therefore, play a role in modulating ecosystem functions such as productivity and carbon and nutrient cycling via modulating nutrient imbalance caused by low and high N:P ratios.

Current Attitudes toward Unfunded Cancer Therapies among Canadian Medical Oncologists.

BACKGROUND: Despite successes in the development of innovative anticancer therapies, the fiscal and capacity restraints of the Canadian public healthcare system result in challenges with drug access. A meaningful proportion of systemic therapies ultimately do not receive public funding despite supporting clinical evidence. In this study, we assessed Canadian medical oncologists' current attitudes toward discussing publicly unfunded cancer treatments with patients and predictors of different practices. METHODS: A web-based survey consisting of multiple choice and case-based scenarios was distributed to medical oncologists identified through the Royal College of Physicians and Surgeons of Canada directory. RESULTS: A total of 116 responses were received. Almost all respondents reported discussing publicly unfunded treatments, including those who did so for Health Canada (HC) approved treatments (50%) and those who discussed off-label treatments (i.e., not HC approved) as guided by national guidelines (48%). Respondents in practice for over 15 years versus less than 5 years (OR 0.14, 95% CI 0.04-0.50, p = 0.002) and those who worked in a community practice versus comprehensive cancer center (OR 0.17, 95% CI 0.03-0.91, p = 0.04) were significantly less likely to discuss off-label treatment options with their patients. Almost half of respondents (47%) indicated that their institution did not permit the administration of unfunded treatments. CONCLUSIONS: There is variability in medical oncologists' practices when it comes to discussing unfunded therapies. Given the limitations within Canada's publicly funded healthcare system, physicians are faced with the challenge of navigating an increasingly complex balance between patient care and available resources. Engagement of relevant stakeholders and policy makers is crucial in the continued evaluation of Canada's drug funding process.

Three Emerging Spiritual Practices in the Canadian Association for Spiritual Care (CASC): From Pastoral Care and Counselling to Multi-Faith, Evidence-Based Spiritual Care and Psycho-Spiritual Therapy.

Describes the relationship between practice and theory (praxis) along with an examination of changes in the last 40 years in the praxis of pastoral care and counselling in the Canadian Association for Spiritual Care (CASC) that led to spiritual care and psycho-spiritual therapy. Developments in spiritual practices include growth in multi-faith, evidence-based spiritual care, and spiritually integrated psychotherapy (psycho-spiritual therapy). Suggests further areas of research and reflection including process theology.

Prevalence of vitamin-mineral supplement use and associated factors among Canadians: results from the 2015 Canadian Community Health Survey.

Vitamin/mineral supplements are used for improving micronutrient intake and preventing deficiencies, particularly for shortfall nutrients. We assessed the prevalence of vitamin/mineral supplement use and associated factors among a representative sample of Canadians aged ≥1 years. We used nationally representative data from the 2015 Canadian Community Health Survey (CCHS)-Nutrition. The prevalence of vitamin/mineral supplement use containing shortfall nutrients (vitamins: A, C, D, B6, B12 and folate; minerals: calcium, magnesium, and zinc) was examined in this study. Logistic regression models were performed to determine factors associated with vitamin/mineral supplement use among Canadian children (1-18 years) and adults (>19 years). The overall prevalence of vitamin/mineral supplement use was 38% among men and 53% among women. Males aged 14-18 years had the lowest prevalence (26.5%; 95% confidence interval (CI) = 21.9-31.0) and females aged ≥71 years had the highest prevalence (67.8%; 95% CI = 64.1-71.5) of vitamin/mineral supplement use. Female gender, older age, higher education level, higher income, living in urban areas, having chronic conditions, having a normal body mass index (BMI), and being non-smoker were independent positive predictors of vitamin/mineral supplement use among adults. Independent positive predictors of vitamin/mineral supplement use among Canadian children included younger age, having a normal BMI, and being food secure. Novelty: The overall prevalence of vitamin/mineral supplement use among Canadian men and women was 38% and 53%, respectively. Sociodemographic and lifestyle variables were associated with vitamin/mineral supplement use, especially among Canadian adults.

Proportions of long-chain ω-3 fatty acids in erythrocyte membranes of Canadian adults: Results from the Canadian Health Measures Survey 2012-2015.

BACKGROUND: The Omega-3 Index (OI) is a proposed marker of coronary artery disease (CAD) risk. Another index, the EPA/arachidonic acid (AA) ratio has also been proposed as a possible risk marker for CAD. OBJECTIVE: Our primary objective was to characterize the Canadian population subgroups that have an undesirable OI (<4%, associated with high CAD risk) and to identify the participants' characteristics most strongly associated with the OI. Our secondary objective was to identify the characteristics most strongly associated with the EPA/AA ratio. DESIGN: Data from 4025 adult participants of cycles 3 and 4 (2012-2015) of the cross-sectional Canadian Health Measures Survey were pooled. Adjusted mean proportions of erythrocyte membrane ω-3 (n-3) fatty acids, total ω-6 fatty acids, and ratios were analyzed by sociodemographic, health, and lifestyle characteristics using covariate-adjusted models. RESULTS: The mean OI was 4.5%. Almost 40% of Canadians had an undesirable (<4%) OI. ω-3 supplement use, fish intake, and race were the variables most strongly associated with OI scores. The prevalence of undesirable OI was significantly higher among participants consuming fish less than twice a week (43.8%; 95% CI: 39.0%, 48.6%) than among those consuming more fish (12.7%; 95% CI: 7.8%, 19.9%), among smokers (62.7%; 95% CI: 52.9%, 71.7%) than nonsmokers (33.4%; 95% CI: 29.4%, 37.7%), in whites (42.7%; 95% CI: 38.2%, 47.4%) than in Asians (23.0%; 95% CI: 15.4%, 33.0%), and in adults aged 20-39 y (49.6%; 95% CI: 42.3%, 56.9%) than in those aged 60-79 y (24.4%; 95% CI: 21.0%, 28.1%). ω-3 supplement intake and fish intake were the characteristics most strongly associated with EPA/AA. All P ≤ 0.05. CONCLUSIONS: An important proportion of Canadian adults has an undesirable (<4%) OI, with higher prevalence in some subgroups. Further assessment is required to determine the value and feasibility of an increase in the population's OI to the currently proposed target of ≥8% as a potential public health objective.

Nutritional implications of dietary gluten avoidance among Canadians: results from the 2015 Canadian Community Health Survey.

Adherence to a gluten-free diet (GFD) is the only available treatment for gluten-related disorders, although a GFD may also be followed for discretionary reasons. The main objectives of the present study were to (1) describe and test for differences in key nutrient intakes among Canadians who follow a GFD compared with Canadians with no dietary exclusions and (2) describe additional dietary avoidances adhered to by Canadians who avoid gluten. We conducted a secondary analysis of the cross-sectional 2015 Canadian Community Health Survey-Nutrition Survey, which included a general health survey and 24-h dietary recall (n 20 487). Participants were categorised as those who avoid dietary gluten and those who reported no avoidances. Key nutrient intakes were assessed, as a percentage of Dietary Recommended Intakes, including fibre, B vitamins, vitamin D, Ca, Fe, Na and Zn, and compared between the two groups using t tests. Canadians who avoided gluten had significantly lower intakes of folate, vitamin B12, vitamin D, Fe, Na and Ca compared with those who did not avoid any food groups. However, Canadians who reported following a GFD were significantly more likely to use vitamin or mineral supplements in the past 30 d. More than 20 % of those who avoided gluten also avoided dairy products. Findings suggest that following a GFD places Canadians at risk for nutrient inadequacies, particularly folate, Ca and vitamin D. Further research is required to further examine how multiple dietary avoidances among those who avoid gluten may contribute to dietary inadequacies.

With a little help from my (Canadian) friends: Health differences between minimal and maximal religiosity/spirituality are partially mediated by social support.

RATIONALE: Higher levels of religion and spirituality (R/S) are associated with better health in both Canadian and American samples. One mechanism that can account forthis relationship is social support, which is positively associated with higher R/S and is positively associated with overall wellness. Although social support has been found to mediate the relationship between R/S and health in American samples, parallel research on Canadian samples is lacking. OBJECTIVE: While having cultural similarities, Canada and the United States have noteworthy differences with respect to religion, politics, and demographics. Consequently, it is problematic to assume that social support accounts for the R/Shealth relationship for Canadians. The goal of the current study was to explore whether social support mediated the relationship between R/S and health outcomes. METHOD: Using individuals ≥20 years of age from the 2012 Canadian Community Health Survey - Mental Health component (N ≥ 9043), we isolated people who had either the lowest or highest possible score on a composite measure of R/S. We then compared 'minimal R/S' respondents to 'maximal R/S' respondents on 11 health outcomes and investigated if these health disparities attenuated when accounting for differences in social support. RESULTS: Maximal R/S was associated with better health for nine of the tested outcomes, but seven of these relationships were attenuated when social support was added to the model. The two remaining outcomes, drug abuse/dependence and alcohol abuse/dependence, were not significantly impacted by the inclusion of social support. CONCLUSION: Social support plays a mediating role in many R/S-health relationships for Canadians. Although R/S appears to have a statistical relationship with many health outcomes, several of these lack practical significance.

Influence of six essential oils on invasive Solidago canadensis L. seed germination.

Solidago canadensis L. (SC) (Canadian goldenrod) is a dangerous plant invader in Europe, which suppress the indigenous flora. Essential oils (EOs) are considered biological control agents. GC-MS analysis for identification of main components was conducted and the potential phytotoxicity of six EOs were also evaluated. Limonene and ß-thujone were dominant components in Salvia officinalis L., menthone and menthol in Mentha × piperita L., carvacrol in Origanum vulgare L., estragole/anisole and anethole in Foeniculum vulgare Mill., limonene and carvone in Anethum graveolens L., and anethole in Pimpinella anisum L. Along with EOs, anethole, anisole, camphor, carvone, estragole, limonene, menthol, menthone, thujone and thymol were used independently to evaluate phytotoxic effect against Canadian goldenrod seed germination. A significant inhibitory effect was registered for origanum (1.250 µg.ml-1). The influence of single components was significant. The highest phytotoxic activity was registered with anethole and estragole. Phenolic compounds were the inhibitoriest, followed by oxygenated and hydrocarbon monoterpenes.