- Email: [email protected]
A1C Reduction Using a Menu Plan Intervention in Patients with Type 2 Diabetes
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Abstracts / Can J Diabetes 37 (2013) S13eS84
participants adopted an atherogenic diet, 67% were sedentary and 48% were either active or former smokers. Patients with MS were more likely to be sedentary (OR [CI]: 3.1 [1.2 to 8.3], p¼0.02) and smokers (OR [IC] ¼ 2.4 [1.0 to 5.4], p¼0.04). No association was observed with diet quality. These preliminary results suggest that a high proportion of patients with T1D adopted unhealthy lifestyle habits, which could contribute to the increasing prevalence of the MS among this population.
202 Programming of Glucose Homeostasis by Developmental Exposure to Folic Acid and Vitamin B12 Imbalance in Female Mice JESSE D. OLSON*, RIKA E. ALEIUNAS, MELISSA B. GLIER, ABEER M. ALJAADI, TIM J. GREEN, ANGELA M. DEVLIN Vancouver, BC Developmental exposure to imbalanced maternal nutrient status may program risk for type 2 diabetes. This phenomenon of developmental programming may be mediated by epigenetic mechanisms. Population studies have reported that children from mothers with high folate and low B12 status during pregnancy have greater adiposity and insulin resistance; however, the mechanisms behind these observations remain unknown. The objective of this study is to investigate the molecular mechanisms underlying programming of adiposity and glucose homeostasis by maternal folate and B12 imbalance. Female C57BL/6J mice were fed a high folic acid (FA) with B12 (HFA+B12), high FA without B12 (HFA-B12) or a control diet during pregnancy and lactation. At weaning, female offspring were fed a western or control diet until 30 weeks of age. Offspring mice fed the post-weaning western diet had greater body weight (p<0.001), visceral (p<0.001) and subcutaneous (p<0.001) fat, and glucose intolerance (p<0.05) than offspring fed the postweaning control diet. Offspring from female mice fed the HFA-B12 diet had greater subcutaneous fat (p<0.05) than offspring from female mice fed the control or HFA+B12 diets. This was accompanied by lower (P<0.05) pancreatic islet MafA mRNA; however, this was only observed in offspring fed the post-weaning control diet. Offspring mice fed the post-weaning western diet that were from females fed the HFA-B12 diet had lower p<0.05) fasting glucose and insulin concentrations compared to offspring from females fed the control diet. These findings provide evidence of programming of glucose homeostasis by developmental exposure to FA and B12 imbalance.
203 Seven-Day Caloric and Saturated Fat Restriction Increases Myocardial Dietary Fatty Acid Partitioning in Subjects with Impaired Glucose Tolerance CHRISTOPHE NOLL*, MARGARET KUNACH, SERGE PHOENIX, BRIGITTE GUÉRIN, ÉRIC E. TURCOTTE, ANDRÉ C. CARPENTIER Sherbrooke, QC We recently found increased myocardial partitioning of dietary fatty acids associated with subclinical ventricular dysfunction in subjects with impaired glucose tolerance (IGT+). These metabolic and functional myocardial abnormalities were significantly improved following an individually tailored 1-year lifestyle intervention leading to weight loss. The aim of the present study was to determine the effect of a 7-day dietary caloric (e500 kcal/day) and saturated fat (<7% of caloric intake) restriction (LowCal) vs. a 7-day isocaloric diet (Control), in random order with a washout period of
at least 10 days in between, on myocardial dietary fatty acid partitioning in IGT+ subjects determined using our positron emission tomography coupled with computed tomography (PET/CT) method with the fatty acid analog 18-Fluoro-6-thia-heptadecanoic acid (18FTHA) during a standard liquid meal. Eight IGT+ subjects (3M/ 5W) have completed the study thus far. Postprandial 18FTHA activity in circulation was not significantly different between the 2 interventions. Myocardial 18FTHA mean standard uptake value (SUV) after 6 hours was increased in LowCal vs. Control (2.40.2 vs. 1.90.2, p¼0.05). Organ-specific partitioning of dietary fatty acids was not significantly changed in the liver, subcutaneous adipose tissue or skeletal muscles in the LowCal vs. Control diet, but tended to be increased in visceral adipose tissue (0.90.7 vs. 0.70.4, p¼0.07). Our preliminary results suggest that a low-calorie, low-fat diet does not explain by itself the normalization of organ-specific dietary fatty acid partitioning associated with a lifestyle-based weight loss intervention in IGT+ subjects.
204 Screening on Quebecois and Brazilian Fruits Aiming to Identify Active Biomolecules Against Obesity and Type 2 Diabetes FERNANDO F. ANHE*, GENEVIÈVE PILON, STÉPHANIE DUDONNÉ, YVES DESJARDINS, ANDRÉ MARETTE Quebec, QC Obesity and type 2 diabetes mellitus (T2D) profoundly affect western societies. An interesting approach aiming to combat this epidemic relies on the utilization of polyphenol-rich berries to generate active nutraceuticals and functional foods. Whole extracts from 10 berries (Lonicera caerulea, Prunus virginiana, Viburnum trilobum, Aronia melanocarpa, Amelanchier alnifolia and Sambucus nigra, Myrciaria dubia and Myrciaria jaboticaba) were prepared. For 8 weeks, control mice received either a chow standard diet or a high fat high sucrose (HFHS) diet, while the remaining groups received each a HFHS diet plus one of the extracts by daily gavage (200 mg/kg). Administration of M. dubia and V. trilobum prevented HFHS fed mice from becoming obese, without affecting energy intake, and by generating, respectively, a 47% and a 37% reduction in body weight gain in parallel to a reduction in fat depots. These effects were accompanied by a prevention toward increasing of adipocyte size, crown-like structure (CLS) density and MCP1 and VEGF contents in adipose tissue. M. dubia and V. trilobum administration improved glucose intolerance and diminished triglyceride content in liver. Interestingly, L. caerulea and P. virginiana improved glucose intolerance and reduced hepatic triglyceride content without affecting body weight gain. P. virginiana also prevented augmentation of CLS density and MCP1 and VEGF contents in adipose tissue. M.dubia and V. trilobum may act by different mechanisms than L. caerulea and P. virginiana to cause beneficial metabolic effects. Identification of the molecules behind these effects will certainly collaborate for the generation of promising nutraceuticals and functional foods.
205 A1C Reduction Using a Menu Plan Intervention in Patients with Type 2 Diabetes GHADA A. ASAAD*, DIANA C. SORIA CONTRERAS, CATHERINE B. CHAN Edmonton, AB Type 2 diabetes patients often find integrating a new dietary pattern into their lifestyle challenging; therefore, the PANDA (Physical Activity and Nutrition for Diabetes in Alberta) program was developed to help people incorporate the Canadian Diabetes Association (CDA) nutrition therapy guidelines into their daily diet.
Abstracts / Can J Diabetes 37 (2013) S13eS84
Our objective was to conduct a phase 2 single-arm trial to evaluate the effectiveness of a nutrition intervention focused on menu planning on glycated hemoglobin (A1c), weight, fat mass, waist circumference, body mass index and diet adherence among type 2 diabetic patients. The intervention structure was based on social cognitive theory and included 5 weekly group sessions, a grocery store tour, a 4-week menu plan that incorporated the overall recommendations of the CDA nutrition therapy guidelines and handson activities. Perceived dietary adherence, anthropometric measurements (height, weight, waist, hip circumferences) and A1c were measured at baseline and 3 months. The average age of participants (n¼22) was 606.8 (SD) and duration of diabetes was 1010 years. After 3 months, there were statistically significant (p<0.05) reductions in HbA1c (e0.65 %), waist circumference (e1.9 cm) and fat mass (e0.78 kg). Also, perceived dietary adherence improved significantly (p<0.000). The preliminary results of this ongoing study suggest that a dietary intervention incorporating education sessions focused on menu planning and hands-on activities may be effective for diabetes management.
206 Dietary Intake of Adults with Type 2 Diabetes Measured Using the Modified Block Food Frequency Questionnaire HAYFORD M. AVEDZI*, NONSIKELELO MATHE, CLARK MUNDT, JEFFREY A. JOHNSON, STEVE T. JOHNSON Edmonton, AB Diet is fundamental in the overall management of type 2 diabetes (T2D). Few studies have described the dietary intake of Canadians with T2D. This study examined the baseline dietary intake of participants of the Healthy Eating and Active Living for Diabetes in Primary Care Networks (HEALD-PCN) study using a modified 55-item Block Food Frequency Questionnaire (FFQ). A total of 196 individuals (51% women), mean age 59.6 years and BMI 33.6 kg/ m2 were included. Overall, mean caloric intake was estimated to be 1286 kcals (95% CI, 1220, 1351) and was higher in men (1363 kcals) compared with women (1211 kcals; p¼0.02). Mean carbohydrate and protein intakes were 594 kcals (95% CI, 562, 627) and 241 kcals (95% CI 229, 254), respectively. Mean fat intake was 498 kcals (95% CI 455, 540) for men and 442 kcals (95% CI 408, 476) for women (p¼0.04). Mean daily consumption of fruits and vegetables were 1.6 (95% CI, 1.5, 1.8) and 1.8 (95% CI 1.7, 1.9) cup equivalents/ person/day, respectively. Overall, mean fibre intake was 13.0 g/day (95% CI 12.3, 13.8); there were no differences between men and women. Adults with T2D reported consuming a diet low in fruits and vegetables and dietary fibre. Men reported higher intakes of dietary fat and total energy. Overall, the Block FFQ may have underestimated energy intake however, these results suggest targeted dietary counselling for men living with T2D should be considered.
207 The Impact of Flaxseed Lignan Complex Consumption on Waist to Height and Hip Ratios, Body Weight, BMI, Insulin Resistance, Percent Pancreatic Beta-Cell Function, Free Fatty Acids, HDL2HDL3- and Non-HDL-Cholesterol and Lp(a) in Older Human Type 2 Diabetics DOUGLAS E. BARRE* Sydney, NS Objective: The variables examined are a waist circumferenceassociated clinically significant cluster not yet examined for
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changes due to flaxseed lignan complex ( FLC) administration in people with type 2 diabetes. It was hypothesized that FLC relative to placebo would increase (or better manage) percent pancreatic beta-cell function and plasma HDL2-cholesterol concentration and decrease (or better manage) the waist:height ratio (WHTR), body weight, BMI, waist:hip ratio, insulin resistance, total plasma free fatty acid, Lp(a), HDL3- and non-HDL-cholesterol concentrations. The objective was to test this hypothesis. Methods: Sixteen (11 male, 5 female) people with type 2 diabetes (mean age 66 years, mean BMI 31.2 kg/m2) completed this doubleblind, randomized, crossover placebo-controlled study. Patients consumed 4 capsules/day of FLC (600 mg secoisolariciresinol diglucoside/day) or placebo for 3 months followed by a 3-month washout period (no exposure to FLC or placebo) followed by 3 months on that (FLC or placebo) to which they had not been previously exposed in this study. Results: All data is reported as mean (SEM). Only WHTR was better FLC managed (60.1 [2.8] [start] e 60.5 [2.8] [finish] [FLC] vs. 60.1 [2.7] [start] e 61.4 [2.7] [finish] [placebo]) (p¼0.04) with no other significant differences due to FLC. Diet (including alcohol), smoking, medication (dose and type) and exercise patterns did not change over the course of the study. Discussion and Conclusion: Better WHTR management has been suggested by some to be an even more powerful indicator of improved metabolic control in type 2 diabetics (compared to waist circumference). However, while it is concluded that FLC significantly better managed the WHTR, it did not affect significantly the other aforementioned dependent variables. The clinical significance, if any, of these findings awaits elucidation.
208 Sugar Claims on Foods: Health Professionals’ Understanding Compared to Marketplace Practise JODI T. BERNSTEIN, CHIARA L. DIANGELO, SANDRA L. MARSDEN, TRISTIN D. BRISBOIS* Toronto, ON Nutrition claims on foods are meant to help consumers make informed dietary choices. However, for sugar claims, comparative reductions in calories and carbohydrates are required for any meaningful changes regarding health. Objectives: 1) To assess health professionals’ understanding of sugar claims (“reduced in sugar”, “no sugar added”, “unsweetened”); 2) to compare calories, carbohydrates and sugar content between claim and reference products in the marketplace; and 3) to determine the level of compliance with Canadian regulations. Methods: In 2012, 4 Toronto grocery stores were surveyed to identify products with sugar claims. Health professionals completed questionnaires at 2 national conferences to assess their understanding of sugar claims. Results: Questionnaire respondents (n¼442) were primarily dietitians. The majority of respondents expected calories to be reduced for products bearing the “reduced in sugar” claim. In the marketplace, of the 402 products that bore a sugar claim, one-third were not reduced in calories by 25% as expected by health professionals; 15% of products were higher in calories, 18% higher in carbohydrates and 6% higher in sugars compared to reference products. One-third of products did not meet the % sugar reduction claimed. Less than 40% of products complied with regulations; concentrated fruit juice was often incorrectly used as a sweetener in “no sugar added” products. Conclusions: Sugar claims may be misleading if used incorrectly or if there is not a meaningful reduction in calories. The perception that these products are free of sugars and/or lower in carbohydrates may be of concern for people with diabetes.
Abstracts / Can J Diabetes 37 (2013) S13eS84
participants adopted an atherogenic diet, 67% were sedentary and 48% were either active or former smokers. Patients with MS were more likely to be sedentary (OR [CI]: 3.1 [1.2 to 8.3], p¼0.02) and smokers (OR [IC] ¼ 2.4 [1.0 to 5.4], p¼0.04). No association was observed with diet quality. These preliminary results suggest that a high proportion of patients with T1D adopted unhealthy lifestyle habits, which could contribute to the increasing prevalence of the MS among this population.
202 Programming of Glucose Homeostasis by Developmental Exposure to Folic Acid and Vitamin B12 Imbalance in Female Mice JESSE D. OLSON*, RIKA E. ALEIUNAS, MELISSA B. GLIER, ABEER M. ALJAADI, TIM J. GREEN, ANGELA M. DEVLIN Vancouver, BC Developmental exposure to imbalanced maternal nutrient status may program risk for type 2 diabetes. This phenomenon of developmental programming may be mediated by epigenetic mechanisms. Population studies have reported that children from mothers with high folate and low B12 status during pregnancy have greater adiposity and insulin resistance; however, the mechanisms behind these observations remain unknown. The objective of this study is to investigate the molecular mechanisms underlying programming of adiposity and glucose homeostasis by maternal folate and B12 imbalance. Female C57BL/6J mice were fed a high folic acid (FA) with B12 (HFA+B12), high FA without B12 (HFA-B12) or a control diet during pregnancy and lactation. At weaning, female offspring were fed a western or control diet until 30 weeks of age. Offspring mice fed the post-weaning western diet had greater body weight (p<0.001), visceral (p<0.001) and subcutaneous (p<0.001) fat, and glucose intolerance (p<0.05) than offspring fed the postweaning control diet. Offspring from female mice fed the HFA-B12 diet had greater subcutaneous fat (p<0.05) than offspring from female mice fed the control or HFA+B12 diets. This was accompanied by lower (P<0.05) pancreatic islet MafA mRNA; however, this was only observed in offspring fed the post-weaning control diet. Offspring mice fed the post-weaning western diet that were from females fed the HFA-B12 diet had lower p<0.05) fasting glucose and insulin concentrations compared to offspring from females fed the control diet. These findings provide evidence of programming of glucose homeostasis by developmental exposure to FA and B12 imbalance.
203 Seven-Day Caloric and Saturated Fat Restriction Increases Myocardial Dietary Fatty Acid Partitioning in Subjects with Impaired Glucose Tolerance CHRISTOPHE NOLL*, MARGARET KUNACH, SERGE PHOENIX, BRIGITTE GUÉRIN, ÉRIC E. TURCOTTE, ANDRÉ C. CARPENTIER Sherbrooke, QC We recently found increased myocardial partitioning of dietary fatty acids associated with subclinical ventricular dysfunction in subjects with impaired glucose tolerance (IGT+). These metabolic and functional myocardial abnormalities were significantly improved following an individually tailored 1-year lifestyle intervention leading to weight loss. The aim of the present study was to determine the effect of a 7-day dietary caloric (e500 kcal/day) and saturated fat (<7% of caloric intake) restriction (LowCal) vs. a 7-day isocaloric diet (Control), in random order with a washout period of
at least 10 days in between, on myocardial dietary fatty acid partitioning in IGT+ subjects determined using our positron emission tomography coupled with computed tomography (PET/CT) method with the fatty acid analog 18-Fluoro-6-thia-heptadecanoic acid (18FTHA) during a standard liquid meal. Eight IGT+ subjects (3M/ 5W) have completed the study thus far. Postprandial 18FTHA activity in circulation was not significantly different between the 2 interventions. Myocardial 18FTHA mean standard uptake value (SUV) after 6 hours was increased in LowCal vs. Control (2.40.2 vs. 1.90.2, p¼0.05). Organ-specific partitioning of dietary fatty acids was not significantly changed in the liver, subcutaneous adipose tissue or skeletal muscles in the LowCal vs. Control diet, but tended to be increased in visceral adipose tissue (0.90.7 vs. 0.70.4, p¼0.07). Our preliminary results suggest that a low-calorie, low-fat diet does not explain by itself the normalization of organ-specific dietary fatty acid partitioning associated with a lifestyle-based weight loss intervention in IGT+ subjects.
204 Screening on Quebecois and Brazilian Fruits Aiming to Identify Active Biomolecules Against Obesity and Type 2 Diabetes FERNANDO F. ANHE*, GENEVIÈVE PILON, STÉPHANIE DUDONNÉ, YVES DESJARDINS, ANDRÉ MARETTE Quebec, QC Obesity and type 2 diabetes mellitus (T2D) profoundly affect western societies. An interesting approach aiming to combat this epidemic relies on the utilization of polyphenol-rich berries to generate active nutraceuticals and functional foods. Whole extracts from 10 berries (Lonicera caerulea, Prunus virginiana, Viburnum trilobum, Aronia melanocarpa, Amelanchier alnifolia and Sambucus nigra, Myrciaria dubia and Myrciaria jaboticaba) were prepared. For 8 weeks, control mice received either a chow standard diet or a high fat high sucrose (HFHS) diet, while the remaining groups received each a HFHS diet plus one of the extracts by daily gavage (200 mg/kg). Administration of M. dubia and V. trilobum prevented HFHS fed mice from becoming obese, without affecting energy intake, and by generating, respectively, a 47% and a 37% reduction in body weight gain in parallel to a reduction in fat depots. These effects were accompanied by a prevention toward increasing of adipocyte size, crown-like structure (CLS) density and MCP1 and VEGF contents in adipose tissue. M. dubia and V. trilobum administration improved glucose intolerance and diminished triglyceride content in liver. Interestingly, L. caerulea and P. virginiana improved glucose intolerance and reduced hepatic triglyceride content without affecting body weight gain. P. virginiana also prevented augmentation of CLS density and MCP1 and VEGF contents in adipose tissue. M.dubia and V. trilobum may act by different mechanisms than L. caerulea and P. virginiana to cause beneficial metabolic effects. Identification of the molecules behind these effects will certainly collaborate for the generation of promising nutraceuticals and functional foods.
205 A1C Reduction Using a Menu Plan Intervention in Patients with Type 2 Diabetes GHADA A. ASAAD*, DIANA C. SORIA CONTRERAS, CATHERINE B. CHAN Edmonton, AB Type 2 diabetes patients often find integrating a new dietary pattern into their lifestyle challenging; therefore, the PANDA (Physical Activity and Nutrition for Diabetes in Alberta) program was developed to help people incorporate the Canadian Diabetes Association (CDA) nutrition therapy guidelines into their daily diet.
Abstracts / Can J Diabetes 37 (2013) S13eS84
Our objective was to conduct a phase 2 single-arm trial to evaluate the effectiveness of a nutrition intervention focused on menu planning on glycated hemoglobin (A1c), weight, fat mass, waist circumference, body mass index and diet adherence among type 2 diabetic patients. The intervention structure was based on social cognitive theory and included 5 weekly group sessions, a grocery store tour, a 4-week menu plan that incorporated the overall recommendations of the CDA nutrition therapy guidelines and handson activities. Perceived dietary adherence, anthropometric measurements (height, weight, waist, hip circumferences) and A1c were measured at baseline and 3 months. The average age of participants (n¼22) was 606.8 (SD) and duration of diabetes was 1010 years. After 3 months, there were statistically significant (p<0.05) reductions in HbA1c (e0.65 %), waist circumference (e1.9 cm) and fat mass (e0.78 kg). Also, perceived dietary adherence improved significantly (p<0.000). The preliminary results of this ongoing study suggest that a dietary intervention incorporating education sessions focused on menu planning and hands-on activities may be effective for diabetes management.
206 Dietary Intake of Adults with Type 2 Diabetes Measured Using the Modified Block Food Frequency Questionnaire HAYFORD M. AVEDZI*, NONSIKELELO MATHE, CLARK MUNDT, JEFFREY A. JOHNSON, STEVE T. JOHNSON Edmonton, AB Diet is fundamental in the overall management of type 2 diabetes (T2D). Few studies have described the dietary intake of Canadians with T2D. This study examined the baseline dietary intake of participants of the Healthy Eating and Active Living for Diabetes in Primary Care Networks (HEALD-PCN) study using a modified 55-item Block Food Frequency Questionnaire (FFQ). A total of 196 individuals (51% women), mean age 59.6 years and BMI 33.6 kg/ m2 were included. Overall, mean caloric intake was estimated to be 1286 kcals (95% CI, 1220, 1351) and was higher in men (1363 kcals) compared with women (1211 kcals; p¼0.02). Mean carbohydrate and protein intakes were 594 kcals (95% CI, 562, 627) and 241 kcals (95% CI 229, 254), respectively. Mean fat intake was 498 kcals (95% CI 455, 540) for men and 442 kcals (95% CI 408, 476) for women (p¼0.04). Mean daily consumption of fruits and vegetables were 1.6 (95% CI, 1.5, 1.8) and 1.8 (95% CI 1.7, 1.9) cup equivalents/ person/day, respectively. Overall, mean fibre intake was 13.0 g/day (95% CI 12.3, 13.8); there were no differences between men and women. Adults with T2D reported consuming a diet low in fruits and vegetables and dietary fibre. Men reported higher intakes of dietary fat and total energy. Overall, the Block FFQ may have underestimated energy intake however, these results suggest targeted dietary counselling for men living with T2D should be considered.
207 The Impact of Flaxseed Lignan Complex Consumption on Waist to Height and Hip Ratios, Body Weight, BMI, Insulin Resistance, Percent Pancreatic Beta-Cell Function, Free Fatty Acids, HDL2HDL3- and Non-HDL-Cholesterol and Lp(a) in Older Human Type 2 Diabetics DOUGLAS E. BARRE* Sydney, NS Objective: The variables examined are a waist circumferenceassociated clinically significant cluster not yet examined for
S71
changes due to flaxseed lignan complex ( FLC) administration in people with type 2 diabetes. It was hypothesized that FLC relative to placebo would increase (or better manage) percent pancreatic beta-cell function and plasma HDL2-cholesterol concentration and decrease (or better manage) the waist:height ratio (WHTR), body weight, BMI, waist:hip ratio, insulin resistance, total plasma free fatty acid, Lp(a), HDL3- and non-HDL-cholesterol concentrations. The objective was to test this hypothesis. Methods: Sixteen (11 male, 5 female) people with type 2 diabetes (mean age 66 years, mean BMI 31.2 kg/m2) completed this doubleblind, randomized, crossover placebo-controlled study. Patients consumed 4 capsules/day of FLC (600 mg secoisolariciresinol diglucoside/day) or placebo for 3 months followed by a 3-month washout period (no exposure to FLC or placebo) followed by 3 months on that (FLC or placebo) to which they had not been previously exposed in this study. Results: All data is reported as mean (SEM). Only WHTR was better FLC managed (60.1 [2.8] [start] e 60.5 [2.8] [finish] [FLC] vs. 60.1 [2.7] [start] e 61.4 [2.7] [finish] [placebo]) (p¼0.04) with no other significant differences due to FLC. Diet (including alcohol), smoking, medication (dose and type) and exercise patterns did not change over the course of the study. Discussion and Conclusion: Better WHTR management has been suggested by some to be an even more powerful indicator of improved metabolic control in type 2 diabetics (compared to waist circumference). However, while it is concluded that FLC significantly better managed the WHTR, it did not affect significantly the other aforementioned dependent variables. The clinical significance, if any, of these findings awaits elucidation.
208 Sugar Claims on Foods: Health Professionals’ Understanding Compared to Marketplace Practise JODI T. BERNSTEIN, CHIARA L. DIANGELO, SANDRA L. MARSDEN, TRISTIN D. BRISBOIS* Toronto, ON Nutrition claims on foods are meant to help consumers make informed dietary choices. However, for sugar claims, comparative reductions in calories and carbohydrates are required for any meaningful changes regarding health. Objectives: 1) To assess health professionals’ understanding of sugar claims (“reduced in sugar”, “no sugar added”, “unsweetened”); 2) to compare calories, carbohydrates and sugar content between claim and reference products in the marketplace; and 3) to determine the level of compliance with Canadian regulations. Methods: In 2012, 4 Toronto grocery stores were surveyed to identify products with sugar claims. Health professionals completed questionnaires at 2 national conferences to assess their understanding of sugar claims. Results: Questionnaire respondents (n¼442) were primarily dietitians. The majority of respondents expected calories to be reduced for products bearing the “reduced in sugar” claim. In the marketplace, of the 402 products that bore a sugar claim, one-third were not reduced in calories by 25% as expected by health professionals; 15% of products were higher in calories, 18% higher in carbohydrates and 6% higher in sugars compared to reference products. One-third of products did not meet the % sugar reduction claimed. Less than 40% of products complied with regulations; concentrated fruit juice was often incorrectly used as a sweetener in “no sugar added” products. Conclusions: Sugar claims may be misleading if used incorrectly or if there is not a meaningful reduction in calories. The perception that these products are free of sugars and/or lower in carbohydrates may be of concern for people with diabetes.