Targeting Policy for Obesity Prevention: Identifying the Critical Age for Weight Gain in Women

The obesity epidemic requires the development of prevention policy targeting individuals most likely to benefit. We used self-reported prepregnancy body weight of all women giving birth in Nova Scotia between 1988 and 2006 to define obesity and evaluated socioeconomic, demographic, and temporal trends in obesity using linear regression. There were 172,373 deliveries in this cohort of 110,743 women. Maternal body weight increased significantly by 0.5 kg per year from 1988, and lower income and rural residence were both associated significantly with increasing obesity. We estimated an additional 82,000 overweight or obese women in Nova Scotia in 2010, compared to the number that would be expected from obesity rates of just two decades ago. The critical age for weight gain was identified as being between 20 and 24 years. This age group is an important transition age between adolescence and adulthood when individuals first begin to accept responsibility for food planning, purchasing, and preparation. Policy and public health interventions must target those most at risk, namely, younger women and the socially deprived, whilst tackling the marketing of low-cost energy-dense foods at the expense of healthier options

Predicting intraurban airborne PM1.0-trace elements in a port city : Land use regression by ordinary least squares and a machine learning algorithm

Airborne particulate matter (PM) has been associated with cardiovascular and respiratory morbidity and mortality, and there is some evidence that spatially varying metals found in PM may contribute to adverse health effects. We developed spatially refined models for PM trace elements using ordinary least squares land use regression (OLS-LUR) and machine leaning random forest land-use regression (RF-LUR). Two-week integrated measurements of PM1.0 (median aerodiameter < 1.0 μm) were collected at 50 sampling sites during fall (2010), winter (2011), and summer (2011) in the Halifax Regional Municipality, Nova Scotia, Canada. PM1.0 filters were analyzed for metals and trace elements using inductively coupled plasma-mass spectrometry. OLS- and RF-LUR models were developed for approximately 30 PM1.0 trace elements in each season. Model predictors included industrial, commercial, and institutional/ government/ military land use, roadways, shipping, other transportation sources, and wind rose information. RF generated more accurate models than OLS for most trace elements based on 5-fold cross validation. On average, summer models had the highest cross validation R2 (OLS-LUR = 0.40, RF-LUR = 0.46), while fall had the lowest (OLS-LUR = 0.27, RF-LUR = 0.31). Many OLS-LUR models displayed overprediction in the final exposure surface. In contrast, RF-LUR models did not exhibit overpredictions. Taking overpredictions and cross validation performances into account, OLS-LUR performed better than RF-LUR in roughly 20% of the seasonal trace element models. RF-LUR models provided more interpretable predictors in most cases. Seasonal predictors varied, likely due to differences in seasonal distribution of trace elements related to source activity, and meteorology

The relationship between anthropometric measures and cardiometabolic health in shift work: findings from the Atlantic PATH Cohort Study

PurposeTo evaluate the relationship between anthropometric measures and cardiometabolic health in shift workers compared to non-shift workers.MethodsA population health study was conducted with 4155 shift workers and 8258 non-shift workers from the Atlantic Partnership for Tomorrow’s Health (PATH) cohort. Linear and logistic regression models were used to assess the differences in anthropometric measures (body adiposity) and self-reported cardiometabolic disease outcomes (obesity, diabetes, and cardiovascular disease) between shift workers and non-shift workers.ResultsThere was a significant increased risk of cardiovascular disease, obesity, and diabetes among shift workers compared to matched controls despite higher levels of physical activity and lower levels of sedentary behaviour. Shift workers were 17% more likely to be obese (95% CI 7–27) and 27% more likely to have diabetes (95% CI 8–51). The strength of this association was demonstrated by also controlling for body mass index and fat mass index.ConclusionsShift work is associated with obesity, cardiovascular disease, and diabetes despite higher levels of physical activity and lower levels of sedentary behaviour. The association between shift work and cardiometabolic health was independent of body mass index for cardiovascular disease and diabetes, and independent of fat mass index for diabetes

Relationship between Adiponectin and apoB in individuals with diabetes in the Atlantic PATH Cohort

ContextThe increasing prevalence of obesity and diabetes greatly influences the risk for cardiovascular (CV) comorbidities and affects the quality of life of many people. However, the relationship among diabetes, obesity, and cardiovascular risk is complex and requires further investigation to understand the biological milieu connecting these conditions.ObjectiveThe aim of the current study was to explore the relationship between biological markers of adipose tissue function (adiponectin) and CV risk (apolipoprotein B) in body mass index (BMI)–matched participants with and without diabetes.DesignNested case-control study.SettingThe Atlantic Partnership for Tomorrow’s Health (PATH) cohort represents four Atlantic Canadian provinces: Newfoundland and Labrador, New Brunswick; Nova Scotia; and Prince Edward Island.ParticipantsThe study population (n = 480) was aged 35 to 69 years, 240 with diabetes and 240 without diabetes.Main Outcome MeasuresGroups with and without diabetes were matched for sex and BMI. Both measured and self-reported data were used to examine disease status, adiposity, and lifestyle factors. Immunoassays were used to measure plasma markers.ResultsIn these participants, plasma adiponectin levels were lower among those with diabetes than those without diabetes; these results were sex-specific, with a strong relationship seen in women. In contrast, in participants matched for sex and adiposity, plasma apoB levels were similar between participants with and those without diabetes.ConclusionMeasures of adiposity were higher in participants with diabetes. However, when matched for adiposity, the adipokine adiponectin exhibited a strong inverse association with diabetes

Reduced Cognitive Assessment Scores Among Individuals With Magnetic Resonance Imaging-Detected Vascular Brain Injury

Background and Purpose- Little is known about the association between covert vascular brain injury and cognitive impairment in middle-aged populations. We investigated if scores on a cognitive screen were lower in individuals with higher cardiovascular risk, and those with covert vascular brain injury. Methods- Seven thousand five hundred forty-seven adults, aged 35 to 69 years, free of cardiovascular disease underwent a cognitive assessment using the Digital Symbol Substitution test and Montreal Cognitive Assessment, and magnetic resonance imaging (MRI) to detect covert vascular brain injury (high white matter hyperintensities, lacunar, and nonlacunar brain infarctions). Cardiovascular risk factors were quantified using the INTERHEART (A Global Study of Risk Factors for Acute Myocardial Infarction) risk score. Multivariable mixed models tested for independent determinants of reduced cognitive scores. The population attributable risk of risk factors and MRI vascular brain injury on low cognitive scores was calculated. Results- The mean age of participants was 58 (SD, 9) years; 55% were women. Montreal Cognitive Assessment and Digital Symbol Substitution test scores decreased significantly with increasing age

Arsenic in Drinking Water and Urinary Tract Cancers : A Systematic Review Update

Problem: There remains uncertainty around cancer risk at lower levels of arsenic in drinking water. This study updates evidence from our previous review on the relationship between arsenic in drinking water and urinary bladder and kidney cancers (updated search January 2013 to February 2023). Method: Thirty-four studies were retained for review; six met criteria for inclusion in meta-analysis. Risk estimates for bladder and kidney cancer incidence and mortality were analyzed separately using Bayesian multilevel linear models. Results: For bladder cancer incidence, the estimated posterior mean relative risks (RRs) were 1.25 (0.92–1.73), 2.11 (1.18–4.22) and 3.01 (1.31–8.17) at arsenic concentrations of 10, 50 and 150 μg/L, respectively, with posterior probabilities of 92%, 99% and 100%, respectively, for the RRs to be >1. The corresponding RRs for kidney cancer were 1.37 (1.07–1.77), 1.95 (1.44–2.65) and 2.47 (1.74–3.52), with posterior probabilities of 100%. For bladder cancer, the posterior mean mortality ratios were 1.36 (0.35–6.39), 2.92 (1.24–7.82) and 4.88 (2.83–9.03) with posterior probabilities of 72%, 99% and 100%, respectively. Conclusions: The findings show increased bladder and kidney cancer risks at lower levels of arsenic in drinking water. Given that many people worldwide are exposed to lower levels of arsenic in drinking water, the public health impacts are substantial.Medicine, Faculty ofNon UBCPopulation and Public Health (SPPH), School ofReviewedFacultyResearcherGraduat

Diet Quality among Cancer Survivors and Participants without Cancer: A Population-Based, Cross-Sectional Study in the Atlantic Partnership for Tomorrow’s Health Project

Cancer survivors are encouraged to have a healthy lifestyle to reduce health risks and improve survival. An understanding of health behaviors, such as diet, is also important for informing post-diagnosis support. We investigated the diet quality of cancer survivors relative to participants without cancer, overall and by cancer site and time from diagnosis. A cross-sectional study design within the Atlantic PATH study was used which included 19,973 participants aged 35 to 69 years from Atlantic Canada, of whom 1,930 were cancer survivors. A diet quality score was derived from a food frequency questionnaire. Comparisons of diet quality between cancer survivors and non-cancer controls, cancer site and years since diagnosis were examined in multivariable multi-level models. Cancer survivors had a mean diet quality of 39.1 out of 60 (SD: 8.82) and a higher diet quality than participants without cancer (mean difference: 0.45, 95% CI: 0.07, 0.84) after adjustment for confounders. Odds of high diet quality was greater in breast cancer survivors than participants without cancer (OR = 1.42, 95% CI: 1.06, 1.90), and higher among survivors diagnosed ≤2 years versus >10 years (OR = 1.71, 95% CI: 1.05, 2.80). No other differences by cancer site and years since diagnosis were observed. The difference in diet quality, although statistically significant, is unlikely to be meaningful, suggesting that cancer survivors have similar diet quality as participants without cancer. There was considerable room for dietary improvement regardless of cancer status, highlighting the need for dietary interventions, especially among cancer survivors, who are at higher risk for secondary health problems.Medicine, Faculty ofNon UBCPopulation and Public Health (SPPH), School ofReviewedFacult