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The Canadian Food Intake Screener/Questionnaire court canadien sur les apports alimentaires was developed to rapidly assess alignment of adults’ dietary intake over the past month with the 2019 Canada Food Guide’s healthy food choices recommendations. From July to December 2021, adults (n=154) aged 18-65 years completed the screener and up to two 24-hour dietary recalls. The screener scoring system was aligned with the Healthy Eating Food Index-2019 (HEFI-2019), to the extent possible. ANOVA compared screener scores among subgroups with known differences in diet quality. Using the recall data, the National Cancer Institute multivariate method was used to model HEFI-2019 components, with the screener score as a covariate, and the correlation coefficient between screener and total HEFI-2019 scores was estimated. The mean screener score was 35 points (SD=4.7; maximum, 65), ranging from 25 (1stpercentile) to 45 (99thpercentile). Differences in scores in hypothesized directions were evident by gender identity (p=0.06), perceived income adequacy (p=0.07), education (p=0.02), and smoking status (p=0.003). The correlation between screener and HEFI-2019 scores was 0.53 (SE=0.12). The screener’s moderate construct validity supports its use for rapid assessment of alignment of adults’ intake with the healthy food choices recommendations when comprehensive dietary assessment is not possible.NoveltyThe Canadian Food Intake Screener was developed to rapidly assess alignment of dietary intake with Canada’s Food Guide-2019 healthy food choices recommendations.Scoring is aligned with the Healthy Eating Food Index-2019, to the extent possible.Among a sample of adults, variation in screener scores was noted, mean screener scores differed between some subgroups with known differences in diet quality, and a moderate correlation between screener scores and total Healthy Eating Food Index-2019 scores based on repeat 24-hour dietary recalls was observed.The Canadian Food Intake Screener has moderate construct validity for rapid assessment of overall alignment of adults’ dietary intake with the Canada’s Food Guide-2019 healthy food choices recommendations when comprehensive dietary assessment is not possible.

Objective:Food literacy (FL) and nutrition literacy (NL) are concepts that can help individuals to navigate the current food environment. Building these skills and knowledge at a young age is important for skill retention, confidence in food practices and supporting lifelong healthy eating habits. The objectives of this systematic review were to: (i) identify existing tools that measure FL and NL among children and/or adolescents and (ii) describe the psychometric properties.Design:A 4-phase protocol was used to systematically retrieve articles. The search was performed in May 2021. Study characteristics and psychometric properties were extracted, and a narrative synthesis was used to summarise findings. Risk of bias was assessed using the COSMIN checklist.Setting:Six databases were searched to identify current tools.Participants:Children (2–12 years) and adolescents (13–18 years) participated in this study.Results:Twelve tools were identified. Three tools measured FL, 1 tool measured NL, 4 tools measured both FL and NL, and 4 tools measured subareas of NL—more specifically, critical NL, food label and menu board literacy. Most tools were self-reported, developed based on a theoretical framework and assessed some components of validity and/or reliability for a specific age and ethnic group. The majority of tools targeted older children and adolescents (9–18 years of age), and one tool targeted preschoolers (3–6 years of age).Conclusions:Most widely used definitions of FL and NL do not acknowledge life-stage specific criterion. Continued efforts are needed to develop a comprehensive definition and framework of FL and NL appropriate for children, which will help inform future assessment tools.

Background: Vitamin D deficiency in pregnancy is reported as a prevalent public health problem. Objectives: We aimed to evaluate, in pregnant Canadian women, 1) vitamin D intake, 2) maternal and cord serum 25-hydroxycholecalciferol [25(OH)D] and maternal 1,25-dihydroxycholecalciferol [1,25(OH)2D], and 3) factors associated with maternal serum 25(OH)D. Methods: Women (n = 187; mean prepregnancy BMI 24.4 kg/m2, mean age 31 y) recruited to the Be Healthy in Pregnancy study provided fasting blood samples and nutrient intake at 12-17 (early) and 36-38 (late) weeks of gestation, and cord blood. Vitamin D intakes (Nutritionist Pro™) and serum 25(OH)D and 1,25(OH)2D concentrations (LC-tandem MS) were measured. Results: Vitamin D intake was comparable in early and late pregnancy [median (IQR) = 586 (459, 859) compared with 689 (544, 974) IU/d; P = 0.83], with 71% consumed as supplements. Serum 25(OH)D was significantly higher in late pregnancy (mean ± SD: 103.1 ± 29.3 nmol/L) than in early pregnancy (82.5 ± 22.5 nmol/L; P < 0.001) and no vitamin D deficiency (50 nmol/L in healthy Canadian pregnant women. This trial was registered at clinicaltrials.gov as NCT01693510.

Pregnancy induces bone mineral mobilization, which may be further compromised if diet and physical activity are suboptimal.We aimed to determine the effects of a Nutrition + Exercise intervention during pregnancy on maternal calciotropic and bone biomarker profiles throughout pregnancy and the postpartum.In the Be Healthy in Pregnancy (BHIP) randomized controlled trial, 203 of 225 participants who consented to the bone health substudy were, randomly assigned at 12-17 weeks gestation to receive either usual care (control) or a structured and monitored Nutrition + Exercise plan (intervention) providing an individualized high dairy protein diet and a walking program throughout pregnancy. Maternal serum total procollagen type 1 N-terminal propeptide (P1NP; bone formation), C-terminal telopeptide of type I collagen (CTX; bone resorption), and insulin-like growth factor-1 (IGF-1) were measured by ELISA, and vitamin D metabolites by ultra-performance LC tandem MS at early and late pregnancy, 6 mo postpartum, and in cord blood.In 187 participants completing all measures, significantly higher intakes were observed in the intervention than in the control group for total protein (P 0.0001), protein intake from dairy foods (P 0.0001), and calcium (P 0.0001), whereas vitamin D intake was similar between treatment groups in both the second and third trimesters. The intervention group had significantly lower serum CTX at end of pregnancy (mean ± SD: 0.78 ± 0.31 ng/mL; n = 91 compared with 0.89 ± 0.33 ng/mL; n = 96, P = 0.034) and in cord serum (0.58 ± 0.13 ng/mL; n = 31 compared with 0.69 ± 0.18 ng/mL; n = 22, P 0.025). Serum concentrations of P1NP rose significantly (P 0.02) from early pregnancy to 6 mo postpartum for the intervention group only. Serum 25-hydroxyvitamin D status was50 nmol/L for 97% of all participants.Higher maternal dietary protein and calcium intakes than usual care in concert with normal vitamin D status minimized bone resorption and maintained bone formation and may protect bone health during pregnancy.This trial was registered at clinicaltrials.gov as NCT01689961.

A randomized two-arm prospective superiority trial tested the efficacy of a novel structured and monitored nutrition (bi-weekly counselling for individualized energy and high dairy protein diet) and exercise program (walking goal of 10,000 steps/day) (intervention) compared to usual care (control) in pregnant women to achieve gestational weight gain (GWG) within current recommendations. Women recruited in communities in southern Ontario, Canada were randomized at 12–17 weeks gestation with stratification by site and pre-pregnancy BMI to intervention (n = 119) or control (n = 122). The primary outcome was the proportion of women who achieved GWG within the Institute of Medicine recommendations. Although the intervention compared to control group was more likely to achieve GWG within recommendations (OR = 1.51; 95% CI (0.81, 2.80)) and total GWG was lower by 1.45 kg (95% CI: (−11.9, 8.88)) neither reached statistical significance. The intervention group achieved significantly higher protein intake at 26–28 week (mean difference (MD); 15.0 g/day; 95% CI (8.1, 21.9)) and 36–38 week gestation (MD = 15.2 g/day; 95% CI (9.4, 21.1)) and higher healthy diet scores (22.5 ± 6.9 vs. 18.7 ± 8.5, p < 0.005) but step counts were similar averaging 6335 steps/day. Pregnancy and infant birth outcomes were similar between groups. While the structured and monitored nutrition with counselling improved diet quality and protein intake and may have benefited GWG, the exercise goal of 10,000 steps/day was unachievable. The results can inform future recommendations for diet and physical activity in pregnancy.

Exposure to sub-optimal maternal vitamin D status during pregnancy has been linked to inadequate in utero bone growth with potential for post-natal deficits, but reported findings are inconsistent. Possible reasons include measurement error in assessing bone length/height, or lack of adjustment for confounding variables such as maternal/infant diet, physical activity and season of birth. The objective of this study was to determine the maternal and child factors associated with bone length traits in children at 3 years of age as part of a longitudinal follow-up of a pregnancy cohort.Mother-child dyads enrolled in the Family Atherosclerosis Monitoring In early Life study were included. Maternal serum 25-hydroxyvitamin D (25(OH)D) concentration was measured by liquid chromatography tandem mass spectrometry (LC-MS/MS). Anthropometry, physical activity by questionnaire and dietary assessment by food frequency questionnaire were completed for mothers during pregnancy (27-40 weeks gestation) and for children at 3 years with diet by 3-day food records (Nutritionist Pro). Whole body bone mineral density in mother and child (n = 473) was measured by dual-energy absorptiometry (DXA) at the 3 year visit. A software program was developed using MATLAB to derive bone length measurements from whole body DXA images using 8 long bones of each child. Association between maternal and child variables with offspring bone length was assessed using unadjusted and adjusted multivariate linear regression analyses.In the final adjusted multivariate regression model, factors associated with child bone length were maternal height (p = 0.05), child birth length (p = 0.005) and child weight z-score at 3 years (p 0.001). No association was observed between maternal serum 25(OH)D concentrations in pregnancy (of which 77% were in normal range) and child bone length.In healthy Canadian mothers and their children, the factors associated with child bone length achieved at 3 years of age appear to be related to genetic traits rather than environmental exposures. Measures of the length of long bones in children using DXA scans may have provided a more accurate assessment of bone length than whole body height measures.

Background Optimal maternal nutrition during pregnancy has been linked to better cognitive and behavioral development in children. However, its influence on the effects of suboptimal postnatal exposures like reduced stimulation and support in the home is not known. Objectives To examine the effect of maternal pregnancy diet on executive function and/or behavioral development in children raised in suboptimal home environments. Methods Data were provided by 808 mother-infant dyads from the Canadian Maternal-Infant Research on Environmental Chemicals-Child Development study. Maternal pregnancy diet was self-reported using the Healthy Eating Index 2010 questionnaire. Stimulation and support in the home was assessed using the Home Observation for Measurement of the Environment (HOME) when children were 3-4 y old. Child executive function was reported by mothers at this age using the Behavior Rating Inventory of Executive Functioning-Preschool Edition, and child behavior was assessed using the Behavior Assessment System for Children-2nd Edition. We examined the interaction of maternal pregnancy diet and postnatal HOME scores on child executive function and behavior using linear regression adjusted for maternal education, postpartum depression, prepregnancy BMI, and smoking. Results Maternal pregnancy diet was associated with an increasingly positive association with child working memory (β: 0.21; 95% CI: 0.82, 3.41; P = 0.001), planning (β: 0.17; 95% CI: 0.38, 2.84; P = 0.007), and adaptability (β: -0.13; 95% CI: -1.72, -0.08; P = 0.032) as levels of postnatal stimulation decreased. Conclusions The positive association of maternal pregnancy diet quality and executive function and adaptability in 3- to 4-y-olds appeared to increase with decreasing levels of postnatal stimulation and support. These results suggest that overall maternal pregnancy diet could be linked to better child neurodevelopment in families experiencing barriers to providing stimulation and support to children in their home.

Purpose: Prenatal multivitamins are recommended in pregnancy. This study assessed food and supplement intakes of folate, vitamin B12 (B12), vitamin D, and choline in pregnant women living in Southern Ontario in comparison with current recommendations.Methods: Women recruited to the Be Healthy in Pregnancy RCT (NCT01693510) completed 3-day diet/supplement records at 12–17 weeks gestation. Intakes of folate, B12, vitamin D, and choline were quantified and compared with recommendations for pregnant women.Results: Folate intake (median (min, max)) was 1963 μg/day dietary folate equivalents (153, 10 846); 90% of women met the Estimated Average Requirement (EAR) but 77% exceeded the Tolerable Upper Intake Level (UL) (n = 232). B12 intake was 12.1 μg/day (0.3, 2336); 96% of women met the EAR with 7% exceeding the EAR 100-fold (n = 232). Vitamin D intake was 564 IU/day (0.0, 11 062); 83% met the EAR, whereas 1.7% exceeded the UL (n = 232). Choline intake was 338 mg/day (120, 1016); only 18% met the Adequate Intake and none exceeded the UL (n = 158).Conclusion: To meet the nutrient requirements of pregnancy many women rely on prenatal vitamins. Reformulating prenatal multivitamin supplements to provide doses of vitamins within recommendations to complement a balanced healthy diet would ensure appropriate micronutrient intakes for pregnant women.

A subgroup of obese individuals, referred to as metabolically healthy obese (MHO), have preserved insulin sensitivity and a normal lipid profile despite being obese. The molecular basis for this improved cardiometabolic profile remains unclear. Our objective was to integrate metabolite and gene expression profiling to elucidate the molecular distinctions between MHO and metabolically unhealthy obese (MUO) phenotypes. A subset of individuals were selected from the Diabetes Risk Assessment study and classified into three groups using anthropometric and clinical measurements: lean healthy (LH), MHO, and MUO. Serum metabolites were profiled using gas chromatography coupled to mass spectrometry. Multivariate data analysis uncovered metabolites that differed between groups, and these were subsequently validated by capillary electrophoresis coupled to mass spectrometry. Subcutaneous adipose tissue (SAT) gene expression profiling using microarrays was performed in parallel. Amino acids were the most relevant class of metabolites distinguishing MHO from MUO individuals. Serum levels of glutamic acid, valine, and isoleucine were positively associated (i.e., LHMHOMUO) with homeostasis model assessment-insulin resistance (HOMA-IR) and glycated hemoglobin (HbA1c) values, while leucine was only correlated with HOMA-IR. The glutamine-to-glutamic acid ratio and glycine were inversely correlated (i.e., LHMHOMUO) with HbA1c values. Concomitantly, SAT gene expression profiling revealed that genes related to branched-chain amino acid catabolism and the tricarboxylic acid cycle were less down-regulated in MHO individuals compared to MUO individuals. Together, this integrated analysis revealed that MHO individuals have an intermediate amino acid homeostasis compared to LH and MUO individuals.

OBJECTIVES: Maternal bone health can be compromised in pregnancy if diet and exercise are inadequate. Our objective was to determine the changes of calciotropic hormones and bone biomarkers in response to a maternal high-dairy diet plus exercise intervention compared to usual care from early to late pregnancy. METHODS: As part of the Be Healthy in Pregnancy RCT (Southern Ontario, Canada) (NCT01689961), healthy pregnant women (≤ 17 wk gestation) were randomized to the control or treatment group (Nutrition: 25% protein energy with ∼50% from dairy and Exercise plan: 10,000 daily steps) for the duration of pregnancy. Calcium and vitamin D intakes were analyzed from 3-day diet and supplement records (Nutritionist Pro). Fasted serum was analyzed for 25(OH)D(2) and D(3) and 1,25(OH)(2)D by LC-MS/MS (Waters Corp.); procollagen type I N-terminal propeptide (PINP, Cloud Clone Corp., TX, USA) and insulin growth factor-1 (IGF-1, R&D Systems, MN, USA) by ELISA) at 12–17 and 36–38 wk gestation. T-tests were used to compare groups at baseline. Two-way ANOVA were performed to assess time and treatment effect. RESULTS: In 118 women (86% of European descent, mean (range) pre-pregnancy BMI 24.9 kg/m2 (17.9 – 39.6 kg/m2)), baseline median (Q1, Q3) vitamin D and calcium intakes (585 IU/d (453, 823) and 1192 mg/d (979, 1512)) and bone biomarkers were similar between control and treatment groups. Baseline 25(OH)D was 79.6 nmol/L (66.1, 97.7), 1,25(OH)(2)D was 71.5 pmol/L (62.3, 89.8), PINP was 57.0 ng/mL (37.4, 74.2) and IGF-1 was 178.0 ng/mL (132.0, 212.0). At the end of pregnancy, concentrations of 25(OH)D, 1,25(OH)(2)D and IGF-1 increased significantly (P

Inflammation is a recognized risk factor for the development of chronic diseases, such as type 2 diabetes and atherosclerosis. Evidence suggests that individual fatty acids (FA) may have distinct influences on inflammatory processes. The goal of this study was to conduct a cross-sectional analysis to examine the associations between circulating FA and markers of inflammation in a population of young healthy Canadian adults. FA, high-sensitivity C-reactive protein (hsCRP), and cytokines were measured in fasted plasma samples from 965 young adults (22.6 ± 0.1 years). Gas chromatography was used to measure FA. The following cytokines were analyzed with a multiplex assay: regulated upon activation normal T cell expressed and secreted (RANTES/CCL5), interleukin 1-receptor antagonist (IL-1Ra), interferon-γ (IFN-γ), interferon-γ inducible protein 10 (IP-10), and platelet-derived growth factor β (PDGF-ββ). Numerous statistically significant associations (p < 0.05, corrected for multiple testing) were identified between individual FA and markers of inflammation using linear regression. Myristic (14:0), palmitic (16:0), palmitoleic (16:1n-7), and dihomo-γ-linolenic (20:3n-6) acids were positively associated with all markers of inflammation. In contrast, stearic acid (18:0) was inversely associated with hsCRP and RANTES, and linoleic acid (18:2n-6) was inversely associated with hsCRP, RANTES and PDGF-ββ. In conclusion, our results indicate that specific FA are distinctly correlated with various markers of inflammation. Moreover, the findings of this study suggest that FA profiles in young adults may serve as an early indicator for the development of future complications comprising an inflammatory component.

Objective Increasing omega-3 fatty acid (FA) intake, particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), is associated with numerous health benefits; however, the benefits on inflammation appear to vary depending on the study population examined. While improvements in inflammatory status have been reported in the elderly, there is less evidence regarding the effects of fish oil supplementation on inflammation in young adults. The goal of the present study was to examine the influence of fish oil supplementation on lipid metabolites and the inflammatory status of young healthy men. Materials/Methods Fasted serum samples were collected from 10 young healthy males (23.4 ± 1.7 years) before and after a 3-month supplementation of fish-oil containing 2.0 g EPA and 1.0 g DHA. Samples were analyzed to investigate changes in FA profiles, bioclinical parameters (e.g. triglyceride and hs-CRP), and a panel of 26 eicosanoids. Paired t-tests were used to evaluate changes between the time points. Results Serum triglycerides decreased (P = 0.0006) while the proportion of HDL-c (relative to total cholesterol) increased significantly (P = 0.0495) after fish oil supplementation. Specific monounsaturated and polyunsaturated FA levels were changed following supplementation, including reductions in palmitoleic and oleic acid, and, as expected, increases in EPA and DHA. We also observed increases in eicosanoids, namely prostaglandin-F2α (P

Purpose: The aim was to validate a food frequency questionnaire (FFQ) against a 3-day food record (3DFR) for pregnant women with a focus on nutrients important for bone health from food and supplements. Methods: The FFQ and 3DFR were administered to pregnant women (n = 42) aged 18–45 years in their third trimester of pregnancy in Hamilton, Ontario. Nutrient analysis of intakes was conducted using an FFQ calculator and Nutritionist-Pro software. The average daily serving consumption of Milk and alternatives group and Vegetable subgroup from Canada’s Food Guide were also compared. Results: There was a high positive correlation between methods for total dietary vitamin D (r = 0.83). Low positive associations were observed for total protein (r = 0.37), calcium (r = 0.36), vitamin K (r = 0.41), and servings of Milk and alternatives (r = 0.36). A cross-classification analysis using participants’ intake quartiles revealed no major misclassifications. Bland–Altman analysis showed that the FFQ mildly underestimated the intake for protein, whereas it grossly overestimated the intake of vitamin K, and daily servings of Milk and alternatives and Vegetable. Conclusions: This FFQ can serve as a useful tool in clinical and research settings to assess key bone nutrients from foods and supplement sources in pregnant women.

Vitamin D deficiency in pregnancy is widely reported, but whether this applies in North America is unclear since no population-based surveys of vitamin D status in pregnancy exist in Canada or the United States. The objectives were to assess (i) the intake and sources of vitamin D, (ii) vitamin D status, and (iii) factors associated with serum 25-hydroxyvitamin D (25-OHD) concentration in two cohorts of pregnant women from Southern Ontario, Canada, studied over a span of 14 years. Maternal characteristics, physical measurements, fasting blood samples and nutrient intake were obtained at enrolment in 332 pregnant women from the Family Atherosclerosis Monitoring In early Life (FAMILY) study and 191 from the Be Healthy in Pregnancy (BHIP) study. Serum 25-OHD was measured by LC/MS-MS. The median (Q1, Q3) total vitamin D intake was 383 IU/day (327, 551) in the FAMILY study and 554 IU/day (437, 796) in the BHIP study. Supplemental vitamin D represented 64% of total intake in participants in FAMILY and 78% in BHIP. The mean (SD) serum 25-OHD was 76.5 (32.9) nmol/L in FAMILY and 79.7 (22.3) nmol/L in BHIP. Being of European descent and blood sampling in the summer season were significantly associated with a higher maternal serum 25-OHD concentration. In summary, health care practitioners should be aware that vitamin D status is sufficient in the majority of pregnant Canadian women of European ancestry, likely due to sun exposure.

Obesity is a risk factor for the development of type 2 diabetes and cardiovascular disease. However, it is now recognized that a subset of individuals have reduced cardiometabolic risk despite being obese. Paradoxically, a subset of lean individuals is reported to have high risk for cardiometabolic complications. These distinct subgroups of individuals are referred to as metabolically unhealthy normal weight (MUNW) and metabolically healthy obese (MHO). Although the clinical relevance of these subgroups remains debated, evidence shows a critical role for white adipose tissue (WAT) function in the development of these phenotypes. The goal of this review is to provide an overview of our current state of knowledge regarding the molecular and metabolic characteristics of WAT associated with MUNW and MHO. In particular, we discuss the link between different WAT depots, immune cell infiltration, and adipokine production with MUNW and MHO. Furthermore, we also highlight recent molecular insights made with genomic technologies showing that processes such as oxidative phosphorylation, branched-chain amino acid catabolism, and fatty acid β-oxidation differ between these phenotypes. This review provides evidence that WAT function is closely linked with cardiometabolic risk independent of obesity and thus contributes to the development of MUNW and MHO.

Background Obesity is associated with numerous health complications; however, a subgroup of obese individuals (termed the metabolically healthy obese or MHO) appear to have lower risk for complications such as type 2 diabetes and cardiovascular disease. Emerging evidence suggests that MHO individuals have reduced inflammation compared to their metabolically unhealthy obese (MUO) counterparts. As it is recognized that fatty acids (FAs) have a strong relationship with inflammation, the current study aimed to uncover if the reduced inflammation observed in MHO individuals is mirrored by a more favourable FA profile. Methods Fasted serum samples were collected from lean healthy (LH), MHO, and MUO participants (n = 10/group) recruited from the Diabetes Risk Assessment study. A panel of pro- and anti-inflammatory markers were measured by immunoassay. Total serum FA profiling, as well as the FA composition of circulating phospholipids (PL) and triglycerides (TG), was measured by gas chromatography. ANOVA and Mann-Whitney-Wilcoxon tests were used to assess statistical significance between the groups (P

Failure to protect total parenteral nutrition (TPN) from ambient light exacerbates the generation of peroxides, which affects blood glucose and plasma triacylglyceride (TG) in neonates. Based on the concept that the origin of adult diseases can be traced back to perinatal life, it was hypothesized that neonatal exposure to peroxides may affect energy availability later in life. Three-day-old guinea pigs, fitted with a jugular catheter, were fed regular chow (sham) +/- i.v. 350 microM H2O2 (sham + H2O2) or nourished with light-protected TPN [TPN(-)L, 209 +/- 9 microM peroxides] or light-exposed TPN [TPN(+)L, 365 +/- 15 microM peroxides]. After 4 d, infusions were stopped and animals fed chow. Spontaneous ambulatory movements, fasting blood glucose, glucose tolerance, TG, hepatic activities of glucokinase, phosphofructokinase (key enzymes of glycolysis), and acetyl-CoA carboxylase (key enzymes of lipogenesis) were determined at 12-14 wk and compared by ANOVA (p < 0.05). Relative to sham, the animals from sham + H2O2, TPN(-)L and TPN(+)L groups had lower plasma TG explained for 36% by low phosphofructokinase activity; they had lower glucose tolerance, lower body weight, and lower physical activity. In conclusion, neonatal exposure to oxidant molecules such as peroxides has important consequences later in life on lipid and glucose metabolism leading to a phenotype of energy deficiency.