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People use dietary supplements to offset nutritional deficiencies and manage metabolic dysfunction. While the beneficial effect of fish proteins on glucose homeostasis is well established, the ability of fish peptides to replicate the protein findings is less clear. With financial support from a programmatic Canadian Institutes of Health Research (CIHR) Team grant, we aimed to identify salmon peptide fractions (SPFs) with the potential to mitigate metabolic dysfunction. Additionally, the grant aims included assessing whether vitamin D, a nutrient commonly found in salmon, could potentiate the beneficial effects of salmon peptides. In parallel, technologies were developed to separate and filter the isolated peptides. We employed an integrative approach that combined nutritional interventions in animal models and human subjects to identify metabolic pathways regulated by salmon peptides and other fish nutrients. This combination of interdisciplinary expertise revealed that a SPF could be a therapeutic tool used in the prevention and management of cardiometabolic diseases. Herein, we present a perspective of our CIHR funded grant that utilized a translational approach to establish the cardiometabolic health effects and mechanisms of action of fish nutrients: from animal models to clinical trials., Competing Interests: AM and LB hold patent WO 2021/108916 A1 Peptides for regulating glucose. PLM, GP, M-CV, HJ, CG and JSW declare no conflict of interest.

Purpose: To (1) assess dietary intakes of pregnant women with previous bariatric surgery in comparison with Dietary Reference Intakes (DRIs); (2) compare their dietary intakes as well as their diet quality with a control group of pregnant women with no history of bariatric surgery., Methods: Twenty-eight (28) pregnant women with previous surgery (sleeve gastrectomy, n = 7 and biliopancreatic diversion with duodenal switch, n = 21) were matched for pre-pregnancy body mass index with 28 pregnant women with no history of bariatric surgery. In at least one trimester, participants completed a minimum of 2 Web-based 24-h dietary recalls from which energy, macro- and micronutrient intakes as well as the Canadian Healthy Eating Index (C-HEI) were derived., Results: No differences were observed for energy intake between groups. All women had protein intakes within the recommended range, but most women with previous surgery had carbohydrate (67%) and dietary fiber intakes (98%) below recommendations. In both groups, mean total fat, saturated fatty acids, free sugars and sodium intakes were above recommendations, as opposed to mean vitamin D, folic acid and iron dietary intakes below recommendations for most women. Compared with the control group, pregnant women with previous bariatric surgery had lower overall C-HEI scores., Conclusion: These results suggest that pregnant women with previous bariatric surgery would benefit from a nutritional follow-up throughout their pregnancy., Level of Evidence: III: Evidence obtained from well-designed cohort or case-control analytic studies., (© 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Objectives: To evaluate the association between individual and environmental determinants of diet quality with diet quality of children exposed to gestational diabetes mellitus (GDM+) and unexposed (GDM-); to study the association between mother and child vegetables and fruit (VF) intakes., Design: Cross-sectional study., Participants: One hundred forty-two children (104 GDM+; 38 GDM-) aged 6.2 ± 2.5 years., Variables: Canadian Healthy Eating Index 2007 (HEI-C) and VF were obtained with 2 24-hour dietary recall questionnaires in children. Maternal VF was obtained by a validated food frequency questionnaire, and weight and height were measured. Sociodemographic determinants were obtained by questionnaires., Analysis: Linear regression models were used to evaluate the association between individual and environmental determinants and the HEI-C score with interaction for GDM status., Results: Family meals were associated with HEI-C among GDM- but not GDM+ children (β = 9.97, P = 0.01 and β = -0.41, P = 0.84, respectively; P for interaction = 0.02). Children's age (β = -1.45; 95% confidence interval, -2.19 to -0.72; P < 0.001) was a determinant of HEI-C among all children. Maternal VF intakes were positively associated with children's VF intake (r = 0.30, P < 0.001, r 2  = 0.09), with association of larger variance among GDM- children (r = 0.38, r 2  = 0.14, P = 0.02) than GDM+ children (r = 0.23, r 2  = 0.05, P = 0.02)., Conclusions: The food environment at home was associated differently with the diet quality of GDM+ and GDM- children. Whether targeting family meals and maternal diet quality is a good strategy to improve children's diet quality among GDM+ children needs to be further investigated., (Copyright © 2021 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.)

Scope: Metabolomics is increasingly used to identify biomarkers of diet or chronic diseases, such as type 2 diabetes. Yet, metabolite signatures following dairy intake in hyperinsulinemic subjects have not been identified. The objective is to evaluate the effects of a high dairy diet (HD) for 6 weeks (4 servings or more per day), compared with an adequate dairy diet (AD) (2 servings or less per day), on serum metabolite profiles in hyperinsulinemic adults., Methods and Results: In this crossover trial, subjects are randomized to HD or AD for 6 weeks. Serum metabolites are assessed using GC/MS. Twenty-six subjects completed the study. Levels of pentadecanoic acid, tyrosine and lathosterol are increased in HD, while 1,5-anhydrosorbitol, myo-inositol, 3-aminoisobutyric acid and beta-sitosterol are decreased (p < 0.05). Sorbitol levels are increased after AD, while hexanoic acid, lauric acid, l-kynurenine, methionine, and benzoic acid levels are reduced (p < 0.05). Histidine, caprylic acid, nonanoic acid, decanoic acid, lauric acid, heptadecanoic acid, and benzoic acid levels are increased in HD compared to AD, while malic acid levels are increased in AD compared with HD (p < 0.05)., Conclusion: Higher dairy products intake modifies metabolite profiles in hyperinsulinemic subjects., (© 2019 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

Aims: The objectives of this study were to assess the profile of lifestyle habits among children exposed (GDM+) or unexposed (GDM-) to GDM and to assess whether a healthy lifestyle profile is associated with lower adiposity values among these children., Methods: A total of 105 GDM+ and 38 GDM- children aged 2-14 years were included. Vegetables and fruit intakes were collected using two 24-h dietary recalls. Physical activity and sedentary time were measured with accelerometers. Screen and sleep time were assessed using questionnaires. Weight, height and waist circumference were measured. Body composition was assessed by absorptiometry., Results: GDM+ children had lower moderate-to-vigorous physical activity practice (p = 0.043) and fruit intake (p = 0.020) than GDM- children. Among children with an unhealthy lifestyle (meeting 0-2 lifestyle recommendations), GDM+ children had greater percentage of fat mass (p = 0.021) and android fat mass (p = 0.020) than GDM- children. Moreover, among GDM+ children, children with a healthy lifestyle (meeting 3-4 lifestyle recommendations) tended to have lower percentage of fat mass (p = 0.053) and android fat mass (p = 0.071) than those with an unhealthy lifestyle., Conclusion: Improving lifestyle habits among GDM+ children could represent a promising approach to prevent deteriorated adiposity values., (Copyright © 2019 Diabetes India. Published by Elsevier Ltd. All rights reserved.)

Children born from mothers with gestational diabetes mellitus (GDM) are at high-risk of obesity and type 2 diabetes. To date, there is a lack of effective strategies to prevent these complications. The aim of this study was to evaluate the association between diet quality and anthropometric and glycemic profiles of children exposed (GDM+) and unexposed (GDM⁻) to GDM. A total of 104 GDM+ and 38 GDM⁻ children were included. Two 24-h dietary recall questionnaires were used to assess dietary intakes. The Healthy Eating Index adapted for the Canadian population (HEI-C) was used to assess diet quality. Spearman correlations adjusted for children's age and sex were computed. Mean age was 6.0 ± 2.5 and 6.8 ± 2.3 years for GDM+ and GDM⁻, respectively ( p = 0.03). Total HEI-C score was negatively associated with the android-to-gynoid fat mass ratio ( r = -0.29, p = 0.03) and homeostasis model assessment for insulin resistance (HOMA-IR) index ( r = -0.22, p = 0.04) in GDM+ children only. The prevalence of being overweight or obese during childhood was 4-fold higher among GDM+ children with a HEI-C score ≤70 compared to GDM+ children with a HEI-C score >70. Results of this study show that a healthy diet is associated with a better cardiometabolic health profile in GDM+ children, including a lower risk of being overweight or obese.

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.

Objective: To determine whether an explained-variance genetic risk score (GRS), with 36 single nucleotide polymorphisms (SNPs) previously associated with type 2 diabetes (T2D), is also associated with gestational diabetes mellitus (GDM), and with the progression to pre-diabetes and T2D among women with prior GDM., Design: A cohort study., Setting: Clinical investigation unit of Laval University, Quebec, Canada., Population: A cohort of 214 women with prior GDM and 82 controls recruited between 2009 and 2012., Methods: Associations between the GRS and GDM., Main Outcomes Measures: GDM and prevalence of pre-diabetes and T2D., Results: Women with prior GDM had a higher GRS compared with controls (38.6 ± 3.9, 95% CI 38.1-39.1, versus 37.4 ± 3.2, 95% CI 36.7-38.1; P < 0.0001). In women with prior GDM, the explained-variance GRS was higher for pre-diabetic women compared with women who remained normoglucotolerant at testing (1.21 ± 0.18, 95% CI 1.18-1.23, versus 1.17 ± 0.15, 95% CI 1.13-1.20; P < 0.0001). Similarly, women with T2D had a higher explained-variance GRS compared with women with prior GDM who remained normoglucotolerant (1.20 ± 0.18, 95% CI 1.14-1.25, versus 1.17 ± 0.17, 95% CI 1.13-1.20; P < 0.0001). The predictive effects of the explained-variance GRS, age, and body mass index (BMI), or the additive effects of the three variables, were tested for pre-diabetes and T2D. We observed an area under the curve of 0.6269 (95% CI 0.5638-0.6901) for age and BMI, and adding the explained-variance GRS into the model increased the area to 0.6672 (95% CI 0.6064-0.7281) for the prediction of pre-diabetes., Conclusions: An explained-variance GRS is associated with both GDM and progression to pre-diabetes and T2D in women with prior GDM., (© 2014 Royal College of Obstetricians and Gynaecologists.)

Aim: Perceived barriers are one determinant of physical activity. Depending on the study population, these barriers can vary. The aim of this study was to assess the reliability and predictive validity of the 'Barriers to Physical Activity in Type 1 Diabetes' (BAPAD-1) scale, developed by Dubé et al., Methods: A total of 77 adults (48% women; age: 43.5±10.4; body mass index: 25.2±4.3kg/m(2); HbA(1c): 7.6±1.3%) with type 1 diabetes completed the questionnaire and an evaluation of their physical activity using an accelerometer (8.4±1.2 days) and cardiorespiratory fitness assessment (VO(2)(peak)). To evaluate the temporal stability of the questionnaire, a subgroup of 17 participants answered the BAPAD-1 scale on both visits required by the protocol (10±4 days)., Results: The BAPAD-1 scale showed good internal validity with an inter-items correlation coefficient (Cronbach's correlation) of 0.85. The intraclass correlation coefficient for the two times the scales were completed was 0.80. The BAPAD-1 score was negatively correlated with both physical activity energy expenditure (r=-0.25; P=0.03) and VO(2)(peak) adjusted for gender and age (r=-0.27; P=0.02)., Conclusion: The BAPAD-1 scale is a reliable and valid tool for assessing salient barriers to physical activity. In future, this scale could be used to describe the factors accounting for physical activity, and for planning interventions aimed at promoting physical activity among adults with type 1 diabetes., (Copyright © 2011 Elsevier Masson SAS. All rights reserved.)

Background: Gestational diabetes mellitus (GDM) and excessive gestational weight gain have significant implications for the health of both mother and child. Our objective was to detail gestational weight gain in women in relationship to GDM., Methods: Data were collected by retrospective reviews of medical records in women who delivered between January and December 2007 at the Laval University Medical Center (Quebec, Canada). The analysis included 294 women (55 GDM and 239 controls) for whom gestational weight gain was calculated by the difference between maternal weight measured at delivery, or at the last prenatal visit (≥37th week), and prepregnancy self-reported weight. Gestational weight gain and rate of weight gain were also calculated for each trimester and until GDM screening. Gestational weight gain was compared to the 2009 recommendations by the Institute of Medicine (IOM). Women with GDM were diagnosed and treated according to the Canadian Diabetes Association guidelines., Results: Weight gain in the first trimester was significantly higher in GDM patients compared to controls (3.40 ± 0.42 vs. 1.87 ± 0.16 kg, p ≤ 0.01) and was above IOM recommendations, whereas weight gain in the third trimester was significantly lower in GDM patients compared to controls (4.11 ± 0.36 vs. 6.35 ± 0.18 kg, p ≤ 0.0001). Prepregnancy body mass index (BMI) and first trimester weight gain were both significant and independent predictors of GDM (odds ratio [OR] 1.11, 95% confidence interval [CI] 1.05-1.17, and OR 1.25, 95% CI 1.10-1.42, respectively)., Conclusions: First trimester gestational weight gain may need more clinical attention, as it has been identified as an independent and significant risk factor for GDM independent of traditional risk factors, including preconception obesity.

Purpose: To determine the glucose supplement required to prevent hypoglycemia during moderate-intensity exercise in Type 1 diabetic patients using newer analog insulins., Methods: Nine subjects performed 60 min of ergocycle exercise (50% VO2max), 3 h after a standard breakfast in three different conditions. Subjects were randomly assigned to preexercise liquid glucose supplement of 0 g of glucose (0G), 15 g of glucose (15G), and 30 g of glucose (30G). Blood glucose (BG) was measured before, during, and following the exercise. All subjects used Humulin N (N) and analog insulin Humalog (Lispro). A dextrose infusion was initiated when BG fell below 5 mmol x L(-1)., Results: There was no significant difference in the magnitude of the decrease in BG exercise-induced when comparing the three experimental conditions. However, the quantity of dextrose infused was significantly higher in the 0G (10.5 +/- 3.2 g) than in the 15G (3.5 +/- 1.8 g) or the 30G conditions (1.6 +/- 1.0 g). The addition of a glucose supplement (15G or 30G) significantly prolonged the delay before the need for dextrose infusion (31.7 +/- 7.5, 51.3 +/- 4.2, and 55.6 +/- 2.6 min; 0G, 15G, and 30G, respectively). The quantity of dextrose infusion was plotted against the three preexercise glucose supplements and a regression equation obtained. Solving this equation, a glucose supplement of 40 g was estimated in order to maintain BG levels within the normal range during and after exercise., Conclusion: For 60 min of late postprandial exercise followed by 60 min of recovery, an estimated 40 g of a liquid glucose supplement, ingested 15 min prior exercise, would seem likely to help maintain safe BG levels in subjects using N-Lispro.

Several genome-wide linkage scans have been carried out to identify quantitative trait loci for type 2 diabetes and related metabolic phenotypes. However, no previous linkage scans have focused on the response to exercise training of relevant metabolic traits. We performed a genome-wide linkage scan for baseline fasting glucose, insulin, and C-peptide and their responses to a 20-week exercise training program in nondiabetic white and black men and women from the HERITAGE Family Study. In SIBPAL linkage analyses, the maximum number of sibpairs available was 344 and 93 for baseline phenotypes and 300 and 72 for exercise training response phenotypes in whites and blacks, respectively. A total of 509 markers with an average spacing of 6.0 Mb were used. The strongest linkage was found for the changes in fasting insulin in response to exercise training with a marker in the leptin gene on 7q31 (empirical multipoint P = 0.0004) in whites. In blacks, the strongest linkage was observed for baseline fasting glucose on 12q13-q14 (empirical multipoint P = 0.0006). These regions harbor several potential candidate genes. The present findings may be important in identifying individuals at increased risk of developing type 2 diabetes and who are most likely to benefit from a physically active lifestyle.