Evaluation of the Healthy Eating Food Index (HEFI)-2019 measuring adherence to Canada's Food Guide 2019 recommendations on healthy food choices

The objective of this study was to evaluate the construct validity and reliability of the Healthy Eating Food Index-2019 (HEFI-2019), which was developed to measure adherence to Canada’s Food Guide 2019 (CFG) recommendations on healthy food choices. Dietary intake data from 24-hour dietary recalls in the 2015 Canadian Community Health Survey - Nutrition were used for that purpose. Multidimensionality was examined using principal component analysis. Mean scores were compared among subgroups of the population. The association between scores and energy intake was assessed using Pearson correlations. Cronbach’s alpha was calculated to assess reliability. The estimated mean HEFI-2019 score (/80) was 43.1 (95%CI, 42.7 to 43.6) among Canadians 2 years and older. The first and 99th percentiles were 22.1 and 62.9 points. The mean HEFI-2019 score for smokers was 7.1 points lower than for non-smokers (95%CI, -8.4 to -5.8). The HEFI-2019 was weakly correlated with energy intake (r=-0.13; 95%CI, -0.20 to -0.06). The principal components analysis revealed at least 4 dimensions. Cronbach’s alpha was 0.66 (95%CI, 0.63 to 0.69). Evidence of construct validity and internal consistency support the use of the HEFI-2019 to assess adherence to CFG-2019’s recommendations on healthy food choices. Novelty: • Examination of the Health Eating Food Index (HEFI)-2019’s psychometric properties is needed prior to implementation • Analyses support the construct validity and internal consistency of the HEFI-2019 • Interpretation of the total HEFI-2019 score must be accompanied by its components’ scores, considering it assesses multiple dimensions of food choices

Development of the Healthy Eating Food Index (HEFI)-2019 measuring adherence to Canada's Food Guide 2019 recommendations on healthy food choices

The release of Canada’s Food Guide (CFG) in 2019 by Health Canada prompted the development of indices to measure adherence to these updated dietary recommendations for Canadians. This study describes the development and scoring standards of the Healthy Eating Food Index (HEFI)-2019, which is intended to measure alignment of eating patterns with CFG-2019 recommendations on food choices among Canadians aged 2 years and older. Alignment with the intent of each key recommendation in the CFG-2019 was the primary principle guiding the development of the HEFI-2019. Additional considerations included previously published indices, data on Canadians’ dietary intakes from the 2015 Canadian Community Health Survey (CCHS) – Nutrition, and expert judgement. The HEFI-2019 includes 10 components: Vegetables and fruits (20 points), Whole-grain foods (5 points), Grain foods ratio (5 points), Protein foods (5 points), Plant-based protein foods (5 points), Beverages (10 points), Fatty acids ratio (5 points), Saturated fats (5 points), Free sugars (10 points), and Sodium (10 points). All components are expressed as ratios (e.g., proportions of total foods, total beverages, or total energy). The HEFI-2019 score has a maximum of 80 points. Potential uses of the HEFI-2019 include research as well as monitoring and surveillance of food choices in population-based surveys. Novelty: ● The Healthy Eating Food Index-2019 was developed to measure adherence to the 2019 Canada's Food Guide recommendations on healthy food choices. ● The HEFI-2019 includes 10 components, of which 5 are based on foods, 1 on beverages and 4 on nutrients, for a total of 80 points.

Neuromuscular recovery from severe- and extreme-intensity exercise in men and women

Maximal voluntary contraction force (MVC), potentiated twitch force (Qpot), and voluntary activation (%VA) recover to baseline within 90s following extreme-intensity exercise. However, methodological limitations masked important recovery kinetics. We hypothesized reductions in MVC, Qpot, and %VA at task failure following extreme-intensity exercise would be less than following severe-intensity exercise, and Qpot and MVC following extreme-intensity exercise would show significant recovery within 120s but remain depressed following severe-intensity exercise. Twelve subjects (6 men) completed two severe-intensity (40, 50%MVC) and two extreme-intensity (70, 80%MVC) isometric knee-extension exercise bouts to task failure (Tlim). Neuromuscular function was measured at baseline, Tlim, and through 150s of recovery. Each intensity significantly reduced MVC and Qpot compared to baseline. MVC was greater at T¬lim (p<0.01) and at 150s of recovery (p=0.004) following exercise at 80%MVC compared to severe-intensity exercise. Partial recovery of MVC and Qpot were detected within 150s following Tlim for each exercise intensity; Qpot recovered to baseline values within 150s of recovery following exercise at 80%MVC. No differences in %VA were detected pre- to post-exercise or across recovery for any intensity. Although further analysis showed sex-specific differences in MVC and Qpot, future studies should closely examine sex-dependent responses to extreme-intensity exercise. It is clear, however, that these data reinforce that mechanisms limiting exercise tolerance during extreme-intensity exercise recover quickly. NOVELTY: •Severe- and extreme-intensity exercise cause independent responses in fatigue accumulation and the subsequent recovery time courses. •Recovery of MVC and Qpot occurs much faster following extreme-intensity exercise in both men and women.

High-intensity interval resistance training (HIIRT) improves liver gluconeogenesis from lactate in Swiss mice

High-intensity physical exercise favors anaerobic glycolysis and increases lactatemia. Lactate is converted back to glucose in the liver, so that the lactate threshold, an indicator of physical performance, must be related to the gluconeogenic capacity of the liver. This research assessed the effect of a high-intensity interval resistance training (HIIRT) on liver gluconeogenesis from lactate. Swiss mice were trained (groups T) on vertical ladder with overload of 90% of their maximal load. Control animals remained untrained (groups C0 and C8). In situ liver perfusion with lactate and adrenaline was performed in rested mice after six hours of food deprivation. There were larger outputs of glucose (T6 71.90%, T8 54.53%) and pyruvate (T8 129.28%) (representative values for 4 mM lactate) in the groups trained for six or eight weeks (T6 and T8), and of glucose in the presence of adrenaline in group T8 (280%). The content of PEPCK, an important regulatory enzyme of the gluconeogenic pathway, was 69.13% higher in group T8 than in the age-matched untrained animals (C8). HIIRT augmented liver gluconeogenesis from lactate and this might improve the lactate threshold. Bullet points: The liver metabolizes lactate from muscle into glucose. Physical training may enhance the gluconeogenic capacity of the liver. As lactate clearance by the liver improves, lactate threshold is displaced to higher exercise intensities.

Muscle hypertrophy and strength gains after resistance training with different volume matched loads: a systematic review and meta-analysis.

The purpose of this paper was to conduct a systematic review and meta-analysis of studies that compared muscle hypertrophy and strength gains between resistance training protocols employing very low (VLL<30% of 1RM or >35 RM), low (LL30%-59% of 1RM, or 16–35 RM), moderate (ML60%-79% of 1RM, or 8 -15RM) and high load (HL≥80% of 1RM, or ≤7 RM) with matched volume loads (sets x reps x weight). A pooled analysis of the standardized mean difference for 1RM strength outcomes across the studies showed a benefit favoring HL vs. LL and vs. ML; and favoring ML vs. LL. Results from LL and VLL indicated little difference. A pooled analysis of the standardized mean difference for hypertrophy outcomes across all studies showed no differences between the training loads. Our findings indicate that, when volume load is equated between conditions, the highest loads induce superior dynamic strength gains. Alternatively, hypertrophic adaptations are similar irrespective of the magnitude of load. NOVELTY BULLETS: • Training with higher loads elicits greater gains in 1RM muscle strength when compared to lower loads, even when volume load is equated between conditions. • Muscle hypertrophy is similar irrespective of the magnitude of load, even when volume load is equated between conditions.

Intakes of nutrients and food categories in Canadian children and adolescents across levels of sugars intake: Cross-sectional analyses of the Canadian Community Health Survey 2015 Public Use Microdata File

Dietary recommendations to reduce sugars consumption may influence choices of sugars-containing foods and affect the intake of key micronutrients. We compared intakes of nutrients and food sources stratified by quintiles of total sugars in Canadian children (2-8y) and adolescents (9-13y, 14-18y) using 24-hour dietary recalls from the 2015 Canadian Community Health Survey-Nutrition. Energy intakes did not differ across quintiles of sugars intake. Those with lower sugars intakes (Q1/Q3) generally had higher protein, fat, sodium, niacin, folate and zinc and lower vitamin C compared to those with the highest sugars intakes (Q5). Q1 also had lower potassium but higher saturated fat compared to Q5. Further, Q1 generally had higher protein, fats and niacin compared to Q3, while children in Q3 had higher potassium and riboflavin and older adolescents had higher calcium and fibre. Q5 had highest intakes of multiple sugar-containing food categories (e.g. fruit, confectionary, milks, cakes/pies/pastries), with higher sugars-sweetened beverages in adolescents. Q3 had higher fruit, milks and fruit juice compared to Q1 and lower sugars/syrups/preserves, confectionary, and fruit juices compared to Q5. Certain nutrient-dense food sources of sugars (fruit, milks) may help increase key nutrients (potassium, calcium, fibre) in older adolescents with low sugars intakes. However, in those with the highest sugars intakes, nutrient-poor foods may displace nutrient-dense foods. Novelty: • Canadian children and adolescents with lower sugars intake have better intakes of some nutrients • Energy intakes did not differ across sugars intake • Older adolescents with mean intakes of total sugars had better intakes of some key nutrients (potassium, calcium, fibre)

Effect of Yoga on Health-Related Outcomes in People at Risk of Fractures: A Systematic Review

We summarized the effects of yoga on health-related outcomes and adverse events in men and postmenopausal women ≥50 years-old at increased risk of fracture, to inform the updated Osteoporosis Canada clinical practice guidelines. Six databases were searched for observational studies, randomized controlled trials and case series. Certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation handbook. Nine studies were included and reported using narrative syntheses due to the limited available evidence. Overall, the available evidence was of very low certainty. There was no effect of yoga on health-related quality of life in randomized trials. Effects on other health-related outcomes were mixed or not available in the literature. Five studies reported no adverse events directly related to the study intervention, and two studies did not report whether adverse events occurred. However, two case series reported vertebral fractures related to yoga participation, possibly due to excessive spinal flexion. Due to the limited and very low certainty evidence, guideline developers will need to draw indirect evidence from yoga studies among middle aged or older adults that are not at fracture risk. (PROSPERO: CRD42019124898) NOVELTY BULLETS: • Evidence in general was of very low certainty. • Yoga had no effect on health-related quality of life in randomized trials. Evidence was mixed or unavailable for other outcomes. • Case studies reported yoga poses involving spinal flexion coincided with incidents of vertebral compression fracture among older adults with increased fracture risk.

Cardiometabolic risk, biological sex, and age do not share an interactive relationship with cognitive function: A cross-sectional analysis of the Canadian Longitudinal Study on Aging

It is unclear whether cardiometabolic risk shares an interactive relationship with age-associated differences in cognition, and whether this relationship varies by biological sex. We conducted a cross-sectional analyses using baseline data from the Canadian Longitudinal Study on Aging (2010-2015) to examine whether: 1) cardiometabolic risk has an interactive relationship with age-associated cognition; and 2) interactive effects are sex-dependent. We measured memory, executive function, and verbal fluency in the Comprehensive cohort (n=25,830; 45-86 years). Each cognitive domain was modeled using restricted cubic splines for age and each cardiometabolic risk factor (HbA1c, HSCRP, TG, and LDL and HDL cholesterol). Sex was included as a predictor in all models. Wald chi-square statistics were used to determine the relative importance of age, cardiometabolic risk, sex, and their interactive effects on cognition. Age was the most important variable in each model (proportion χ2=34-48%). Biological sex was the second most important variable for memory (proportion χ2=26%), but was unimportant for executive function and verbal fluency (proportion χ2=3-5%). Cardiometabolic risk factors were unimportant predictors in each model (proportion χ2=1-3%). Two and three-way interactions between cardiometabolic risk, age, and sex were also unimportant (proportion χ2=0-2%). Thus, cardiometabolic risk factors did not meaningfully account for age-associated differences in cognition, and these associations (or lack thereof) did not vary by sex. Novelty: Males have poorer age-associated cognitive performance than females Females and males differ in cardiometabolic risk across middle and older adulthood Cardiometabolic risk has a small association with age-associated cognition, and there are no sex differences in this relationship

Naringin Prevents Bone Damage in the Experimental Metabolic Syndrome Induced by a Fructose Rich Diet

We have analyzed the effect of naringin (NAR), a flavonoid from citric fruits, on bone quality and bone biomechanical properties as well as the redox state of bone marrow in rats fed a fructose rich diet (FRD), an experimental model to mimic human metabolic syndrome. NAR blocked the enhancement in the number of osteoclasts and adipocytes and the decrease in the number of osteocytes and osteocalcin (+) cells caused by FRD. The trabecular number was significantly higher in the FRD+NAR group. FRD induced a decrease in femoral trabecular and cortical bone mineral density, which was blocked by NAR. The fracture and ultimate loads were also decreased by the FRD and FRD+NAR groups. NAR increased the number of nodes to terminal trabecula, the number of nodes to node trabecula, the number of nodes, and the number of nodes with two terminals, and decreased the Dist (mean size of branches) value. Bone marrow catalase activity was decreased by the FRD, an effect prevented by NAR. In conclusion, FRD produces detrimental effects on long bones, which are associated with oxidative stress in bone marrow. Most of these changes are avoided by NAR through its antioxidant properties and promotion of bone formation. Novelty bullets: • Fructose rich diet produces detrimental effects on long bones, which are associated with oxidative stress in bone marrow. • Most of these changes are avoided by Naringin through its antioxidant properties and promotion of bone formation.