Browsing by Author "Friedenreich, Christine"

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    Association between glycemic load and cognitive function in community-dwelling older adults: results from the Brain in Motion study
    (2017) Garber, Anna; Poulin, Marc; Friedenreich, Christine; Csizmadi, Ilona; Longman, Richard S.; Sajobi, Tolulope; Shearer, Jane
    Background: Impaired glucose tolerance is a risk factor for non-age-related cognitive decline and is also associated with measures of physical activity (PA) and cardiorespiratory fitness (CRF). A low glycemic load (GL) diet can aid in the management of blood glucose levels, but little is known about its effect on cognition with poor glucoregulation. Objective: The aim of this thesis was to assess the relation between GL and cognitive function by glucoregulation, and possible mediatory effects by CRF and PA, in older adults. Design: A cross-sectional analysis of 194 cognitively healthy adults aged ≥55 years (mean=65.7, SD=6.1) was conducted. GL was assessed using a quantitative food frequency questionnaire, and glucoregulation was characterized on the HOMA-IR index. Subjects also completed a cognitive assessment, CRF testing, a validated self-reported PA questionnaire, and a blood draw. Multiple linear regression models adjusted for significant covariates were used to evaluate the relation between GL and cognition, and mediation analysis was used to assess potential mediatory effects by CRF and PA. Results: GL was inversely associated with global cognition (β=-0.014; 95% CI -0.024, -0.0036) and figural memory (β =-0.035; 95% CI -0.052, -0.018) in subjects with poor glucoregulation. Neither CRF nor PA mediated these relations. In subjects with good glucoregulation, no association was found between GL and cognitive function (p>0.05). Conclusions: A low GL diet is associated with better cognitive function in older adults with poor glucoregulation. This study provides supportive evidence for the role of GL in maintaining better cognitive function during the aging process.
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    Associations between the Neighbourhood Food Environment, Neighbourhood Socioeconomic Status and Diet Quality in Canadian Adults
    (2016-02-05) McInerney, Maria; McCormack, Gavin; Csizmadi, Ilona; Friedenreich, Christine
    High quality diet is integral for maintaining health and preventing chronic diseases. Diet quality has many determinants that interact across the intra-individual, inter-individual, physical environment, and policy levels of influence. This thesis presents a novel method to create Canada’s Food Guide serving equivalents in the Canadian Diet History Questionnaire II nutrient database for the purpose of deriving the Canadian Healthy Eating Index (C-HEI). The C-HEI was used as a measure of diet quality in an analytical study investigating the potential independent and joint effects of the neighbourhood food environment and neighbourhood socioeconomic status on diet quality of adults living in Calgary, Alberta. The density of all neighbourhood food destinations, but not neighbourhood socioeconomic status independently or jointly with neighbourhood food destination density, plays a small role in diet quality of Calgary adults. With additional research, these findings may help inform population level interventions aimed at improving diet quality for all Canadians.
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    Determining research priorities for young women with breast cancer: A priority setting partnership
    (2021-09) Keehn, Alysha; Quan, May Lynn; Friedenreich, Christine; Elliott, Meghan
    BACKGROUND: Women under the age of 40 years account for approximately 5-7% of breast cancer cases. Young women with breast cancer (YWBC) often have a biologically distinct disease and unique considerations compared to older women, leading to significant opportunities for research to improve patient outcomes and quality of life. Potential disconnects between research being performed and that deemed meaningful and relevant to patients may impede clinical uptake and knowledge translation. The James Lind Alliance (JLA) brings patients, caregivers and clinicians together in priority setting partnerships (PSPs) to determine key priorities in health research. OBJECTIVE: To determine the top-10 research priorities for YWBC using an established, multi-stakeholder, priority setting methodology. METHODS: An adapted JLA PSP process was used to determine research priorities for YWBC. A balanced, 15-member steering committee composed of patients, caregivers and clinician representatives from across Canada was created to coordinate and implement the activities of the PSP including the creation, approval and dissemination of a nation-wide survey. Survey responses were received in text-based format, sorted and separated into themes, and eventually organized into scientific questions. A raw list of potential uncertainties underwent a reduction process whereby duplicates were combined and out of scope questions were removed. The steering committee voted on a shortlist of 50 questions to be used in the interim prioritization survey. The interim prioritization survey was disseminated back to participants and a reverse ranking process was used to identify the top-30 priorities brought to the final consensus meeting. The final meeting took place through an interactive, virtual, one-day workshop using a nominal group technique with patients, caregivers, clinicians and other stakeholders from across Canada and culminated in consensus on the top-10 priorities for YWBC. RESULTS: One thousand, four hundred and twelve responses were generated from 359 respondents (75% patient generated). A raw list of 423 unique questions were developed once out of scope (n=278) and repeat questions (n=711) were eliminated. Of the remaining questions, 209 were deemed to be gaps in knowledge pertaining specifically to YWBC while the remainder were questions about breast cancer in general. This list was reduced through iterative voting to a Top-50 by the steering committee, Top-30 through the interim prioritization survey and eventual a Top-10 through a final consensus meeting. The priority areas identified include: surgical outcomes, Tamoxifen duration, effect of interruption to hormone blockade, biological markers to detect microscopic disease, long-term consequences of treatment induced menopause, lifestyle and modifiable factors to reduce recurrence, prediction tools for identifying young women at high risk of developing breast cancer, the impact of inflammatory and autoimmune diseases on developing breast cancer in the young, indications for more aggressive treatment and quality improvement to reduce the interval period between diagnostic treatment and diagnosis. CONCLUSION: This work is part of an integrative knowledge translation strategy in partnership with the RUBY study and will inform future research moving forward. Additionally, it be of interest to the broader early onset breast cancer community as well as funding agencies.
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    Interactions between Neighbourhood Urban Form and Socioeconomic Status and Their Associations with Anthropometric Measurements in Canadian Adults
    (2017-09-05) McCormack, Gavin R.; Friedenreich, Christine; McLaren, Lindsay; Potestio, Melissa; Sandalack, Beverly; Csizmadi, Ilona
    Neighbourhood-level socioeconomic composition and built context are correlates of weight-related behaviours. We investigated the relations between objective measures of neighbourhood design and socioeconomic status (SES) and their interaction, in relation to self-reported waist circumference (WC), waist-to-hip ratio, and body mass index (BMI) in a sample of Canadian adults ( from 12 Calgary neighbourhoods). WC and BMI were higher among residents of disadvantaged neighbourhoods, independent of neighbourhood design (grid, warped grid, and curvilinear street patterns) and individual-level characteristics (sex, age, education, income, dog ownership, marital status, number of dependents, motor vehicle access, smoking, sleep, mental health, physical health, and past attempts to modify bodyweight). The association between neighbourhood-level SES and WC was modified by neighbourhood design; WC was higher in disadvantaged-curvilinear neighbourhoods and lower in advantaged-grid neighbourhoods. Policies making less obesogenic neighbourhoods affordable to low socioeconomic households and that improve the supportiveness for behaviours leading to healthy weight in low socioeconomic neighbourhoods are necessary.
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    The relationship between cluster-analysis derived walkability and local recreational and transportation walking among Canadian adults
    (Elsevier, 2012-09) McCormack, Gavin R; Friedenreich, Christine; Sandalack, Beverly A; Giles-Corti, Billie; Doyle-Baker, Patricia K; Shiell, Alan
    We investigated the association between objectively-assessed neighborhood walkability and local walking among adults. Two independent random cross-sectional samples of Calgary (Canada) residents were recruited. Neighborhood-based walking, attitude towards walking, neighborhood self-selection, and socio-demographic characteristics were captured. Built environmental attributes underwent a two-staged cluster analysis which identified three neighborhood types (HW: high walkable; MW: medium walkable; LW: low walkable). Adjusting for all other characteristics, MW (OR 1.40, p < 0.05) and HW (OR 1.34, approached p < 0.05) neighborhood residents were more likely than LW neighborhood residents to participate in neighborhood-based transportation walking. HW neighborhood residents spent 30-min/wk more on neighborhood-based transportation walking than both LW and MW neighborhood residents. MW neighborhood residents spent 14-min/wk more on neighborhood-based recreational walking than LW neighborhood residents. Neighborhoods with a highly connected pedestrian network, large mix of businesses, high population density, high access to sidewalks and pathways, and many bus stops support local walking.
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    Socio-Economic Equity in Neighbourhood Built Environments and Physical Activity
    (2022-09-21) Christie, Chelsea Desirée; McCormack, Gavin; Friedenreich, Christine; Vena, Jennifer
    Despite well-established health benefits, most adults in Canada do not engage in sufficient physical activity to meet physical activity recommendations. Neighbourhood built environment characteristics, such as pedestrian connectivity, population density, and land use mix are consistently found to be positively associated with physical activity. However, much of this evidence has been derived from studies with samples of adults with higher socioeconomic status (SES). It remains unclear whether similar associations between neighbourhood built environments and physical activity exist amongst adults with lower SES. Furthermore, there is little evidence regarding the extent to which access to physical activity-supportive neighbourhood built environments is equitable across SES groups. The three studies presented in this thesis address these knowledge gaps. The aim of this research was to increase understanding about socioeconomic equity in the associations between neighbourhood built environments and physical activity. The first study involved a systematic review of Canadian research and found that neighbourhood built environment characteristics, such as greenness, density of destinations, and overall walkability were positively associated with physical activity among adults with low SES. The second study included cross-sectional and longitudinal analyses of Alberta’s Tomorrow Project data and found that associations between neighbourhood built environments and walking were similar across SES groups. The third study included a cross-sectional analysis of national data from the Canadian Active Living Index and the Canadian Census and found that associations between neighbourhood walkability and home values were conditional on city size and the proportion of detached homes within the neighbourhood. For small and medium sized cities, neighbourhood-level home values tended to be approximately the same (or less expensive) across neighbourhood walkability levels. Within larger cities, however, home values were higher in neighbourhoods with higher walkability. Thus, interventions to increase the amount of affordable housing in high walkable neighbourhoods may be needed in larger cities. Findings from this thesis suggest that modifying existing neighbourhood built environments or building new neighbourhoods to be more supportive of physical activity may be effective ways to increase population-level physical activity without exacerbating socioeconomic disparities in physical activity.