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Lemire, Mélanie

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Lemire

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Mélanie

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Université Laval. Département de médecine sociale et préventive

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ncf10883432

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  • PublicationAccès libre
    Associations between dietary profiles and perfluoroalkyl acids in Inuit youth and adults
    (Elsevier, 2022-10-22) Aker, Amira; Ayotte, Pierre; Caron-Beaudoin, Élyse; De Silva, Amila; Ricard, Sylvie; Lemire, Mélanie
    Background: Perfluoroalkyl acids (PFAAs), a subset of perfluoroalkyl substances (PFAS), are synthetic chemicals used in industrial and consumer applications. They are exceptionally stable and highly mobile in the environment, and were detected in high concentrations in Arctic wildlife and Nunavik Inuit. The study's objective was to study the association between dietary profiles in Nunavik and plasma PFAAs concentrations. Methods: The study used data from the Qanuilirpitaa? 2017 Nunavik Inuit Health Survey (Q2017) (N = 1172) on Inuit adults aged 16-80 years. Nine PFAAs congeners were measured in plasma samples (six were detected). Dietary profiles were identified using latent profile analysis. Two sets of dietary profiles were included; the first included market (store-bought) and country foods (harvested/hunted from the land), and the second included only country foods. Multiple linear regression models regressed log-transformed PFAAs concentrations against the dietary profiles, adjusting for sociodemographic variables. Results: We identified statistically significant 24.54-57.55 % increases in all PFAAs congeners (PFOA, PFNA, PFDA, PFUnDA, PFHxS, and PFOS) in the dietary profile defined by frequent country food consumption compared to the dietary profile defined by frequent market food consumption. Individuals defined by low consumption of foods (related to food insecurity) had higher concentrations of six PFAAs compared to individuals with frequent market food consumption. The associations were stronger with profiles defined by more frequent country food consumption, and particularly those with increased marine mammal consumption. PFDA, PFUnDA, and PFOS were particularly associated with high country food consumption frequency, such that their concentrations increased by approximately 67-83 % compared to those reporting no or very little consumption of any country foods. Conclusions: Increased country food consumption was strongly associated with higher PFAAs concentrations, particularly PFOS, PFDA, and PFUnDA. The results provide further evidence that the quality of country foods is being threatened by PFAAs contamination. Additional national and international regulations are required to protect the Arctic and its inhabitants from these pollutants.
  • PublicationRestreint
    The unique contribution of a local response group in the field investigation and management of a trichinellosis outbreak in Nunavik (Québec, Canada)
    (Canadian Public Health Association, 2019-10-21) Lemire, Mélanie; Proulx, Jean-François; Lévesque, Benoît; Simard, Manon; Iqaluk, Martha; Ducrocq, Julie; Elijassiapik, Lisa; Ningiuk, Etok; Perkins, Pamela
    Setting : Consumption of raw game meats is important for Inuit health and well-being but may sometimes increase risk of exposure to parasites. In Nunavik, following trichinellosis outbreaks in the 1980s caused by raw walrus consumption, a diagnostic test was developed for the region and offered to all Inuit communities by 1997. Despite this prevention program, an important trichinellosis outbreak occurred in 2013, affecting 18 inhabitants of Inukjuak. Intervention : Because the classical outbreak investigation did not rapidly converge toward a common food source or specific event, a local response group, composed of four community members appointed by the Municipal Council as well as the regional public health physician, nurse and wildlife parasitologist, was created. Their objective was to investigate potential sources of infection related to the outbreak, hence the investigation of the types of meats consumed, the movement of meats between and within the community, and the local practices of processing game meat. Outcomes : Though the source of infection was not fully confirmed, this local investigation identified the distribution of transformed polar bear meat as the most probable source of infection. The creation of this unique, intersectoral and intercultural local response group fostered the use of local knowledge to better understand aspects of the modern food system, and is one of the most innovative outcomes of this investigation. Implications : Integrating multiple ways of knowing was critical for the management of this important public health issue and contributed to community members’ mobilization and empowerment with respect to local food safety issues.
  • PublicationAccès libre
    Determinants of selenoneine concentration in red blood cells of Inuit from Nunavik (Northern Québec, Canada)
    (Elsevier Inc., 2019-03-28) Lemire, Mélanie; Little, Matthew; Achouba, Adel; Ayotte, Pierre; Dumas, Marie-Pierre; Ouellet, Nathalie
    Selenium (Se) is a trace mineral essential to human health, and is especially abundant in marine foods consumed by Inuit populations in Nunavik (northern Quebec, Canada), leading to exceptionally high whole blood Se levels. While most epidemiological studies to date examine plasma or whole blood Se, little is known about the health implications of specific Se biomarkers (e.g. selenoproteins and small Se compounds). Selenoneine, a novel Se compound, is found in high concentrations in marine foods (and particularly beluga mattaaq) and the red blood cells (RBCs) of populations that consume them. We report here RBC selenoneine concentrations in a population of Inuit adults (n = 885) who participated in the Qanuippitaa? 2004 survey. Simple associations between RBC selenoneine and other Se and mercury (Hg) biomarkers were assessed using Spearman correlations and linear regressions. Wilcoxon ranksum tests were used to examine differences in biomarkers and characteristics between tertiles of RBC selenoneine concentration. A multiple linear regression analysis was used to determine factors (sociodemographic, lifestyle, and dietary) associated with RBC selenoneine concentrations. Selenoneine comprised a large proportion of whole blood Se and RBC Se in this population. Age and sex-adjusted geometric mean RBC selenoneine concentration was 118 μg/L (range: 1-3226 μg/L) and was much higher (p = 0.001) among women (150.3 μg/L) than men (87.6 μg/L) across all regions of Nunavik after controlling for age, region, and diet. RBC selenoneine was highly correlated with RBC Se (rs = 0.96, p < 0.001) and whole blood Se (rs = 0.89, p < 0.001), but only weakly correlated with plasma Se (rs = 0.13, p < 0.001). Overall, increasing age (standardized β = 0.24), higher body-mass index (BMI; β = 0.08), female sex (β = 0.10), living in a Hudson Strait community (compared to Hudson Bay and Ungava Bay; β = 0.38), and consuming beluga mattaaq (g/day; β = 0.19) were positively associated with RBC selenoneine. Meanwhile, consumption of market meats (g/day; β = -0.07) was negatively associated with RBC selenoneine. RBC selenoneine is an important biomarker of Se dietary intake from local marine foods in Inuit populations. Further studies are needed to examine the health effects of selenoneine intake and the underlying mechanisms for sex differences among Inuit populations.
  • PublicationAccès libre
    Sociodemographic patterning of dietary profiles among Inuit youth and adults in Nunavik, Canada: a cross-sectional study
    (Canadian Public Health Association, 2022-12-08) Aker, Amira; Ayotte, Pierre; Furgal, Chris; Kenny, Tiff-Annie; Little, Matthew; Gauthier, Marie-Josée; Bouchard, Amélie; Lemire, Mélanie
    Objectives Country (traditional) foods are integral to Inuit culture, but market food consumption is increasing. The Qanuilirpitaa? 2017 Nunavik Health Survey (Q2017) reported similar country food consumption frequency compared to that in 2004; however, examining food items individually does not account for diet patterns, food accessibility, and correlations between food items. Our objective was to identify underlying dietary profiles and compare them across sex, age, ecological region, and food insecurity markers, given the links among diet, health, and sociocultural determinants. Methods Food frequency and sociodemographic data were derived from the Q2017 survey (N = 1176). Latent profile analysis identified dietary profiles using variables for the relative frequencies of country and market food consumption first, followed by an analysis with those for country food variables only. Multinomial logistic regression examined the associations among dietary profiles, sociodemographic factors, and food insecurity markers (to disassociate between food preferences and food access). Results Four overall dietary profiles and four country food dietary profiles were identified characterized by the relative frequency of country and market food in the diet. The patterns were stable across several sensitivity analyses and in line with our Inuit partners’ local knowledge. For the overall profiles, women and adults aged 30–49 years were more likely to have a market food–dominant profile, whereas men and individuals aged 16–29 and 50+ years more often consumed a country food–dominant profile. In the country food profiles, Inuit aged 16–29 years were more likely to have a moderate country food profile whereas Inuit aged 50+ were more likely to have a high country food–consumption profile. A low country and market food–consumption profile was linked to higher prevalence of food insecurity markers. Conclusion We were able to identify distinct dietary profiles with strong social patterning. The profiles elucidated in this study are aligned with the impact of colonial influence on diet and subsequent country food promotion programs for Inuit youth. These profiles will be used for further study of nutritional status, contaminant exposure, and health to provide context for future public health programs.
  • PublicationAccès libre
    Selenoneine is a major selenium species in beluga skin and red blood cells of Inuit from Nunavik
    (Elsevier Ltd, 2019-04-30) Lemire, Mélanie; Dumas, Pierre; Little, Matthew; Achouba, Adel; Ayotte, Pierre; Ouellet, Nathalie
    Nunavimmiut (Inuit of Nunavik, Northern Quebec, Canada) exhibit a high selenium (Se) status because oftheir frequent consumption of marine mammal foods. Indirect evidence from our previous studies hadsuggested that selenoneineea novel selenocompoundemay be accumulating in the blood of Nuna-vimmiut. We used a liquid-chromatography/inductively coupled tandem mass spectrometry (LC-ICP-MS/MS) method to measure concentrations of selenoneine and its methylated metabolite Se-methylselenoneine in archived red blood cells (RBC) obtained from 210 Nunavimmiut living in com-munities along the Hudson Strait, where marine mammal hunting and consumption are most frequent inNunavik. This method was adapted to quantify selenoneine and its methylated metabolite in belugamattaaq, an Inuit delicacy consisting of the skin with the underlying layer of fat and the major dietarysource of Se for Nunavimmiut. Total selenium concentration was also measured in RBC and belugamattaaq samples by isotope dilution ICP-MS/MS. The median selenoneine concentration in RBC was413mg Se/L (range¼3.20e3230mg Se/L), representing 54% (median) of total Se content (range¼1.6e91%). Quantification of selenoneine infive beluga mattaaq samples (skin layer) from Nunavik revealed amedian concentration of 1.8mg Se/g wet wt (range¼1.2e7.4mg Se/g), constituting 54% (median) of thetotal Se content (range¼44e74%). Se-methylselenoneine was also detected in Inuit RBC but not inbeluga mattaaq, suggesting that selenoneine undergoes methylation in humans. Selenoneine may protect Nunavimmiut from methylmecury toxicity by increasing its demethylation in RBC and in turndecreasing its distribution to target organs.
  • PublicationAccès libre
    Cardiometabolic health and per and polyfluoroalkyl substances in an Inuit population
    (Elsevier Ltd, 2023-10-21) Aker, Amira; Ayotte, Pierre; Caron-Beaudoin, Élyse; Ricard, Sylvie; Gaudreau, Éric; Lemire, Mélanie
    Introduction: The cardiometabolic health status of Inuit in Nunavik has worsened in the last thirty years. The high concentrations of perfluoroalkyl acids (PFAAs) may be contributing to this since PFAAs have been linked with hypercholesterolemia, diabetes, and high blood pressure. The aim of this study was to examine the association between a PFAAs mixture and lipid profiles, Type II diabetes, prediabetes, and high blood pressure in this Inuit population. Methods: We included 1212 participants of the Qanuilirpitaa? 2017 survey aged 16–80 years. Two mixture models (quantile g-computation and Bayesian Kernel Machine Regression (BKMR)) were used to investigate the associations between six PFAAs (PFHxS, PFOS, PFOA and three long-chain PFAAs (PFNA, PFDA and PFUnDA)) with five lipid profiles and three cardiometabolic outcomes. Non-linearity and interaction between PFAAs were further assessed. Results: An IQR increase in all PFAAs congeners resulted in an increase in total cholesterol (β 0.15, 95% confidence interval (CI) 0.06, 0.24), low-density lipoprotein cholesterol (LDL) (β 0.08, 95% CI 0.01, 0.16), highdensity lipoprotein cholesterol (HDL) (β 0.04, 95% CI 0.002, 0.08), apolipoprotein B-100 (β 0.03, 95% CI 0.004, 0.05), and prediabetes (OR 1.80, 95% CI 1.11, 2.91). There was no association between PFAAs and triglycerides, diabetes, or high blood pressure. Long-chain PFAAs congeners were the main contributors driving the associations. Associations were largely linear, and there was no evidence of interaction between the PFAAs congeners. Conclusions: Our study provides further evidence of increasing circulating lipids with increased exposure to PFAAs. The increased risk of prediabetes points to the influence of PFAAs on potential clinical outcomes. International regulation of PFAAs is essential to curb PFAAs exposure and related health effects in Arctic communities.
  • PublicationAccès libre
    Plasma concentrations of perfluoroalkyl acids and their determinants in youth and adults from Nunavik, Canada
    (Pergamon, 2022-10-14) Aker, Amira; Ayotte, Pierre; Caron-Beaudoin, Élyse; Silva, Amila de; Ricard, Sylvie; Gaudreau, Éric; Lemire, Mélanie
    Perfluoroalkyl acids (PFAAs), a subset of per- and poly-fluoroalkyl substances (PFAS), are environmentally stable, mobile and bioaccumulative compounds. This leads to high concentrations in wildlife species essential to the cultural identity and subsistence of Arctic populations. Our objective was to characterize the distribution and exposure determinants of PFAAs among Nunavik Inuit adults. The study included up to 1322 Nunavik residents aged 16–80 years who participated in the Qanuilirpitaa? 2017 Nunavik Inuit Health Survey (Q2017). Plasma concentrations were compared to those the general Canadian population using data from the Canadian Health Measures Survey Cycle 5 (2016–2017). Associations between plasma concentrations of nine PFAAs, determined by liquid chromatography-tandem mass spectrometry, and sociodemographic factors and traditional activity participation were examined using multiple linear regression models. Overall exposure to PFAAs was twice as high compared to the general Canadian population and less regulated perfluorononanoic acid (PFNA) and perfluoroundecanoic acid (PFUnDA) concentrations were 7-fold higher, and perfluorodecanoic acid (PFDA) concentrations were 4-fold higher. Males had higher concentrations of perfluorooctanoic acid (PFOA) and perfluorohexane sulfonate (PFHxS), whereas females had higher concentrations of PFDA and PFUnDA. PFAAs concentrations increased with age and were highest among those aged 60+ years. PFNA and PFOA