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Papers by Milly Ryan-Harshman

Research paper thumbnail of Public-Private Partnership: Successful Development of a Social Marketing Course

INTED2016 Proceedings, 2016

Research paper thumbnail of Effects of Phenylalanine and Aspartame on Mealtime Food Intake and Behavior in Adult Males

Dietary Phenylalanine and Brain Function, 1988

Research paper thumbnail of Folic acid and prevention of neural tube defects

Canadian family physician Médecin de famille canadien, 2008

Now that flour and pasta have been fortified with folic acid in Canada, do I still need to recomm... more Now that flour and pasta have been fortified with folic acid in Canada, do I still need to recommend folic acid supplements to my patients who are of child-bearing age? If I should recommend supplements, when should I recommend them, and what is an appropriate dose? Non-pregnant women should consume 400 microg of folic acid daily, and pregnant women should consume 600 microg of folic acid daily. Mean intakes of folate in Canada before fortification were around 200 microg/d or less. Fortification increased intake of folic acid by up to 100 microg/d. You should discuss the importance of folic acid with your patients who are planning pregnancy; it is recommended that a folic acid supplement or prenatal multivitamin containing at least 400 microg of folic acid be consumed daily. The upper limit for folic acid is 1 mg/d. Women in intermediate- to high-risk categories for neural tube defects, such as a previous neural tube defect-affected pregnancy, should take 4 to 5 mg of folic acid daily.

Research paper thumbnail of Diet and colorectal cancer: Review of the evidence

Canadian family physician Médecin de famille canadien, 2007

To investigate whether diet has a role in the development and progression of colorectal cancer (C... more To investigate whether diet has a role in the development and progression of colorectal cancer (CRC). MEDLINE was searched from January 1966 to December 2006 for articles on the relationship between diet and CRC using the key words colorectal cancer and folic acid, calcium, vitamin D, red meat, or fibre. Evidence that these factors are associated with CRC came from case-control and prospective cohort studies and some clinical trials. Whether red meat is a culprit in causing CRC remains unanswered, although any effect it might have is likely moderate and related to processing or cooking. The effect of dietary fibre on risk of CRC has also been difficult to determine because fibre intake is generally low. Evidence that folic acid, calcium, and vitamin D reduce risk of CRC is stronger. In particular, recent research indicates that calcium and vitamin D might act together, rather than separately, to reduce the risk of colorectal adenomas. There might also be an interaction between low f...

Research paper thumbnail of Carpal tunnel syndrome and vitamin B6

Canadian family physician Médecin de famille canadien, 2007

A 42-year-old woman with carpal tunnel syndrome tells you she has started taking a vitamin B6 sup... more A 42-year-old woman with carpal tunnel syndrome tells you she has started taking a vitamin B6 supplement to relieve her symptoms. Her work in an automotive parts department involves both lifting moderately heavy packages and typing at a computer terminal. What does the research indicate about vitamin B6 as a treatment option, and what health issues should you discuss with this patient? Although its effectiveness is controversial, vitamin B6 is often used as a conservative and adjunct therapy in treatment of carpal tunnel syndrome. Many patients attempt to treat their symptoms with vitamin B6 on their own. Vitamin B6 at less than 200 mg daily is not likely to cause any adverse effects, but patients should be monitored for changes in symptoms, particularly when high doses are taken over long periods.

Research paper thumbnail of New dietary reference intakes for macronutrients and fibre

Canadian family physician Médecin de famille canadien, 2006

VOL 52: FEBRUARY • FEVRIER 2006 d Canadian Family Physician • Le Médecin de famille canadien 177 ... more VOL 52: FEBRUARY • FEVRIER 2006 d Canadian Family Physician • Le Médecin de famille canadien 177 FOR PRESCRIBING INFORMATION SEE PAGE 242 ➛

Research paper thumbnail of Calcium and optimal bone health

Canadian family physician Médecin de famille canadien, 2005

Research paper thumbnail of Bone health. New role for vitamin K?

Canadian family physician Médecin de famille canadien, 2004

To assess growing evidence that vitamin K (phylloquinone) plays an important role in bone health ... more To assess growing evidence that vitamin K (phylloquinone) plays an important role in bone health and, subsequently, in prevention of osteoporotic fractures. We searched MEDLINE from January 1972 to December 2002 using the key words vitamin K and bone health. We reviewed 30 articles that seemed relevant or had a human focus. All evidence can be categorized as level II. Evidence suggests that dietary phylloquinone intake of <100 microg daily might not be optimal for bone health. Low intake of vitamin K could contribute to osteoporosis and subsequent fracture due to the undercarboxylation of osteocalcin. Family physicians need to be aware of the importance of encouraging adequate vitamin K intake, particularly among institutionalized elderly people, to prevent increased bone resorption. Further study is needed to determine the exact role of vitamin K in bone metabolism, and methods of assessing vitamin K requirements need to be standardized.

Research paper thumbnail of Preventing diverticular disease. Review of recent evidence on high-fibre diets

Canadian family physician Médecin de famille canadien, 2002

To review recent evidence on dietary factors associated with diverticular disease (DD) with speci... more To review recent evidence on dietary factors associated with diverticular disease (DD) with special emphasis on dietary fibre. MEDLINE was searched from January 1966 to December 2001 for articles on the relationship between dietary and other lifestyle factors and DD. Most articles either focused on dietary intervention in treating symptomatic DD or were case-control studies with inherent limitations for studying diet-disease associations. Only one large prospective study of male health professionals in the United States assessed diet at baseline and before initial diagnosis of DD. A diet high in fibre mainly from fruits and vegetables and low in total fat and red meat decreases risk of DD. Evidence indicates that the insoluble component of fibre is strongly associated with lower risk of DD; this association was particularly strong for cellulose. Caffeine and alcohol do not substantially increase risk of DD, nor does obesity, but higher levels of physical activity seem to reduce risk...

Research paper thumbnail of Phenylalanine and aspartame fail to alter feeding behavior, mood and arousal in men

Physiology & Behavior, 1987

Two experiments were designed to investigate the neurobehavioral effects of phenylalanine (PHE; 0... more Two experiments were designed to investigate the neurobehavioral effects of phenylalanine (PHE; 0.84, 2.52, 5.04, and 10.08 g) and aspartame (APM; 5.04 and 10.08 g) on energy and macronutrient selection and on subjective feelings of hunger, mood and arousal in normal weight adult males. Neither phenylalanine nor aspartame altered mean energy intakes or macronutrient selection at a lunch begun 60 to 105 min after the amino acids were consumed. During this time, increased (p less than 0.05) visual analog scale (VAS) scores for emptiness, rumbling, weakness, degree of hunger and urge to eat were found in both experiments, but no treatment effects or interactions were seen for any variable in either experiment. Plasma PHE levels and ratios to other large neutral amino acids (NAA) rose significantly (p less than 0.05) after all treatments except 0.84 g PHE; plasma tyrosine (TYR) levels increased (p less than 0.05) only when greater than or equal to 2.52 g PHE was given. TYR/NAA ratios were higher (p less than 0.05) after 2.52 and 5.04 g PHE, and 10.08 g APM. No relationships were found between food intake and plasma amino acid levels. We conclude that, in normal weight men, PHE and APM, in doses up to 10 g, do not affect short-term energy and macronutrient intakes, or subjective feelings of hunger, mood and arousal.

Research paper thumbnail of The Relevance of Selenium to Immunity, Cancer, and Infectious/Inflammatory Diseases

Canadian Journal of Dietetic Practice and Research, 2005

Selenium is an essential trace element involved in several key metabolic activities via selenopro... more Selenium is an essential trace element involved in several key metabolic activities via selenoproteins, enzymes that are essential to protect against oxidative damage and to regulate immune function. Selenium also may have other health benefits unrelated to its enzymatic functions. It may provide important health benefits to people whose oxidative stress loads are high, such as those with inflammatory or infectious diseases like rheumatoid arthritis or human immunodeficiency virus/acquired immunodeficiency syndrome, or who are at high risk for cancers, particularly prostate cancer. Some studies have generated compelling evidence that selenium is beneficial, either alone or in conjunction with other micronutrients. Additional data from large clinical trials that provide the highest level of evidence will be key to determining the benefits accrued at various selenium intake levels. When the strength of the evidence becomes sufficient, clinical health professionals will need to use dietary and clinical assessment methods to ensure that people at increased risk for cancer or inflammatory and infectious diseases can be appropriately advised about selenium intake.

Research paper thumbnail of <i>Nutritional Genomics and</i> Dietetic Professional Practice

Canadian Journal of Dietetic Practice and Research, 2008

Nutrigenomics is concerned with the role of nutrients in gene expression, and nutrigenetics is th... more Nutrigenomics is concerned with the role of nutrients in gene expression, and nutrigenetics is the study of how genetic variants or polymorphisms (mutations) can affect responses to nutrients; nutritional genomics is the umbrella term. Nutritional genomics can be expected to revolutionize the way dietitians and other health professionals identify people with chronic diseases and treat those diseases. Understanding the science of nutritional genomics is important to dietitians and other health professionals because major scientific advancements such as this usually have a significant impact on ethics, policy, and practice. Blood lipid profiles are one area in which nutritional genomics has quickly advanced knowledge. New knowledge is available on blood lipid profiles and associated conditions, such as obesity and type 2 diabetes. New technology has also had an impact on policy and practice issues, and ethics is an important issue to consider.

Research paper thumbnail of Advancing Knowledge Translation in Nutritional Genomics by Addressing Knowledge, Skills and Confidence Gaps of Registered Dietitians

Nutrition and Genomics, 2009

Research paper thumbnail of Public-Private Partnership: Successful Development of a Social Marketing Course

INTED2016 Proceedings, 2016

Research paper thumbnail of Effects of Phenylalanine and Aspartame on Mealtime Food Intake and Behavior in Adult Males

Dietary Phenylalanine and Brain Function, 1988

Research paper thumbnail of Folic acid and prevention of neural tube defects

Canadian family physician Médecin de famille canadien, 2008

Now that flour and pasta have been fortified with folic acid in Canada, do I still need to recomm... more Now that flour and pasta have been fortified with folic acid in Canada, do I still need to recommend folic acid supplements to my patients who are of child-bearing age? If I should recommend supplements, when should I recommend them, and what is an appropriate dose? Non-pregnant women should consume 400 microg of folic acid daily, and pregnant women should consume 600 microg of folic acid daily. Mean intakes of folate in Canada before fortification were around 200 microg/d or less. Fortification increased intake of folic acid by up to 100 microg/d. You should discuss the importance of folic acid with your patients who are planning pregnancy; it is recommended that a folic acid supplement or prenatal multivitamin containing at least 400 microg of folic acid be consumed daily. The upper limit for folic acid is 1 mg/d. Women in intermediate- to high-risk categories for neural tube defects, such as a previous neural tube defect-affected pregnancy, should take 4 to 5 mg of folic acid daily.

Research paper thumbnail of Diet and colorectal cancer: Review of the evidence

Canadian family physician Médecin de famille canadien, 2007

To investigate whether diet has a role in the development and progression of colorectal cancer (C... more To investigate whether diet has a role in the development and progression of colorectal cancer (CRC). MEDLINE was searched from January 1966 to December 2006 for articles on the relationship between diet and CRC using the key words colorectal cancer and folic acid, calcium, vitamin D, red meat, or fibre. Evidence that these factors are associated with CRC came from case-control and prospective cohort studies and some clinical trials. Whether red meat is a culprit in causing CRC remains unanswered, although any effect it might have is likely moderate and related to processing or cooking. The effect of dietary fibre on risk of CRC has also been difficult to determine because fibre intake is generally low. Evidence that folic acid, calcium, and vitamin D reduce risk of CRC is stronger. In particular, recent research indicates that calcium and vitamin D might act together, rather than separately, to reduce the risk of colorectal adenomas. There might also be an interaction between low f...

Research paper thumbnail of Carpal tunnel syndrome and vitamin B6

Canadian family physician Médecin de famille canadien, 2007

A 42-year-old woman with carpal tunnel syndrome tells you she has started taking a vitamin B6 sup... more A 42-year-old woman with carpal tunnel syndrome tells you she has started taking a vitamin B6 supplement to relieve her symptoms. Her work in an automotive parts department involves both lifting moderately heavy packages and typing at a computer terminal. What does the research indicate about vitamin B6 as a treatment option, and what health issues should you discuss with this patient? Although its effectiveness is controversial, vitamin B6 is often used as a conservative and adjunct therapy in treatment of carpal tunnel syndrome. Many patients attempt to treat their symptoms with vitamin B6 on their own. Vitamin B6 at less than 200 mg daily is not likely to cause any adverse effects, but patients should be monitored for changes in symptoms, particularly when high doses are taken over long periods.

Research paper thumbnail of New dietary reference intakes for macronutrients and fibre

Canadian family physician Médecin de famille canadien, 2006

VOL 52: FEBRUARY • FEVRIER 2006 d Canadian Family Physician • Le Médecin de famille canadien 177 ... more VOL 52: FEBRUARY • FEVRIER 2006 d Canadian Family Physician • Le Médecin de famille canadien 177 FOR PRESCRIBING INFORMATION SEE PAGE 242 ➛

Research paper thumbnail of Calcium and optimal bone health

Canadian family physician Médecin de famille canadien, 2005

Research paper thumbnail of Bone health. New role for vitamin K?

Canadian family physician Médecin de famille canadien, 2004

To assess growing evidence that vitamin K (phylloquinone) plays an important role in bone health ... more To assess growing evidence that vitamin K (phylloquinone) plays an important role in bone health and, subsequently, in prevention of osteoporotic fractures. We searched MEDLINE from January 1972 to December 2002 using the key words vitamin K and bone health. We reviewed 30 articles that seemed relevant or had a human focus. All evidence can be categorized as level II. Evidence suggests that dietary phylloquinone intake of <100 microg daily might not be optimal for bone health. Low intake of vitamin K could contribute to osteoporosis and subsequent fracture due to the undercarboxylation of osteocalcin. Family physicians need to be aware of the importance of encouraging adequate vitamin K intake, particularly among institutionalized elderly people, to prevent increased bone resorption. Further study is needed to determine the exact role of vitamin K in bone metabolism, and methods of assessing vitamin K requirements need to be standardized.

Research paper thumbnail of Preventing diverticular disease. Review of recent evidence on high-fibre diets

Canadian family physician Médecin de famille canadien, 2002

To review recent evidence on dietary factors associated with diverticular disease (DD) with speci... more To review recent evidence on dietary factors associated with diverticular disease (DD) with special emphasis on dietary fibre. MEDLINE was searched from January 1966 to December 2001 for articles on the relationship between dietary and other lifestyle factors and DD. Most articles either focused on dietary intervention in treating symptomatic DD or were case-control studies with inherent limitations for studying diet-disease associations. Only one large prospective study of male health professionals in the United States assessed diet at baseline and before initial diagnosis of DD. A diet high in fibre mainly from fruits and vegetables and low in total fat and red meat decreases risk of DD. Evidence indicates that the insoluble component of fibre is strongly associated with lower risk of DD; this association was particularly strong for cellulose. Caffeine and alcohol do not substantially increase risk of DD, nor does obesity, but higher levels of physical activity seem to reduce risk...

Research paper thumbnail of Phenylalanine and aspartame fail to alter feeding behavior, mood and arousal in men

Physiology & Behavior, 1987

Two experiments were designed to investigate the neurobehavioral effects of phenylalanine (PHE; 0... more Two experiments were designed to investigate the neurobehavioral effects of phenylalanine (PHE; 0.84, 2.52, 5.04, and 10.08 g) and aspartame (APM; 5.04 and 10.08 g) on energy and macronutrient selection and on subjective feelings of hunger, mood and arousal in normal weight adult males. Neither phenylalanine nor aspartame altered mean energy intakes or macronutrient selection at a lunch begun 60 to 105 min after the amino acids were consumed. During this time, increased (p less than 0.05) visual analog scale (VAS) scores for emptiness, rumbling, weakness, degree of hunger and urge to eat were found in both experiments, but no treatment effects or interactions were seen for any variable in either experiment. Plasma PHE levels and ratios to other large neutral amino acids (NAA) rose significantly (p less than 0.05) after all treatments except 0.84 g PHE; plasma tyrosine (TYR) levels increased (p less than 0.05) only when greater than or equal to 2.52 g PHE was given. TYR/NAA ratios were higher (p less than 0.05) after 2.52 and 5.04 g PHE, and 10.08 g APM. No relationships were found between food intake and plasma amino acid levels. We conclude that, in normal weight men, PHE and APM, in doses up to 10 g, do not affect short-term energy and macronutrient intakes, or subjective feelings of hunger, mood and arousal.

Research paper thumbnail of The Relevance of Selenium to Immunity, Cancer, and Infectious/Inflammatory Diseases

Canadian Journal of Dietetic Practice and Research, 2005

Selenium is an essential trace element involved in several key metabolic activities via selenopro... more Selenium is an essential trace element involved in several key metabolic activities via selenoproteins, enzymes that are essential to protect against oxidative damage and to regulate immune function. Selenium also may have other health benefits unrelated to its enzymatic functions. It may provide important health benefits to people whose oxidative stress loads are high, such as those with inflammatory or infectious diseases like rheumatoid arthritis or human immunodeficiency virus/acquired immunodeficiency syndrome, or who are at high risk for cancers, particularly prostate cancer. Some studies have generated compelling evidence that selenium is beneficial, either alone or in conjunction with other micronutrients. Additional data from large clinical trials that provide the highest level of evidence will be key to determining the benefits accrued at various selenium intake levels. When the strength of the evidence becomes sufficient, clinical health professionals will need to use dietary and clinical assessment methods to ensure that people at increased risk for cancer or inflammatory and infectious diseases can be appropriately advised about selenium intake.

Research paper thumbnail of <i>Nutritional Genomics and</i> Dietetic Professional Practice

Canadian Journal of Dietetic Practice and Research, 2008

Nutrigenomics is concerned with the role of nutrients in gene expression, and nutrigenetics is th... more Nutrigenomics is concerned with the role of nutrients in gene expression, and nutrigenetics is the study of how genetic variants or polymorphisms (mutations) can affect responses to nutrients; nutritional genomics is the umbrella term. Nutritional genomics can be expected to revolutionize the way dietitians and other health professionals identify people with chronic diseases and treat those diseases. Understanding the science of nutritional genomics is important to dietitians and other health professionals because major scientific advancements such as this usually have a significant impact on ethics, policy, and practice. Blood lipid profiles are one area in which nutritional genomics has quickly advanced knowledge. New knowledge is available on blood lipid profiles and associated conditions, such as obesity and type 2 diabetes. New technology has also had an impact on policy and practice issues, and ethics is an important issue to consider.

Research paper thumbnail of Advancing Knowledge Translation in Nutritional Genomics by Addressing Knowledge, Skills and Confidence Gaps of Registered Dietitians

Nutrition and Genomics, 2009