Volume 79 • Number 1 • March 2018

Editor's Message

Research

Vol. 79No. 1pp. 2–6
Purpose: Dietary patterns established in childhood track into adulthood. Despite this, little research has explored preschoolers’ snacking. This study examined snacking patterns (frequency, quality, quantity) of preschool-aged boys and girls.Methods: Cross-sectional data were collected on 52 children (23 males; 3.4 ± 1.1 years of age; BMI 16.1 ± 1.4 kg/m2) enrolled in the Guelph Family Health Study pilot. Parent-reported 3-day food records were analyzed for children’s snacking patterns including frequency (number of snacking occasions per day), quantity (percent energy from snacks) and quality (inclusion of food groups from Eating Well with Canada’s Food Guide, macronutrient distribution, sugary and salty snacks). Mann–Whitney U tests examined sex differences in snacking patterns.Results: Ninety-six percent of children snacked daily, consuming a mean of 2.3 ± 0.7 snacks per day. Snacks accounted for one-third of daily energy. 78% of boys’ versus 63% of girls’ snacks contained a food group (P = 0.016). Boys consumed significantly fewer sugary snacks (0.5 ± 0.4 vs 0.9 ± 0.6 snacks per day, P = 0.016), although the percent of snack calories from sugar for both boys and girls was high (group mean 37.2 ± 6.7%).Conclusions: Nearly all preschoolers in this study snacked daily, and consumed a variety of snack foods. Boys’ and girls’ snacking preferences begin to diverge early in life. Preschool children should be encouraged to consume healthful snacks.

Perspectives in Practice

Vol. 79No. 1pp. 7–12
With the burdens that preventable health conditions place on individuals, workplaces, and society, workplace wellness programs (WWP) are critical to ensuring employees have access to health promotion supports tailored to their work environments. Such programs are best guided by a knowledge-to-action (KTA) framework; a theoretically grounded, systematic process that considers the ongoing exchange of knowledge with employees to engage them in health behaviour change and to garner employers’ support for the interventions. Therefore the purpose of this project was to develop, implement, and evaluate WWP healthy eating and active lifestyle supports at a university. A KTA process guided the consultations with employees and stakeholders that led to the development and implementation of a range of resource effective supports and the incorporation of wellness in the organization culture. A key support was the Wellness Passport that encouraged participation in scheduled WWP activities, as well as allowing for self-identified ones. Quality assurance assessments demonstrated a desire for a continuation of these WWP supports and activities. Dietitians, as health promotion leaders, can play key roles in the emerging field of WWPs. University dietetic and internship programs should consider adding WWP and KTA training components.
Vol. 79No. 1pp. 13–17
Our objectives were to explore the perspectives of a community-based sample of Canadian parents with 2–5-year-old children on: (i) strategies to support the development of healthful weight-related behaviours and (ii) assessment approaches to measure weight-related behaviours and outcomes among children and families. We conducted 4 focus groups with 28 parents (89% mothers and 68% identified as White). Transcripts were analyzed using conventional content analysis. Regarding parent’s perceptions of strategies to support healthful behaviours, we found that parents largely valued: home-based interventions, expert opinion, practical health behaviour strategies delivered in a nonjudgmental manner, and opportunities for social support. Regarding perceptions of assessment procedures, parents had mixed views on children providing blood samples, but looked upon it more favourably if it would contribute to research on child health. Our results suggest that to increase parental engagement interventions focused on improving weight-related behaviours among families with young children should be delivered within the home and include easy-to-implement behaviour change strategies communicated by experts, such as dietitians working in the clinical or public health setting. Using social media to share information and provide a platform for social support may also be an effective way to engage parents of young children.
Vol. 79No. 1pp. 18–22
It is important to consider health inequities when exploring the extent to which school food programs may contribute to the stigmatization and social exclusion of families experiencing food insecurity. As part of a broader school-based project, this paper considers evidence derived from a secondary analysis of research in Nova Scotia (NS). In the original research, interviews were conducted with key stakeholders involved in supporting health promotion activities across NS elementary schools. For this article, data were re-examined using tenets of critical discourse analysis to evaluate if school practices were addressing the root social issues by identifying patterns in language and institutional norms. Our findings suggested that further illumination of programs may be needed to ensure that they do not contribute to the stigmatization and social exclusion of families experiencing food insecurity. Nutrition professionals are in a position to engage families experiencing food insecurity in policy action that will shift from a focus on individual determinants towards the social–structural conditions that underlie the complex issue of food insecurity.
Vol. 79No. 1pp. 23–27
La marge d’erreur dans l’évaluation de la prise alimentaire au moyen des outils traditionnels comme le rappel de 24 h, le questionnaire de fréquence et le journal alimentaire est grande et peut conduire à l’interprétation erronée de résultats de recherche. La recherche sur des biomarqueurs associés à la consommation de fruits et de légumes a le potentiel d’améliorer sensiblement la validité de l’évaluation de la prise alimentaire ainsi que la mesure des associations entre la qualité nutritionnelle et la santé. Les caroténoïdes, des pigments issus presque exclusivement du monde végétal, présentent un intérêt grandissant dans ce domaine. Les caractéristiques des caroténoïdes ainsi que les avantages et les défis que pose leur utilisation dans l’évaluation nutritionnelle seront explorés dans la présente revue.
Vol. 79No. 1pp. 28–34
A whole-system perspective is critical in efforts to create a healthy population and a productive, equitable, and sustainable food system. In 2009, the Ontario Collaborative Group on Healthy Eating and Physical Activity undertook a bold initiative to develop a comprehensive provincial strategy encompassing the entire food system. The Ontario Food and Nutrition Strategy was shaped through extensive consultation with diverse stakeholders. This strategy identified strategic directions and priority actions for productive, equitable, and sustainable food systems intended to promote the health and well-being of all Ontarians. Paramount to the strategy is a collaborative governance mechanism allowing for a cross-government, multistakeholder coordinated approach to food policy development. Key actors participated in a collective impact process to develop a theory of change and potential governance model. Different models for collaborative work were examined and a governance model for a multistakeholder coordinated provincial mechanism was proposed. Lessons learned from this process will inform others involved in food systems work at the provincial, regional, or local level and may pave the way towards successful inter-sectoral action on priority recommendations geared towards improved nutrition-related and food systems outcomes.

Review

Vol. 79No. 1pp. 35–41
The high prevalence of constipation in long-term care (LTC) residents has been a long-standing issue for caregivers, attending health professionals, and the residents themselves. The traditional medical response has been to utilize pharmaceutical laxatives, enemas, and suppositories for treatment. The purpose of this review was to determine if fibre supplementation (including fibre added to foods) is effective in increasing stool frequency, improving stool consistency, and decreasing laxative use in LTC residents. A systematic search was conducted using PubMed and CINAHL databases, inclusive to March 2017. Search terms included: “long-term care” or “nursing home” AND “fiber (fibre),” “bran,” “psyllium,” “inulin,” or “prebiotic.” Intervention trials of fibre supplementation with ≥5 LTC residents were included. The search generated 456 articles following removal of duplicates; 8 studies met the inclusion criteria. Three additional trials were identified through a hand search of references of pertinent articles. Current evidence suggests that added fibre may be effective in increasing stool frequency and/or decreasing laxative use in LTC residents and, thus, may lessen the burden of constipation. However, randomized controlled trials are needed to clearly demonstrate the effects of adding fibre to foods, particularly insoluble and less fermentable sources, on constipation in LTC residents.

Report

Vol. 79No. 1pp. 42–45
Purpose: To assess whether the current food security measurement tool used in Canada, the Canadian Community Health Survey, is appropriate for use with homeless adults.Methods: The Household Food Security Survey Module (HFSSM), a validated measurement tool utilized for determining the food security status of Canadian households, was used with a group of homeless men (n = 40). In-depth interviews were also conducted with participants to obtain particulars about their food acquisition strategies. Data were analyzed by comparing the results of the HFSSM with qualitative data.Results: The HFSSM measurement tool found that 90% (n = 36) of the study participants experienced food insecurity with 67.5% (n = 27) experiencing severe food insecurity and 22.5% (n = 9) experiencing moderate food insecurity. The qualitative data, however, suggested that all participants (n = 40) were food insecure based on food acquisition practices, food accessibility, and diet quality.Conclusions: The HFSSM has validity concerns when applied to homeless populations. Nutrition professionals and other key stakeholders should work to develop valid tools for measuring the food security status of homeless individuals who are highly vulnerable to food insecurity.
cover
About the cover photo

Nutrition Month 2018 campaign is helping Canadians Unlock the Potential of Food including the potential to discover food. Teaching children to shop and cook can help foster healthy eating habits.

À propos de la photo de couverture

La campagne du Mois de la nutrition 2018 aide la population canadienne à découvrir le pouvoir des aliments, entre autres le pouvoir de découvrir. Apprendre aux enfants à faire les courses et à cuisiner peut favoriser de saines habitudes alimentaires.
 
 
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