Purpose: To examine whether Indigenous identity and food insecurity combined were associated with self-reported poor health.Methods: Data from the 2015-2016 Canadian Community Health Survey and multiple logistic regression were employed to evaluate the association between Indigenous identity, household food insecurity, and health outcomes, adjusted for individual and household covariates. The Alexander Research Committee in Alexander First Nation (Treaty 6) reviewed the manuscript and commented on the interpretation of study findings.Results: Data were from 59082 adults (3756 Indigenous). The prevalence of household food insecurity was 26.3% for Indigenous adults and 9.8% for non-Indigenous adults (weighted to the Canadian population). Food-secure Indigenous adults, food-insecure non-Indigenous adults, and food-insecure Indigenous adults had significantly (p < 0.001) greater odds of poor health outcomes than food-secure non-Indigenous adults (referent group). Food-insecure Indigenous adults had 1.96 [95% CI:1.53,2.52], 3.73 [95% CI: 2.95,4.72], 3.00 [95% CI:2.37,3.79], and 3.94 [95% CI:3.02,5.14] greater odds of a chronic health condition, a chronic mental health disorder, poor general health, and poor mental health, respectively, compared to food-secure non-Indigenous adults.Conclusions: Health policy decisions and programs should focus on food security initiatives for all Canadians, including addressing the unique challenges of Indigenous communities, irrespective of their food security status.

OBJECTIVE: Type 2 diabetes (T2D) disproportionately impacts adolescents living in challenging socioeconomic conditions. However, the impacts of T2D on quality of life (QOL) in this context are unknown. Our aim in this study was to evaluate QOL and identify its biological, psychological, and social determinants among adolescents living with and without T2D from similar sociodemographic backgrounds. Relationships between glycemic stability, early complications, and treatments of T2D and QOL were also examined.
METHODS: Ninety-two adolescents with T2D and 59 at-risk controls were included from the Improving Renal Complications in Adolescents With Type 2 Diabetes Through Research (iCARE) cohort. The main outcome was QOL (Pediatric QOL Inventory [PedsQL]). Biological covariates included age, sex, body mass index z score, glycated hemoglobin, estimated glomerular filtration rate, and urine albumin-to-creatinine ratio. Psychological factors included perceived stress (14-item Perceived Stress Scale) and mental distress (6-item Kessler scale). Social factors included food security (Household Food Security Survey Module) and income quintile. Multivariate linear regression analyses were used to identify factors associated with QOL between adolescents with and without T2D, and within the T2D cohort.
RESULTS: Mean total QOL scores among adolescents with T2D were lower than in controls (67.0±14.8 vs 71.7±16.2, p=0.04). Age, sex, and percent Indigenous ethnicity were not significantly different between groups. Mean duration of T2D was 2.3±2.0 years. In the multivariate analysis, QOL was not associated with diabetes status, but negative associations were seen between mental distress (β=-1.46, p<0.001) and food insecurity QOL (β=-6.26, p=0.037). No differences were seen between biological factors and QOL in either analysis.
CONCLUSIONS: Significant factors associated with decreased QOL in adolescents living with T2D include mental distress and food insecurity, indicating areas for targeted intervention.

OBJECTIVE: The purpose of this study was to explore the perspectives of Indigenous adults on consuming beverages with non-nutritive sweeteners.
METHODS: In this work, we used a community-based, participatory design in partnership with National Indigenous Diabetes Association, Four Arrows Regional Health Authority, and Fearless R2W. We conducted 74 qualitative interviews with Indigenous adults living in Manitoba, including Island Lake First Nations (n=39), Flin Flon (n=15), and the North End neighbourhood of Winnipeg (n=20). Data were indexed in NVivo, and transcripts were analyzed thematically.
RESULTS: Participants exclusively discussed beverages with non-nutritive sweeteners (BNNSs) as an alternative to regular pop or sugary drinks, which were widely available, accessible, and consumed. Why or how BNNSs were viewed as an alternative comprised 3 subthemes: an alternative for health reasons; divergent taste preferences; and an alternative with mysterious but negative health effects. Participants who reported regular consumption of BNNSs largely described consuming them to manage type 2 diabetes. Fewer participants discussed BNNS as a means of weight management or as a preventive health behaviour. Participants who did not report regular BNNS consumption described not liking the taste of BNNSs. Finally, many participants described negative health impacts of consuming BNNSs, and specifically aspartame, although few articulated what those negative impacts were.
CONCLUSIONS: Divergent perspectives among Indigenous adults regarding the health implications of consuming BNNSs may reflect ongoing scholarly debates. These findings have implications for the prevention and dietary management of type 2 diabetes in Indigenous communities.

Litchi (Litchi chinensis) is a widely consumed fruit that has been used in many food and health-promoting products worldwide. Litchi is a good source of nutrients including vitamin and minerals, dietary fibers, proteins, and carbohydrates. Of note, several studies have reported that the constituents of litchi fruits elicit antioxidant properties and help to maintain blood pressure, and reduce the risk of stroke and heart attack. An unclearly explained outbreak occurred in June 2019 in Muzaffarpur (Bihar), India resulted in the death of more than 150 children in a week, followed by a total of 872 cases and 176 deaths. This outbreak was associated with the consumption of Litchi fruits and the occurrence of acute encephalitis syndrome. In this high Litchi production region, a huge number of acute encephalitis syndrome cases have been registered in children in the past two decades with high mortality due to these neurological disorders linked to the consumption of litchi. While finding out the causes for this recurrent outbreak, whether or not it is caused by a virus or the phytotoxins of litchi is to be considered critical. Amongst the probable causes were observed to be methylene cyclopropyl acetic acid and hypoglycin-A found in unripe Litchi fruits which can cause hypoglycemia and as a plausible cause of AES outbreaks. This review addresses this recurrent outbreak in-depth exploring the possible causes and discusses the possible mechanisms by which phytotoxins of litchi such as hypoglycin A and methylene cyclopropylglycine which may elicit such toxic effects.

Food insecurity disproportionately impacts Aboriginal and Torres Strait Islander Australians. This review sought to investigate research and evaluations of programs and interventions implemented to address food insecurity among Aboriginal and Torres Strait Islander communities. A rapid review was conducted to collate the available research from 6 databases. The search was conducted in May 2020. Search constructs related to food insecurity, Aboriginal and Torres Strait Islander people, and Australia. Twenty-five publications were included in this review, 24 reported on an intervention, while 9 were evaluations of an intervention. Interventions included behaviour change projects, including projects that sought to change purchasing and cooking behaviours, school-based education programs, and gardening programs. In general, the studies included in this sample were small and lacked a systematic consideration of the factors that shape the experience of food insecurity among Aboriginal and Torres Strait Islander people specifically. Based on the findings of this review, authors suggest greater consideration to the systematic determinants of food insecurity among Aboriginal and Torres Strait Islander communities to have lasting and sustainable impact on food insecurity. This review has been registered with the international prospective register of systematic reviews (PROSPERO: CRD42020183709). Novelty: Food insecurity among Aboriginal and Torres Strait Islander people poses significant risk to health and wellbeing. Small-scale food security interventions may not provide ongoing and sustained impact. Any intervention to promote food security will need to involve Aboriginal and Torres Strait Islander people and be sustained once external parties have left.

The food security crisis and disproportionately high burden of dietary related disease amongst northern Indigenous populations in Canada continues to be a troubling reality with little sign of improvement. The Government of Canada is responding by developing programs to support local food initiatives for northern isolated communities. While such investments appear commendable, the impact of local food harvesting to improve food security has yet to be determined. While there are clear nutritional and cultural benefits to traditional food sources, communities face considerable barriers acquiring it in sufficient amounts because of historically imposed lifestyle changes that have increased food insecurity rates. This study responds by providing a novel multidisciplinary approach that draws from firsthand experiences working with First Nations community members in a remote subarctic region in northwestern, Ontario, to estimate their community\'s total food requirement and the amount of wild animal food sources needed to sustain yearly food intake. This transferrable energy demand approach will be critical for policy makers to put into perspective the amount of wild food needed to have an impact on food security rates and ultimately improve dietary related diseases. Novelty: Provide government policy makers information about current harvest yields in a remote northern First Nation to understand the potential contribution of traditional food to improve local food security. Provide Indigenous communities a means to assess local food resources to measure the caloric contributions of traditional foods toward household food security.

In Canada, caffeinated energy drinks (CEDs) currently sold under Temporary Marketing Authorizations must meet strict eligibility criteria. These criteria, which include compositional and labelling requirements, were developed based on the outcome of a health risk assessment conducted by Health Canada (HC) in 2013. HC updated its assessment by reviewing new information with the focus on potential cardiovascular effects associated with the consumption of CEDs available for sale in Canada. Due to limited data on CED consumption among Canadians to derive accurate exposure information, the composition of a typical CED was characterized to assess the potential effects of single ingredients and synergistic interactions between ingredients on the cardiovascular system. Surveillance data on potential adverse effects related to CED consumption was also analyzed. After extensive review, HC\'s updated assessment confirms the current risk management approach for CEDs is health protective for Canadian consumers, including the potential for cardiovascular effects. The available evidence supports that moderate consumption (up to 500 mL per day) of a typical CED authorized for sale in Canada is safe for the general population of healthy adults and adolescents. It also re-confirms that vulnerable sub-populations (i.e., children, pregnant and/or breastfeeding women, and caffeine-sensitive individuals) should not consume CEDs. Novelty: Consumption up to 500 mL per day of a typical CED is not associated with an increased risk of cardiovascular effects. Children, pregnant and/or breastfeeding women, and caffeine-sensitive individuals should not consume CEDs.

OBJECTIVE: An earlier study from Nova Scotia showed that food insecurity (FI) is more prevalent (21.9%) in families of children with diabetes, yet little is known about its impact on these families. We aimed to describe the day-to-day experiences of families living with FI while caring for a child with type 1 diabetes (T1D).
METHODS: This investigation was a qualitative study with thematic analyses using semistructured interviews to explore perceptions of caregivers living with pediatric T1D and FI (N=13 households).
RESULTS: Three major themes emerged: 1) FI had a disproportionate impact on families after T1D diagnosis compared with before diagnosis. The cost of healthy food threatened food security before T1D; however, there is increased hardship once high-quality food and hypoglycemia supplies are required. 2) Sacrifices to combat FI have disproportionate impacts among family members. At times, caregivers sacrificed the needs (food, medicine) of other family members (including children) to prioritize the needs of the child with T1D. 3) Caregivers perceived T1D needs as posing unique barriers to traditional FI supports, such as school breakfast programs.
CONCLUSIONS: This study provides insight into the realities of life with pediatric T1D and FI. Living with T1D and FI poses challenges, and caregivers often cope by making difficult choices when providing for their family. Caregivers struggled to meet dietary recommendations while finding that T1D needs are often not met by traditional FI supports. This suggests that T1D clinicians should assess FI and help families in problem solving to mitigate its impact.

A pork sausage was produced with low sodium content (1.64%) to which Lactobacillus sakei was added with the aim of developing a meat pork sausage for cooking and having technological, organoleptic, and hygienic advantages. The lactic acid bacteria (LAB) L. sakei, Lactococcus sp., and Pediococcus pentosaceus were submitted to extreme pH, temperature, and NaCl conditions. Lactobacillus sakei was used in pork sausage because of its resistance to different culture conditions and its antimicrobial potential. The food-borne pathogens Listeria monocytogenes Scott A, Enterococcus faecalis, and Staphylococcus aureus were used as indicator microorganisms to evaluate the antimicrobial activity of selected LAB strains. Salmonella enterica serotype Choleraesuis is a common pathogen of pigs. To the raw sausage product containing L. sakei and nonpathogenic endogenous microbiota, we added about >104 and <105 CFU/g of S. enterica serotype Choleraesuis to evaluate the inhibitory potential of L. sakei towards this pathogen. Salmonella Choleraesuis was inhibited in the presence of L. sakei over 7 days of storage of the meat product (about 3.0 log cycles reduction). Lactobacillus sakei significantly increased inhibition when compared with the nonfermented sausage. Thus, L. sakei BAS0117 played an important role as an additional hurdle in the fermented meat pork sausage during storage.

BACKGROUND: In Switzerland, just over 700 veterinary medicinal products are authorized. Nevertheless, in practice veterinarians are often confronted with extraordinary situations in which a suitable veterinary medicinal product is not authorized, unavailable or otherwise not applicable. For livestock and horses in particular, this poses a challenge for pharmacotherapy due to food safety regulations. In these cases, the reclassification assistant can be used to determine whether and how a medicinal product containing the appropriate drug can be reclassified and correctly applied in food-producing animals. The users will be guided step by step with selectable options through the online assistant. If the desired reclassification is permitted in the legal framework, information on the withdrawal periods to be observed for the chosen medicinal product will be provided. This online assistant follows an algorithm based on the reclassification cascade and applicable food safety regulations.
BACKGROUND: In der Schweiz sind etwas mehr als 700 Tierarzneimittel zugelassen. Trotzdem stehen die Tierärzte in der Praxis immer wieder vor ausserordentlichen Situationen, in denen ein passendes Tierarzneimittel nicht zugelassen, nicht verfügbar oder aus anderen Gründen nicht anwendbar ist. Für die Pharmakotherapie stellt dies vor allem bei Nutztieren und Pferden auf Grund der gesetzlichen Vorschriften bezüglich Lebensmittelsicherheit eine Herausforderung dar. In diesen Fällen kann mit Hilfe des Umwidmungs-Assistenten geprüft werden, ob ein Präparat mit dem passenden Wirkstoff umgewidmet werden kann und wie dieses Präparat korrekt anzuwenden ist. Die Nutzerinnen und Nutzer werden schrittweise mit wählbaren Optionen durch den Online-Assistenten geführt. Sofern die gewünschte Umwidmung im gesetzlichen Rahmen erlaubt ist, werden Angaben zu den für das Arzneimittel einzuhaltenden Absetzfristen angezeigt. Der Umwidmungs-Assistent folgt dabei einem auf der Umwidmungskaskade und den Bestimmungen der Lebensmittelsicherheit basierenden Algorithmus.
BACKGROUND: En Suisse, un peu plus de 700 médicaments vétérinaires sont autorisés. Néanmoins, dans la pratique, les vétérinaires sont souvent confrontés à des situations extraordinaires dans lesquelles un médicament vétérinaire approprié n’est ni autorisé, ni disponible, ni utilisable pour d’autres raisons. En particulier pour le bétail et les chevaux, cela pose un défi pour la pharmacothérapie en raison de la réglementation sur la sécurité alimentaire. Dans ces cas, l’assistant de reconversion peut être utilisé pour déterminer si et comment un médicament contenant le principe actif approprié peut être reconverti et correctement appliqué. Les utilisateurs seront guidés pas à pas avec des options sélectionnables via l’assistant en ligne. Si la reconversion souhaitée est autorisée dans le cadre légal, des informations sur les délais d’attente à respecter pour le médicament choisi seront fournies. Cet assistant en ligne suit un algorithme basé sur la cascade de reconversion les réglementations applicables en matière de sécurité alimentaire.
BACKGROUND: In Svizzera sono poco più di 700 i medicamenti veterinari omologati. Tuttavia, nella pratica, i veterinari si trovano ripetutamente confrontati a situazioni straordinarie in cui un medicamento veterinario adatto non è omologato, non disponibile o non utilizzabile per altri motivi. Per la farmacoterapia, ciò rappresenta una sfida, soprattutto per gli animali da reddito e i cavalli, a causa delle disposizioni legali in materia di sicurezza delle derrate alimentari. In questi casi, l’assistente al cambiamento di destinazione può essere utilizzato per verificare se un preparato con il principio attivo appropriato può ottenere una nuova destinazione e come questo preparato può essere utilizzato correttamente. Gli utenti vengono guidati passo dopo passo attraverso l’assistente online con opzioni selezionabili. Se il cambiamento di destinazione desiderato è consentito dal quadro giuridico, vengono visualizzate le informazioni sui termini di attesa da rispettare per il medicamento. L’assistente per il cambiamento di destinazione segue un algoritmo basato sulle norme di sicurezza delle derrate alimentari e sulla cascata per il cambiamento di destinazione.