Canadian statistics indicate that the incidence of obesity is rising, and that the prevalence of type 2 diabetes mellitus (T2DM) within this group is significantly higher than those of a healthy weight. Preliminary evidence has shown that the oil-rich grain, Salvia hispanica L. (Salba), improves glycemic control, suppresses appetite, and affects additional cardiovascular disease (CVD) risk factors. This study followed a randomized, double-blind, placebo-controlled, parallel design in a sub-set population of twenty individuals who were overweight or obese and had T2DM. Participants received supplements of Salba, or an energy- and fibre-matched control, and followed a hypocaloric diet for 24 weeks. Findings of this study reveal that Salba does not significantly affect weight loss, glycemic control or other CVD risk factors. These findings are preliminary and highlight the complexities of weight loss research. Further investigation into the potential health benefits of Salba is currently being carried out.

High fibre diets are associated with reduced risk of type 2 diabetes mellitus (T2DM). This may be due to short-chain-fatty-acids (SCFA) influencing insulin resistance and secretion via changes in free-fatty-acids (FFA) and specific gut hormones. We aimed to determine the postprandial effects of inulin, a fermentable, soluble fibre in healthy subjects. Twelve fasted subjects were studied for 6 hours after either 80g high fructose corn syrup (HFCS), 56g HFCS plus 24g inulin, or 56g HFCS drinks using a randomized, cross-over design. SCFA were higher after inulin beginning at 4 hours. FFA were lower 4 hours after inulin than 56gHFCS. GLP-1 was higher 30 minutes after inulin than 56 and 80HFCS, while ghrelin was lower from 4-6 hours after inulin. The results support the hypothesis that inulin and SCFA generated from colonic fermentation of dietary fibre may improve insulin resistance and secretion via modulation of FFA and specific gut hormones.

Background: Vitamin D may have beneficial effects on cardiometabolic disease, but the evidence is equivocal. This may be due to unaccounted confounders, such as lifestyle factors and genetic variation. We examined the association between circulating 25-hydroxyvitamin D [25(OH)D] and biomarkers of cardiometabolic disease risk, including biomarkers of inflammation, glycemic dysregulation and lipid metabolism, and a panel of 54 plasma proteomic biomarkers, and determined whether lifestyle variables and genetic variation modified these associations. Methods: Participants were from the Toronto Nutrigenomics and Health Study, an ethnically diverse population of individuals aged 20-29 years. Anthropometric measurements were obtained. Participants answered general health and lifestyle and food frequency questionnaires and provided a fasting blood sample for biochemical measurements and genotyping. Results: Across ethnic groups, women who used hormonal contraceptives (HC) had higher 25(OH)D and C-reactive protein (CRP) than women HC non-users and men. Circulating 25(OH)D was positively associated with CRP in the entire population in models not accounting for HC use. However, there was no association after accounting for HC use. 25(OH)D was also not associated with inflammatory cytokines after adjusting for HC use. 25(OH)D was inversely associated with insulin, HOMA-IR, and HOMA-Beta among Caucasians and East Asians and among men and women HC non-users. No biomarkers were associated with 25(OH)D among South Asians and women HC users, although non-significant inverse trends were observed for markers of glycemic dysregulation. Only two of the 54 plasma proteomic biomarkers were associated with 25(OH)D in women HC non-users, and none were associated in men. Among women HC users, after accounting for hormone dose, only three proteins were associated with 25(OH)D. Finally, 25(OH)D affected the association between rs2239182, a variant in the vitamin D receptor (VDR) and the pro-inflammatory cytokine interferon gamma-induced protein 10 (IP-10). However, the association was suggestive of heterosis and may have been due to chance. Conclusions: We identified a confounding effect of HC use on the association between 25(OH)D, biomarkers of inflammation and plasma proteomic biomarkers. In addition, HC use might also affect the association between 25(OH)D and biomarkers of glycemic dysregulation. Genetic variation in VDR did not modify any associations.

Background: Vitamin D may have beneficial effects on cardiometabolic disease, but the evidence is equivocal. This may be due to unaccounted confounders, such as lifestyle factors and genetic variation. We examined the association between circulating 25-hydroxyvitamin D [25(OH)D] and biomarkers of cardiometabolic disease risk, including biomarkers of inflammation, glycemic dysregulation and lipid metabolism, and a panel of 54 plasma proteomic biomarkers, and determined whether lifestyle variables and genetic variation modified these associations. Methods: Participants were from the Toronto Nutrigenomics and Health Study, an ethnically diverse population of individuals aged 20-29 years. Anthropometric measurements were obtained. Participants answered general health and lifestyle and food frequency questionnaires and provided a fasting blood sample for biochemical measurements and genotyping. Results: Across ethnic groups, women who used hormonal contraceptives (HC) had higher 25(OH)D and C-reactive protein (CRP) than women HC non-users and men. Circulating 25(OH)D was positively associated with CRP in the entire population in models not accounting for HC use. However, there was no association after accounting for HC use. 25(OH)D was also not associated with inflammatory cytokines after adjusting for HC use. 25(OH)D was inversely associated with insulin, HOMA-IR, and HOMA-Beta among Caucasians and East Asians and among men and women HC non-users. No biomarkers were associated with 25(OH)D among South Asians and women HC users, although non-significant inverse trends were observed for markers of glycemic dysregulation. Only two of the 54 plasma proteomic biomarkers were associated with 25(OH)D in women HC non-users, and none were associated in men. Among women HC users, after accounting for hormone dose, only three proteins were associated with 25(OH)D. Finally, 25(OH)D affected the association between rs2239182, a variant in the vitamin D receptor (VDR) and the pro-inflammatory cytokine interferon gamma-induced protein 10 (IP-10). However, the association was suggestive of heterosis and may have been due to chance. Conclusions: We identified a confounding effect of HC use on the association between 25(OH)D, biomarkers of inflammation and plasma proteomic biomarkers. In addition, HC use might also affect the association between 25(OH)D and biomarkers of glycemic dysregulation. Genetic variation in VDR did not modify any associations.

We determined whether children older than 1 year from non-western immigrant families had lower serum 25-hydroxyvitamin D levels than children from western born families. Children ages 1-6 years were recruited through the TARGet Kids! practice based research network. Univariable analysis revealed that non-western immigrant children had 4 nmol/L lower 25-hydroxyvitamin D (p=0.006; 95% CI:1.4-8.0) and increased odds of 25-hydroxyvitamin D <50 nmol/L (OR 1.9, 95% CI:1.3–2.9). After adjustment for known vitamin D determinants, cow’s milk intake, vitamin D supplements, season and age were significant covariates and current vitamin D supplementation had the strongest confounding effect. In order to use the ethnicity variable, we developed a new standardized geographically based closed-ended ethnicity question, which was a practical alternative to the widely used open-ended ethnicity questions. There was an association between non-western immigration and lower 25-hydroxyvitamin D in early childhood and this appears primarily related to known vitamin D determinants.

We determined whether children older than 1 year from non-western immigrant families had lower serum 25-hydroxyvitamin D levels than children from western born families. Children ages 1-6 years were recruited through the TARGet Kids! practice based research network. Univariable analysis revealed that non-western immigrant children had 4 nmol/L lower 25-hydroxyvitamin D (p=0.006; 95% CI:1.4-8.0) and increased odds of 25-hydroxyvitamin D <50 nmol/L (OR 1.9, 95% CI:1.3–2.9). After adjustment for known vitamin D determinants, cow’s milk intake, vitamin D supplements, season and age were significant covariates and current vitamin D supplementation had the strongest confounding effect. In order to use the ethnicity variable, we developed a new standardized geographically based closed-ended ethnicity question, which was a practical alternative to the widely used open-ended ethnicity questions. There was an association between non-western immigration and lower 25-hydroxyvitamin D in early childhood and this appears primarily related to known vitamin D determinants.

Background: Reduced bone mineral density (BMD) is an established complication of anorexia nervosa (AN). There is inconclusive evidence as to whether this reduction in bone mass is permanent or can be reversed with recovery from AN. The objectives of this study were to: i. determine the extent of reversal of skeletal deficits with recovery from AN, and the duration of recovery required for complete reversal, if this occurred; and, ii. evaluate the effect of key illness characteristics on BMD. Methods: Women (aged 17-40 years) who had previously received inpatient treatment for AN at one of two hospital-based programs were selected for this cross-sectional study; 514 healthy premenopausal women recruited from the community served as a control group. A detailed lifetime illness history was obtained by a Life History Calendar interview. BMD was measured by dual-energy X-ray absorptiometry (DXA) at the spine, hip and total body. Low BMD was defined as a weight and age-matched standard deviation (Z-score) of ≤ -1.5 at one or more skeletal sites. Participants were considered recovered if they had maintained a body mass index ≥ 18.5 kg/m2 and resumed regular menstruation for ≥ 1 year. Results: Of 190 AN participants, 77 were considered recovered and 113 were ill. The prevalence of low BMD was 11.7% in the recovered group, 47.3% in the ill group and 6.8% in the control group. The odds of low BMD in the recovered participants was significantly lower than in the ill participants (odds ratio [OR] = 0.17, 95% CI 0.07, 0.36, p<0.0001) and was not significantly different from the controls (OR = 1.81, 95% CI 0.79, 3.78, p=0.15). Duration of illness was associated with low BMD (OR = 1.16, 95% CI 1.08, 1.25, p<0.0001) and was negatively associated with the odds of AN recovery. Normal mean BMD values at each skeletal site were observed in women recovered ≥ 3 years. Conclusion: The results emphasize the importance of early and sustained AN recovery for the prevention and treatment of low bone mass in this population and may offer motivation for AN patients to make positive behavioural changes leading to successful, long-term recovery.

The purpose of this cluster-randomized equivalence trial was to investigate the effectiveness of two supplemental foods in children with moderate malnutrition by comparing: (i) time to recovery by survival analysis, and (ii) recovery rates (after 16 weeks of treatment). A total of 2,600 children 6-60 months of age were randomized by cluster (district) to receive 16 weeks of conventional (Corn-Soya Blended flour, CSB) or intervention (Ready-to-Use Supplemental Food, RUSF) foods. Overall, time to recovery from malnutrition (mean 74 days) and recovery rates (mean 76%) were equivalent with both foods. The time to recovery outcomes were equivalent, independent of location, whereas the recovery rate in children receiving CSB was significantly higher in the more food insecure southern region. Intra-household food sharing was significantly higher in the CSB group compared to RUSF. Overall, the response to the two different supplemental foods was equivalent for the treatment of moderately malnourished children in Ethiopia.

Gestational Diabetes Mellitus develops in 3.7-18% of Canadian women, and can cause serious maternal-fetal complications. Low-GI foods have been shown to increase β-cell function in subjects with impaired glucose tolerance. Theoretically, this effect should improve glucose tolerance and reduce the risk of gestational hyperglycemia. Thus, we aimed to explore the effects of a low-GI diet on glucose challenge test (GCT) results in women at risk for GDM. Women were randomized to receive education during pregnancy focused on incorporation of low- or medium- to high-GI foods. Key foods were provided to assist compliance. Information was obtained from medical records and questionnaires. Ninety-four (94) women completed the study. After adjustment for confounding variables, there was no significant difference in GCT values between intervention groups. Results suggest that low-GI foods do not affect blood glucose control during pregnancy.

Background: Reduced bone mineral density (BMD) is an established complication of anorexia nervosa (AN). There is inconclusive evidence as to whether this reduction in bone mass is permanent or can be reversed with recovery from AN. The objectives of this study were to: i. determine the extent of reversal of skeletal deficits with recovery from AN, and the duration of recovery required for complete reversal, if this occurred; and, ii. evaluate the effect of key illness characteristics on BMD. Methods: Women (aged 17-40 years) who had previously received inpatient treatment for AN at one of two hospital-based programs were selected for this cross-sectional study; 514 healthy premenopausal women recruited from the community served as a control group. A detailed lifetime illness history was obtained by a Life History Calendar interview. BMD was measured by dual-energy X-ray absorptiometry (DXA) at the spine, hip and total body. Low BMD was defined as a weight and age-matched standard deviation (Z-score) of ≤ -1.5 at one or more skeletal sites. Participants were considered recovered if they had maintained a body mass index ≥ 18.5 kg/m2 and resumed regular menstruation for ≥ 1 year. Results: Of 190 AN participants, 77 were considered recovered and 113 were ill. The prevalence of low BMD was 11.7% in the recovered group, 47.3% in the ill group and 6.8% in the control group. The odds of low BMD in the recovered participants was significantly lower than in the ill participants (odds ratio [OR] = 0.17, 95% CI 0.07, 0.36, p<0.0001) and was not significantly different from the controls (OR = 1.81, 95% CI 0.79, 3.78, p=0.15). Duration of illness was associated with low BMD (OR = 1.16, 95% CI 1.08, 1.25, p<0.0001) and was negatively associated with the odds of AN recovery. Normal mean BMD values at each skeletal site were observed in women recovered ≥ 3 years. Conclusion: The results emphasize the importance of early and sustained AN recovery for the prevention and treatment of low bone mass in this population and may offer motivation for AN patients to make positive behavioural changes leading to successful, long-term recovery.