Temporal changes in diet quality and the associated economic burden in Canada.

A high-quality diet is associated with a reduced of risk of chronic disease and all-cause mortality. In this study, we assessed changes in diet quality and the associated economic burden in the Canadian population between 2004 and 2015. We used a prevalence-based cost-of-illness approach. We first calculated the diet quality using the Healthy Eating Index-Canada-2010 (HEI-C-2010) and 24-hour recall data from the Canadian Community Health Surveys (CCHS) on nutrition (CCHS 2004 cycle 2.2 and the CCHS-NU 2015). We then retrieved relative risks of HEI-2010 quintiles for chronic diseases from meta-analyses. Based on the proportions of the population following diets of varying qualities and these relative risks, we computed the population-attributable fractions and attributable costs (direct health care and indirect costs) by survey year (2004 and 2015) as well as by age and sex group. Costs were estimated in 2017 Canadian dollars for comparison purposes. We observed that on average the diet quality of Canadians improved between 2004 and 2015: the proportion of the Canadian population that did not eat a diet of high quality decreased from 83% to 76%. This improvement in diet quality translated in a decrease in economic burden of $133 million, down from$13.21 billion in 2004 to $13.08 billion in 2015. The economic burden decreased by$219 million among males but increased by $86 million among females. It also decreased among people under the age of 65 years ($333 million) but increased among those over 65 years ($ 200 million). Our findings suggest that, despite some temporal improvements, the diet of the majority of Canadians is of poor quality resulting in a high attributable economic burden. Policy and decision makers are encouraged to expand nutrition programs and policies and to specifically target the elderly in order to prevent chronic diseases and reduce health care costs

2-AZA-1,3-DIENES - METHODS OF SYNTHESIS AND STEREOCHEMICAL STUDIES

2-Aza-1,3-dienes bearing an activating trialkylsilyloxy group at C-3 have been prepared via three routes. The first route involves the silylation of N-acylimidates which are readily available from iminoether hydrochlorides and acid chlorides. According to a more general route towards these doubly activated dienes, N-trialkylsilylimidates and N-trialkylsilylimines derived from non-enolizable aldehydes were conveniently converted in a one-pot sequence into the corresponding azadienes by reaction with an acid chloride in the presence of triethylamine. Finally, cyclic dienes could be prepared by direct silylation of glutarimide on both oxygens with trialkylsilyltriflate in the presence of triethylamine. The configuration and conformation of 2-azadienes have been established by 1H, 13C and 15N NMR spectroscopy. © 1995 Elsevier Science Ltd