Dalia El Khoury

Introduction: Gluten-related disorders have been increasingly reported across all gender and age groups. In addition to their higher cost, gluten-free products are often higher in fat, sugar, and sodium. Despite the substantial nutritional benefits of beans, they remain insufficiently represented in gluten-free dietary patterns. Aim: In this study, our aim was to explore knowledge and consumption of beans among adults with gluten-related disorders, including celiac disease (CD) and non-celiac gluten sensitivity (NCGS). Methods: This study followed a cross-sectional, observational design. In collaboration with Celiac Canada, individuals with a diagnosis of CD or NCGS were recruited. Participants were asked to complete a Qualtrics-based questionnaire, exploring self-reported Diagnosis and Health Status, Eating Habits and Consumption of Beans, Knowledge, Determinants of Bean Consumption, Barriers and Drivers of Bean Consumption, and Demographics. Descriptive statistics as well as exploratory analyses and regression analyses were conducted, with statistical significance defined as p ≤ 0.05. Results: A total of 528 participants, including 490 individuals with CD and 38 with NCGS, completed the survey. Several self-reported micronutrient deficiencies were mentioned at the time of diagnosis, with iron-deficiency anemia being the most prevalent (69.0%). In addition, the most frequently self-reported symptom was fatigue (72.2%), followed by flatulence and abdominal pain (71.2%). Most participants (96.4%) strongly agreed that following a gluten-free diet is essential for the management of their diagnosis. Although a high proportion of participants (88.6%) reported daily consumption of plant-based foods, only 0.9% of participants reported daily consumption of dry beans and 0.4% reported daily consumption of canned beans. The most frequently mentioned motivators were the nutritional value of beans (74.9%), whereas the most common barrier to bean consumption was the long cooking and soaking time (40.2%). In addition, potential cross-contamination with gluten was mentioned as another major concern to including beans in gluten-free diets. Despite participants’ confidence in knowledge about beans and their nutritional value and health benefits, most participants (68.9%) agreed that knowing more about how to prepare beans would encourage them to consume them as part of their diets. Based on multivariable linear regression analysis, confidence in knowledge about bean preparation (p ≤ 0.001) and interest in learning more about them (p ≤ 0.001) were positively associated with increased bean consumption. Conclusions: Despite high interest in beans and strong confidence in bean-related knowledge among individuals with CD or NCGS, consumption remains relatively low. Educational resources focused on preparation, recipes, and gastrointestinal tolerance may help increase consumption. Future research should evaluate the tolerability and long-term health effects of bean consumption in CD and NCGS populations.

Background/Objectives: The rising prevalence of dietary supplement use among athletes raises concerns, given the risks associated with unnecessary or excessive use. This study evaluated the impact of a Theory of Planned Behaviour (TPB)-based online educational intervention, “Nutrition for Athletes”, on dietary supplement use among varsity athletes at a Canadian university. Methods: Thirty varsity athletes were randomized into intervention (n = 18) and control (n = 12) groups. The intervention was delivered online over four weeks and consisted of four units that covered topics related to sports nutrition, hydration in sports, dietary supplements, and risks associated with dietary supplement use. Dietary supplement use was measured at baseline and post-intervention using self-reported questionnaires. Results: The most commonly used supplements at baseline were vitamin D (57%), vitamin C (53%), sports drinks (50%), protein bars, powders, and shakes (43%), and whey protein (40%). Binary logistic regression revealed a reduced likelihood of dietary supplement use in the experimental group compared to the control group post intervention, but this difference was not statistically significant (OR = 0.18, 95% CI = 0.01 to 1.76, p = 0.14). There was also no significant change in the behaviour of dietary supplement use within the experimental group, when comparing baseline to post-intervention (OR = 0.12, 95% CI = 0.01 to 1.11, p = 0.06). Conclusions: These findings reflect the potential existence of an intention-behaviour gap. Future interventions may benefit from incorporating strategies that address control-related barriers.

This paper describes the development and design of Nutrition for Athletes: A Focus on Dietary Supplements, an online educational intervention created for varsity athletes at the University of Guelph. Guided by the Theory of Planned Behaviour (TPB), the program aimed to improve athletes’ nutrition and dietary supplement-related knowledge while modifying attitudes, subjective norms, perceived behavioral control, intentions, and behaviors associated with dietary supplement use. Formative research with the target population revealed widespread misconceptions, strong social influences, and high perceived benefits of supplement use, which highlighted the need for an intervention focused on reshaping underlying beliefs. The program covered topics related to sports nutrition, hydration, dietary supplements, and risks of supplement use, and was integrated into the university’s learning management system. Each unit was mapped onto relevant TPB constructs, with an emphasis on correcting inaccurate beliefs and promoting a food-first approach. The program’s effectiveness was evaluated through pre- and post-intervention questionnaires assessing knowledge and TPB constructs. This paper outlines the theoretical framework, development process, and content structure of the intervention, and presents a model that can be replicated in future educational programs.

The reciprocal relationship between genes and nutrients, known as nutrigenetics and nutrigenomics, has been established in many studies. However, current investigations of maternal and neonatal nutrition using a precision nutrition approach focused on genomics are limited, especially in the Middle East and North Africa (MENA) region. This review aims to summarize the impacts of the dietary micronutrients, folic acid, thiamine, and cobalamin on optimal health outcomes during pregnancy, fetal development, lactation, and infant growth. In this review, the roles of folic acid, thiamine, and cobalamin are discussed in the context of various aspects of pregnancy, such as preconception, fetal development, and lactation, highlighting how genetic events occurring during developmental periods can have consequential impacts on health outcomes later in life. Deficiency rates and related health consequences as well as the prevalence of genetic mutations related to these nutrients of interest in the MENA region are also elaborated on. How to advance knowledge and applications of precision nutrition, how genes interact with the neurochemical changes during pregnancy, and how this interaction impacts maternal eating behaviors, and consequently fetal development and infant and child growth and health, should be further explored in future studies. This includes taking advantage of cutting-edge technologies and the role of artificial intelligence in this endeavor.

The market for gluten-free (GF) snack products has expanded, even among children without gluten-related disorders, but few studies have assessed their nutritional quality relative to gluten-containing (GC) counterparts. This study compared the macronutrient composition and fibre additive content of such snack bars marketed to children in Ontario. A total of 110 snack bars were identified using a standardized set of marketing-based criteria. Nutritional data, including macronutrient content and the presence of fibre additives such as inulin and fructooligosaccharides (FOSs), were collected. Data was standardized per 100 kcals and bar size, then analyzed using an independent sample t-test and chi-square. Results indicated that GF bars contained significantly higher levels of protein (1.7 ± 0.77 g vs. 1.3 ± 0.44 g; p = 0.002) and fibre (1.9 ± 0.95 g vs. 1.4 ± 0.98 g; p = 0.015). No significant differences were observed for sugar, carbohydrates, total fat, saturated fat, or trans fat content. Fibre additives were more common in GF bars (24.4% vs. 10.1%), though this association was not statistically significant (p = 0.079). Findings suggest that while GF bars show slight nutritional advantages, their similar overall profiles and greater use of fibre additives indicate room for improvement across both categories.

Proteins elicit various metabolic and physiological functions that are related to physical performance. Due to increased need in athletes, protein supplementation has been widely used to support recovery and performance. However, the extent to which acute gains in muscle protein synthesis translate into measurable performance remains debated. This narrative review synthesizes evidence from trials on supplemental proteins across resistance, endurance, and mixed-modality training, comparing sources (whey, casein, soy, pea, and blends). Moreover, this review summarizes dosing and timing strategies, with notes for master, diabetic, and female athletes. It is well-established that supplemental protein enhances fat-free mass and, to a lesser extent, strength when baseline dietary protein is suboptimal. However, the effects are smaller when habitual intake already meets athletic targets. Whey, as a rapid protein and rich in leucine, reliably elicits an acute anabolic response, while casein provides prolonged elevated aminoacidemia. When total intake and leucine thresholds are matched, plant proteins and blends can yield comparable long-term adaptations. In addition, studies showed that the distribution and strategic timing around exercise (post-exercise first, with optional pre-sleep casein or blends) support recovery during high-frequency training or energy deficit. Protein co-ingested with carbohydrate in endurance and high-intensity functional training (HIFT) can also help glycogen restoration and attenuate muscle-damage markers, though effects on sport outcomes are inconsistent. The evidence in diabetic athletes is limited; guidance extrapolates from diabetes and athlete studies, with benefits apparent when intake, quality, or distribution are limited. Furthermore, evidence indicates that anabolic resistance in master athletes requires higher per-meal doses and distribution, with post-exercise and pre-sleep feedings valuable. Consistently, female athletes partaking in aerobic and resistance training while supplementing with protein demonstrate desired body composition adaptations. Overall, although supplemental protein helps close gaps between intake and physiological demand, various factors may influence its regimen. Protein source may help the kinetics balance, amino-acid profile, and dietary preferences. Alternatively, timing may influence the protein effects on training and recovery.

Background: Biotinidase deficiency (BD) is a common autosomal recessive metabolic disorder in Qatar and the Arab world. It is treatable if detected early, making it essential to understand the genetic variants involved. This study aimed to investigate the carrier frequency of BD-related variants in a healthy Qatari population, reflecting the genetic landscape of the broader Middle Eastern region; classify them using bioinformatics tools; and compare findings with global datasets. Methods: Whole-genome sequencing data from 14,669 participants in the Qatar Genome Program (QGP), a multiethnic cohort including Qatari nationals and long-term residents (≥15 years), were analyzed to identify BTD variants. A total of 723, including 653 single-nucleotide polymorphisms (SNPs) and 70 structural variants (SVs) in BTD associated with BD, were screened against the Qatari cohort and compared with international data. In silico tools were used to assess variant pathogenicity, conservation, and protein stability. Molecular dynamics (MD) simulations were performed to evaluate structural and functional changes in the BTD. Results: A total of 80 SNPs and 3 SVs were identified, among which 21 variants (19 SNPs and 2 SVs) were classified as pathogenic or likely pathogenic, according to ClinVar. The carrier frequency of BTD-related variants in Qatar was 1:20, primarily driven by rs13078881 (D444H). Molecular dynamics (MD) simulations revealed significant conformational changes with H323R, D444H, and P497S, which demonstrated increased flexibility (higher RMSD/RMSF and PCA trace values). Additionally, R209C and D444H showed reduced compactness (higher Rg) and distinct energy minima, suggesting altered conformational states. Conclusions: This study demonstrates a high carrier frequency of pathogenic BTD variants in the Qatari population, underscoring the need to integrate these SNPs and SVs into the national genomic neonatal screening program (gNBS) for enhanced early detection and treatment strategies. The mild structural deviations observed in the D444H mutant through MD simulations may explain its association with milder clinical phenotypes of BTD, offering valuable insights for personalized therapeutic approaches.

Background/Objectives: Dietary supplement use among varsity athletes is influenced by various psychological and social factors, yet there is limited evidence on the effectiveness of educational interventions in influencing these determinants. The aim of this study was to determine the effects of an online nutrition education program on improvements in intentions and related determinants towards the use of dietary supplements in varsity athletes at the University of Guelph in Canada. The theory of planned behavior served as the theoretical framework for examining these determinants as predictors of behavior change. Methods: A randomized wait-list controlled trial was conducted on a total of 30 varsity athletes, randomized into experimental (n = 18) and control (n = 12) groups. The experimental group received access to an online nutrition education program focused on sports nutrition and dietary supplements, while the control group did not have access during the study. Results: There was a significant (p < 0.05) intervention effect on varsity athletes’ attitudes (Mean1_(control) = 13.17; Mean1_{(experimental)} = 13.56; Mean2_(control) = 13.92; Mean2_{(experimental)} = 12.11), perceived behavioral control (Mean1_(control) = 15.92; Mean1_{(experimental)} = 16.11; Mean2_(control) = 16.33; Mean2_{(experimental)} = 18.39), and intentions (Mean1_(control) = 12.5; Mean1_{(experimental)} = 12.89; Mean2_(control) = 11.58; Mean2_{(experimental)} = 9.44) towards dietary supplement use. No significant changes were made to descriptive and injunctive norms. Conclusions: These findings suggest that this nutrition education program significantly improved intentions and related determinants towards dietary supplement use in varsity athletes. The absence of a successful change in subjective norm should be a focus for similar future interventions.

Background/Objectives: Research has shown that athletes often have poor nutritional knowledge, particularly regarding dietary supplements. The purpose of this study was to investigate the effectiveness of an online nutrition education program in improving nutritional and dietary supplement knowledge among varsity athletes at the University of Guelph in Ontario, Canada. Methods: A total of 30 varsity athletes at the University of Guelph were randomized into experimental [n = 18] and control [n = 12] groups. A randomized wait-list controlled intervention was used, where participants in the experimental group were granted access to an online, 4-week nutrition education program, while no program was provided to the control group within the duration of the study. The program covered nutrition topics and focused on sports nutrition and dietary supplementation. Both groups were administered a validated online nutrition and dietary supplement questionnaire at baseline and post-intervention. Results: Mean baseline knowledge scores for the experimental and control groups were 13.78 ± 2.76 and 13.92 ± 2.39, respectively, and were not significantly different [p = 0.888]. Post-intervention scores were 16.28 ± 1.49 and 14.5 ± 1.88 for the experimental and control groups, respectively, [p < 0.05]. There was a significant interaction between the intervention and time on knowledge. Conclusions: These results indicate that this nutrition education program was successful in significantly improving nutritional and dietary supplement knowledge in varsity athletes.

There is a lack of research regarding dietary supplement (DS) use among Gay, Bisexual, Transgender, Two-Spirit, Queer (GBT2Q) men and non-binary individuals, despite the higher prevalence of body image issues and societal pressure within this community. This study aimed to investigate patterns and predictors of DS use in this population, including types of DS used, sources of information, and reasons for DS use. A validated and anonymous online questionnaire was completed by 204 participants (52.5% men, 43.1% gay, mean age 29.34 + 6.77 years) across Canada, who were consuming DS at the time of the study. Analyses included descriptive statistics to characterize the sample based on gender, sexuality, age, ethnicity, and other demographic attributes, using Pearson’s chi-square tests and multi-way cross-tabulation analyses. Additionally, regression analyses, including binary and logistic regressions, were employed to identify predictors of DS use. Data analysis concluded that vitamins/minerals (92.2%), proteins (84.3%) and carbohydrates (75.5%) were the most consumed types of supplements. Identifying as certain genders and sexualities was significantly associated with supplement preferences, such that men reported higher use of amino acids (p = 0.033) and non-vitamins/mineral antioxidants compared to individuals identifying as other genders (p = 0.006). Moreover, bisexual participants consumed amino acids (p = 0.043) and carbohydrates (p = 0.026) more frequently when compared to non-bisexual participants. The most listed reason for DS use was to improve immunity (60.3%), with health care professionals being listed as the source of information by most participants (51.0%). Findings from this study can serve as a foundation for further research in this area and can guide the formulation and implementation of adequate policies targeting this underserved population.