A Longitudinal Dataset of Incidence and Intervention Policy Impacts Regarding the COVID-19 Pandemic in Canadian Provinces

One year after identifying the first case of the 2019 coronavirus disease (COVID-19) in Canada, federal and provincial governments are still struggling to manage the pandemic. Provincial governments across Canada have experimented with widely varying policies in order to limit the burden of COVID-19. However, to date, the effectiveness of these policies has been difficult to ascertain. This is partly due to the lack of a publicly available, high-quality dataset on COVID-19 interventions and outcomes for Canada. The present paper provides a dataset containing important, Canadian-specific data that is known to affect COVID-19 outcomes, including sociodemographic, climatic, mobility and health system related information for all 10 Canadian provinces and their health regions. This dataset also includes longitudinal data on the daily number of COVID-19 cases, deaths, and the constantly changing intervention policies that have been implemented by each province in an attempt to control the pandemic

Association between Dietary Macronutrient Intake and Symptoms in Uninvestigated Dyspepsia: Evidence from a Population-Based, Cross-Sectional Study

(1) Background: Limited evidence from laboratory-based studies suggests that specific dietary macronutrients, particularly fat, can induce dyspeptic symptoms. Through a population-based study, we investigated the relationship between dietary macronutrients and dyspeptic symptoms and sought to determine macronutrient intake thresholds to predict or prevent dyspepsia and reduce symptoms in patients with dyspepsia. (2) Methods: A total of 4763 Iranian people were enrolled in this population-based, cross-sectional study. Uninvestigated dyspepsia (UD) and its symptoms, including postprandial fullness, early satiation, and epigastric pain, were evaluated using a modified Persian version of the Rome III criteria. The dietary intakes of participants were evaluated using a validated food–frequency questionnaire. Receiver operating characteristic (ROC) curve analysis was used to calculate threshold intakes of dietary macronutrients to prevent UD in the general population. The analysis was then repeated in those with UD to calculate intake thresholds for reducing UD symptoms. (3) Results: Early satiation occurred in 6.3% (n = 302), postprandial fullness in 8.0% (n = 384) and epigastric pain in 7.8% (n = 371) of participants. The prevalence of UD was 15.2%. Compared with individuals without UD, those with UD had a lower intake of carbohydrates (48.2% vs. 49.1%) and a higher intake of fats (38.3% vs. 37.4%), while protein and energy intakes did not differ. Higher dietary fat and protein intakes were associated with a higher prevalence of postprandial fullness and epigastric pain, respectively. Macronutrient intakes to predict UD in the general population were 14.7% from protein, and >37.7% from fats. Carbohydrate, protein, and fat intakes to prevent symptoms among those with UD were calculated to be >48.2%, <14.6%, and <38.6%, respectively. (4) Conclusion: Higher carbohydrate intake and lower fat or protein intakes were associated with a lower likelihood of UD. Prospective studies carefully manipulating dietary macronutrient composition are warranted to investigate the value of dietary changes to improve symptoms in people with UD.Shahram Agah, Azadeh Aminianfar, Ammar Hassanzadeh Keshteli, Vida Bitarafan, Peyman Adibi, Ahmad Esmaillzadeh, and Christine Feinle-Bisse

The relation between breakfast consumption and psychological symptoms among adults

Background: Breakfast skipping was related to obesity and obesity has been associated with psychological disorders, but limited data are available linking breakfast consumption to psychological symptoms. Objective: The association between breakfast consumption and psychological disorders, including depression and anxiety, was studied among Iranian adults. Methods: This cross-sectional study was conducted on 4378 healthy adults in Isfahan, Iran. Breakfast consumption was assessed using a validated detailed dietary habits’ questionnaire; and depression and anxiety using an Iranian validated Hospital Anxiety and Depression Scale (HADS) questionnaire. Psychological distress was also examined by means of Iranian validated version of General Health Questionnaire. Findings: Overall, 611 numbers (13.95%) of study participants had anxiety, 1253 numbers (28.62%) depression, and 1015 numbers (23.18%) probable mental disorders symptoms. After controlling for the confounding variables, participants with every day breakfast consumption had lower odds for depression symptoms (OR: 0.49; 95% CI: 0.36-0.66) compared with those with the least frequent intake of breakfast, even after further adjustment for BMI (OR: 0.47; 95% CI: 0.34- 0.63). Frequent breakfast consumption was inversely associated with anxiety before and after controlling for BMI (P<0.001). The same findings were obtained for probable mental disorders (P<0.001). Conclusion: This study showed an inverse relation between breakfast consumption and symptoms of depression, anxiety, and probable mental disorders among Iranian adults. Further prospective studies are needed to confirm these findings

Association between healthy lifestyle score and upper gastrointestinal disorders in Iranian adults

Background and Objective: Although lifestyle-related factors have separately been examined in relation to functional gastrointestinal disorders (FGIDs), there is no epidemiologic data on the combined association of lifestyle factors with these conditions. We aimed to examine how combinations of several lifestyle factors were associated with functional dyspepsia (FD), its symptoms and gastro-esophageal reflux disease (GERD) in a large group of Iranian adults. Methods: This descriptive -analytic study was conducted on 3363 Iranian adults (19-70 yr), whom were working in 50 health centers across Isfahan province in Iran during 2012. We used easy non-random sampling to select participants. The “healthy lifestyle score” for each participant was calculated by summing up the binary score given for five lifestyle factors, including dietary habits, dietary intakes, psychological distress, smoking and physical activity. A dish-based 106-item semi-quantitative validated food frequency questionnaire, General Practice Physical Activity Questionnaire, General Health Questionnaire and other pre-tested questionnaires were used to assess the components of healthy lifestyle score. A validated Persian version of ROME III questionnaire was used, to assess functional gastrointestinal disorders. Results: The prevalence of FD and GERD among study participants was 14.5 and 23.6%, respectively. After adjustment for potential confounders, we found that individuals with the highest score of healthy lifestyle had 79 and 74% lower odds of FD (95% CI: 0.05-0.92, OR: 0.21, P=0.03) and GERD (95% CI: 0.09-0.69, OR: 0.26, P=0.01), respectively, compared with those with the lowest score. They were also less likely to have early satiation (95% CI: 0.11-0.73, OR: 0.28, P=0.001), postprandial fullness (95% CI: 0.09-0.50, OR: 0.22, P<0.001) and epigastric pain (95% CI: 0.21-0.92, OR: 0.44, P=0.03). In addition to the combined healthy lifestyle score, low levels of psychological distress, a healthy diet, healthy dietary habits and non-smoking were separately associated with FGIDs (P<0.05). Conclusion: This study showed that adherence to a healthy lifestyle was associated with lower odds of GERD, FD and its symptoms in this group of Iranian adults. Individual lifestyle-related factors were also associated with these conditions

Editorial: metabolomic biomarkers for colorectal adenocarcinoma and in the differentiation between irritable bowel syndrome and ulcerative colitis in clinical remission - confounded by the gut microbiome? Authors' reply

status: publishe

Comparison of the metabolomic profiles of irritable bowel syndrome patients with ulcerative colitis patients and healthy controls: new insights into pathophysiology and potential biomarkers

BACKGROUND: Evaluation of the metabolomic profile of patients with irritable bowel syndrome offers an opportunity to identify novel pathophysiological targets and biomarkers that could discriminate this disorder from related conditions. AIM: To identify potential urinary biomarkers that discriminate irritable bowel syndrome patients from ulcerative colitis patients in remission and healthy controls and to explore the pathophysiology of irritable bowel syndrome using a metabolomic approach. METHODS: Urine samples were collected from 39 irritable bowel syndrome patients, 53 ulcerative colitis patients in clinical remission and 21 healthy controls. Urinary metabolites were identified and quantified using direct infusion/liquid chromatography tandem mass spectrometry and gas-chromatography mass spectrometry. RESULTS: Patients with irritable bowel syndrome had a unique urinary metabolome that could separate them from ulcerative colitis patients with an area under the curve = 0.99 (95% confidence interval 0.95-1.00). The most important metabolites for this separation were a group of amino acids and organic acids. In addition, subjects with irritable bowel syndrome could be discriminated from healthy controls using their metabolic fingerprints. Irritable bowel syndrome patients had lower urinary Phosphatidyl choline acyl-alkyl C38:6, dopamine and p-hydroxybenzoic acid than healthy controls. Levels of some urinary metabolites including histamine correlated significantly with irritable bowel syndrome symptom severity scores. CONCLUSIONS: Irritable bowel syndrome patients have a unique urinary metabolomic profile compared to ulcerative colitis patients in clinical remission or healthy subjects. These data suggest that metabolomic profiling may provide important insights into pathophysiology and testable biomarkers to discriminate irritable bowel syndrome from other disorders that can mimic this condition and can be used to assess its severity and identify potential novel pathophysiological pathways.status: publishe

Anti-Inflammatory Diet Prevents Subclinical Colonic Inflammation and Alters Metabolomic Profile of Ulcerative Colitis Patients in Clinical Remission

A relationship between ulcerative colitis (UC) and diet has been shown in epidemiological and experimental studies. In a 6-month, open-label, randomized, placebo-controlled trial, adult UC patients in clinical remission were randomized to either an &ldquo;Anti-inflammatory Diet (AID)&rdquo; or &ldquo;Canada&rsquo;s Food Guide (CFG)&rdquo;. Menu plans in the AID were designed to increase the dietary intake of dietary fiber, probiotics, antioxidants, and omega-3 fatty acids and to decrease the intake of red meat, processed meat, and added sugar. Stool was collected for fecal calprotectin (FCP) and microbial analysis. Metabolomic analysis was performed on urine, serum, and stool samples at the baseline and study endpoint. In this study, 53 patients were randomized. Five (19.2%) patients in the AID and 8 (29.6%) patients in the CFG experienced a clinical relapse. The subclinical response to the intervention (defined as FCP &lt; 150 &micro;g/g at the endpoint) was significantly higher in the AID group (69.2 vs. 37.0%, p = 0.02). The patients in the AID group had an increased intake of zinc, phosphorus, selenium, yogurt, and seafood versus the control group. Adherence to the AID was associated with significant changes in the metabolome, with decreased fecal acetone and xanthine levels along with increased fecal taurine and urinary carnosine and p-hydroxybenzoic acid levels. The AID subjects also had increases in fecal Bifidobacteriaceae, Lachnospiraceae, and Ruminococcaceae. In this study, we found thatdietary modifications involving the increased intake of anti-inflammatory foods combined with a decreased intake of pro-inflammatory foods were associated with metabolic and microbial changes in UC patients in clinical remission and were effective in preventing subclinical inflammation