Iron Status and Associated Factors among Canadian Women: Results from the Canadian Health Measures Survey

Cardiometabolic health, socioeconomic status, and 2019 Canada's Food Guide Food Choices Assessment Score: findings from the Canadian Health Measures Survey

Suboptimal diets are linked to higher cardiometabolic risks and influenced by socioeconomic status. In 2019, Health Canada released an updated Canda's Food Guide (CFG) supported with Canada's Dietary Guidelines (CDG) to help Canadians achieve healthy diet. This study aims to investigate the association between food choices assessed by a Food Choices Assessment Score (FCAS) according to 2019 CFG/CDG, and socioeconomic status and cardiometabolic risk factors among Canadian adults. Dietary choices of Canadian adults (n = 6352) from the food frequency questionnaire data of the Canadian Health Measures Survey cycles 5 and 6 (2016-2019) were used. Canadian adults with post-secondary education and high household income were associated with higher FCAS (+6.2; 95%CI 4.2, 8.2) and (+2.1; 95%CI 0.3, 3.8), respectively. Compared with the lowest quintile of the FCAS, Canadians in the highest quintile of the FCAS had lower odds of elevated BMI (0.63; 95%CI 0.44, 0.91), elevated WC (0.51; 95%CI 0.27, 0.97) in females but not in males, elevated systolic (0.69; 95%CI 0.48, 0.97), diastolic blood pressure (0.69; 95%CI 0.50, 0.96), TC (0.59; 95%CI 0.39, 0.89), non-HDL-C (0.51; 95%CI 0.31, 0.86), LDL-C (0.60; 95%CI 0.38, 0.95), Apo-B (0.62; 95%CI 0.39, 0.96), HbA1C (0.53; 95%CI 0.31, 0.93), FBG (0.62; 95%CI 0.4, 0.94), HOMA-IR (0.60; 95%CI 0.39, 0.91), and hs-CRP (0.59; 95%CI 0.36, 0.96). HDL-C and TG were not associated with FCAS. These analyses suggest strong associations between dietary choices, aligned with 2019 CFG/CDG as measured by the FCAS, and socioeconomic status and better cardiometabolic health among Canadian adults.

Animal board invited review: The contribution of red meat to adult nutrition and health beyond protein

Red meat has been a critical part of human diets for millennia, providing a source of high-quality protein, micronutrients and essential fatty acids. However, as societies evolved and industrialisation reshaped our food systems, there has been a noticeable shift in meat-eating trends driven by concerns about the environmental impact of meat production and its potential risk to health. Yet, despite falling out of favour with some dietary experts and influencers, meat has an important role in a healthy diet and most adults still consume it. This article explores the nutritional value of red meat, authorised nutrition and health claims, how red meat fits into diet, providing the example of the United Kingdom (UK), and the health benefits and risks associated with both eating and avoiding red meat. Benefits of red meat include nutrient density and bioavailability while risks include colorectal cancer at high intakes of processed meats, based on observational studies. Benefits of meat-free diets include a lower risk of chronic diseases, based on observational studies, while risks include nutrient inadequacy, higher bone fracture risk and low protein quality. Hence, a wholesale shift to plant-based diets may not benefit adults who are vulnerable to sub-optimal nutrient intakes, such as women of child-bearing age and the elderly. More evidence from randomised controlled trials is recommended to fully understand the benefits and risks of both meat-containing and meat-free diets.

Population iron status in Canada: results from the Canadian Health Measures Survey 2012-2019

BACKGROUND

In Canada, population iron status estimates are dated (2009-2011) and did not consider the presence of inflammation.

OBJECTIVE

To update iron status estimates in Canada using serum ferritin (SF) and evaluate different correction methods for inflammation based on c-reactive protein (CRP).

METHODS

Data from the Canadian Health Measures Survey cycles 3 to 6 (2012-2019) formed a multi-year, cross-sectional, nationally representative sample (3 to 79 years) (n=21,453). WHO cut-offs for SF and hemoglobin were used to estimate iron deficiency (ID), iron deficiency anemia (IDA), anemia and elevated iron stores. ID was first estimated without considering inflammation. Correction approaches evaluated were: excluding individuals with CRP>5 mg/L; using modified SF cut-offs; and regression correction.

RESULTS

Total population uncorrected prevalence estimates were 7% (95%CI: 6.2, 7.9) ID, 6.1% (95%CI: 5.2, 7.0) anemia and 2.0% (95%CI: 1.6, 2.4) IDA. Uncorrected prevalence of ID was highest among females of reproductive age with 21.3% (95%CI: 17.6, 25.0) and 18.2% (95%CI: 15.4, 21.1) in 14-18y and 19-50y respectively. Corrected ID estimates were higher compared to uncorrected values, independent of the correction approach. Regression correction led to a moderate increase in prevalence to 10.5% for the total population while applying the higher modified SF cut-offs (70μg/L for those over 5y) led to the largest increases in prevalence, to 12.6%. Applying modified cut-offs led to implausibly high ID estimates among those with inflammation. Elevated iron stores were identified in 17.2% (95%CI: 16.2, 18.2) of the population, mostly in adult males.

CONCLUSIONS

Correction methods for estimating population iron status need further research. Considering the fundamental drawbacks of each method, uncorrected and regression corrected estimates provide a reasonable range for ID in the Canadian population. Important sex-based differences in iron status and a public health ID problem of moderate magnitude among females of reproductive age are evident in Canada.