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Personne :
Lucas, Michel

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Lucas

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Michel

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Université Laval. Département de médecine sociale et préventive

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ncf10544559

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  • PublicationAccès libre
    Effets d'une supplémentation en acide gras oméga-3 enrichie en éthyl-acide eicosapentanoïque (E-EPA) sur la détresse psychologique, les symptômes dépressifs et vasomoteurs chez des femmes d'âge moyen : un essai comparatif randomisé (ECR), à double insu, contrôlé par placebo
    (2008) Lucas, Michel; Mérette, Chantal; Dodin-Dewailly, Sylvie
    La dépression est une maladie chronique et récurrente qui affecte deux fois plus les femmes que les hommes. Les périodes entourant la ménopause sont marquées par des fluctuations hormonales qui sont associées à des bouffées de chaleur, des troubles psychologiques et du sommeil qui affectent significativement la qualité de vie des femmes. Toutefois, il n'existe pas actuellement de consensus de traitements dans les cas de troubles dépressifs moins sévères. Cette lacune est particulièrement problématique, car leur prévalence dépasse celle de la dépression majeure, laissant ainsi les cliniciens sans recommandations de traitement de base pour la majorité des patients. Parallèlement au manque de confiance des femmes envers les thérapeutiques conventionnelles, plusieurs d'entre elles se tournent vers des pratiques alternatives non médicamenteuses qui n'ont pas été validées. Les suppléments d'acides gras oméga-3 connaissent une popularité grandissante, notamment pour leurs effets cardiovasculaires protecteurs, mais également pour leurs supposés bénéfices dans l'amélioration des symptômes dépressifs. Nos résultats auprès de la population québécoise montrent qu'effectivement la prévalence de consommation de supplément d'oméga-3 est élevée. Notre essai clinique de 8 semaines mené auprès de 120 femmes d'âge moyen n'a pas démontré d'avantages du supplément enrichi en éthyl-EPA par rapport au placebo dans le traitement de la détresse psychologique et les symptômes dépressifs. Toutefois, à la suite de sous-analyses selon le diagnostic d'épisode dépressif majeur (EDM) à la randomisation, nous nous sommes aperçus que les changements à 8 semaines dans les échelles de détresse psychologique et de dépression étaient significativement plus importants dans le groupe EEPA comparativement au placebo chez les femmes sans EDM. De plus, d'autres sousanalyses réalisées auprès des femmes ayant des bouffées de chaleur ont indiqué que la supplémentation en oméga-3 réduirait significativement leurs fréquences et scores comparativement au placebo. En somme, les résultats obtenus dans cette thèse de doctorat indiqueraient que dans les cas de détresse psychologique et de symptômes dépressifs légers chez des femmes d'âge moyen, la supplémentation d'acides gras oméga-3 enrichie d'éthyl- EPA pourrait procurer certains avantages au placebo. Puisque le présent essai clinique est le premier du genre à être réalisé lors de ces périodes importantes de la vie féminine, nos résultats devront être confirmés.
  • PublicationAccès libre
    Food insecurity and nutritional biomarkers in relation to stature in Inuit children from Nunavik
    (Canadian Public Health Association, 2014-07-22) Dallaire, Renée; Lucas, Michel; Ayotte, Pierre; Muckle, Gina; Jacobson, Joseph L.; Dewailly, Éric; Jacobson, Sandra W.; Pirkle, Catherine
    OBJECTIVES: Inuit in Canada experience alarming levels of food insecurity, but nutritional and physiological consequences are poorly documented, especially in school-age children. The objective of this study was to assess the relation of food insecurity to iron deficiency and stature in school-aged Inuit children from Nunavik (Northern Quebec). METHODS: Food insecurity, iron deficiency, and stature were assessed in a cohort of children. Food insecurity was determined by interviewing the children’s mothers. Multiple logistic regression was used to evaluate the association of food insecurity to iron deficiency and short stature. We defined short stature as a height in the lowest tertile for age and sex, based on Canadian growth charts. The relation of food insecurity to height (cm) was analyzed with a general linear model. Statistical models controlled for age, sex, normal/overweight/obese status, prenatal lead exposure and postnatal polychlorinated biphenyls exposure. RESULTS: Half of the children (49.7%, n=145) were food insecure, while one third were iron depleted, 12.6% had anaemia, and 8.7% had irondeficiency anaemia. The multivariate odds ratio of anaemia was 1.82 (95% CI: 0.97, 3.42, p=0.06) for food-insecure children. Prevalence of short stature was 18.7%. Food-insecure children were an average of 2 cm shorter (95% CI: -0.48, -3.17) than food-secure children (p<0.01). CONCLUSION: In this population, food-insecure children have greater burdens of nutritional deficiencies and slower linear growth. Considering the high prevalence of food insecurity among Inuit children in Nunavik, nutritional deficiencies and adverse effects on development should be carefully monitored.
  • PublicationAccès libre
    Overweight and obesity prevalence among school-aged Nunavik Inuit children according to three BMI classification systems
    (Elsevier Science Pub. Co., 2015-06-18) Roy, Cynthia; Lucas, Michel; Medehouenou, Thierry Comlan Marc; St-Jean, Audray; Meziou, Salma; Ayotte, Pierre; Muckle, Gina
    Purpose Little is known about the suitability of three commonly used body mass index (BMI) classification system for Indigenous children. This study aims to estimate overweight and obesity prevalence among school-aged Nunavik Inuit children according to International Obesity Task Force (IOTF), Centers for Disease Control and Prevention (CDC), and World Health Organization (WHO) BMI classification systems, to measure agreement between those classification systems, and to investigate whether BMI status as defined by these classification systems is associated with levels of metabolic and inflammatory biomarkers. Methods Data were collected on 290 school-aged children (aged 8–14 years; 50.7% girls) from the Nunavik Child Development Study with data collected in 2005–2010. Anthropometric parameters were measured and blood sampled. Participants were classified as normal weight, overweight, and obese according to BMI classification systems. Weighted kappa (¿w) statistics assessed agreement between different BMI classification systems, and multivariate analysis of variance ascertained their relationship with metabolic and inflammatory biomarkers. Results The combined prevalence rate of overweight/obesity was 26.9% (with 6.6% obesity) with IOTF, 24.1% (11.0%) with CDC, and 40.4% (12.8%) with WHO classification systems. Agreement was the highest between IOTF and CDC (¿w = .87) classifications, and substantial for IOTF and WHO (¿w = .69) and for CDC and WHO (¿w = .73). Insulin and high-sensitivity C-reactive protein plasma levels were significantly higher from normal weight to obesity, regardless of classification system. Among obese subjects, higher insulin level was observed with IOTF. Conclusions Compared with other systems, IOTF classification appears to be more specific to identify overweight and obesity in Inuit children.
  • PublicationAccès libre
    Anemia, iron status, and associated protective and risk factors among children and adolescents aged 3 to 19 years old from four First Nations communities in Quebec
    (Canadian Public Health Association, 2020-03-13) Tahir, Emad; Lemire, Mélanie; Lucas, Michel; Little, Matthew; Anassour-Laouan Sidi, Elhadji; Mergler, Donna; Bélanger, Richard E.; Ayotte, Pierre; Gros-Louis McHugh, Nancy
    Objectives: Anemia and iron deficiency (ID) are frequent among Indigenous children of Canada, but few data are available in Quebec. The present study aimed to characterize anemia and ID prevalence and associated protective and risk factors among First Nations youth in Quebec. Methods: The 2015 First Nations (JES!-YEH!) pilot study was conducted among children and adolescents (3 to 19 years; n=198) from four First Nations communities in Quebec. Blood and urine samples and anthropometric measurements were collected. Hemoglobin (Hb), serum ferritin (SF), plasma hs-CRP, and urinary cotinine levels were measured. Factors associated with anemia and ID (including traditional and market food consumption) were assessed using an interview-administered food frequency questionnaire, based on which nutritional intakes were calculated. Structural equation models were used totest associations. Results: The prevalence of anemia and ID was elevated (16.8% and 20.5% respectively). Traditional meat, fruit, and fruit juice (naturaland powdered)—via their positive association with vitamin C intake—were the only food variables positively associated with SF (coefficient [95% CI] 0.017 [0.000, 0.114]; 0.090 [0.027, 0.161]; and 0.237 [0.060, 0.411]). Male sex was also associated with higher SF (0.295 [0.093, 0.502]). Inflammation status (hs-CRP > 5 mg/L) was inversely associated with Hb (−0.015 [−0.025,−0.005]), whereas SF was positively associated with Hb (0.066 [0.040, 0.096]). Fruit and juice consumption was also positively associated with Hb, via vitamin C intake and SF (0.004 [0.001, 0.010]; 0.008 [0.003, 0.017]). Conclusions: Interventions fostering healthier food environments as well as higher consumption of traditional meats and foods naturally rich in vitamin C, which is known to enhance iron absorption, and fighting inflammation could contribute to decrease the high prevalence of anemia and ID in this young Indigenous population.