Volume 78 • Number 3 • September 2017
Editor's Message
Research
Purpose: We aimed to determine if adherence to established Canadian, American, and WHO-developed nutrition recommendations supported children’s academic achievement.Methods: Data from a health survey of 1595 grade 5 students in Alberta, Canada, was used. Dietary intake was assessed using a validated food frequency questionnaire. Adherence to recommendations for food group servings, saturated fat intake, and free sugars intake was assessed. Survey data were linked to grade 6 standardized exam results. Multivariable mixed effects linear regression models were employed to assess the association between adherence to recommendations and academic achievement.Results: Boys who met current recommendations for free sugars scored on average 5.67% better on exams (β: 5.67; 95% CI: 3.14, 8.29). Boys who met recommendations for milk and alternatives scored 3.45% better on exams (β: 3.45; 95% CI: 0.67, 6.23). Though results indicated that adhering to dietary recommendations was beneficial for girls’ academic achievement, no result was statistically significant.Conclusions: Adherence to current dietary recommendations has benefits for children’s academic achievement. This evidence may be used to inform continued development and promotion of dietary recommendations and to support school-based nutrition initiatives.
Purpose: Both providers and patients may have important insights to inform the development of obesity prevention and management services in Canadian primary care settings. In this formative study, insights for new obesity management services were sought from both providers and patients in 1 progressive citywide organization (150 physicians, team services, separate offices).Methods: Seven focus groups with interprofessional health providers (n = 56) and 4 focus groups with patients (n = 34) were conducted. Two clinical vignettes (adult, child) were used to focus discussion. Four analysts coded for descriptive content and interpretative themes on possible tools and care processes using NVivo.Results: Participants identified numerous strategies for care processes, most of which could be categorized into 1 or more of 11 themes: 6 directed at clinical care of patients (raising awareness, screening, clinical care, skill building, ongoing support, and social/peer support) and 5 directed at the organization (coordination/collaboration, creating awareness among health professionals, adding new expertise to the team, marketing, and lobbying/advocacy).Conclusions: The approach was successful in generating an extensive list of diverse activities to be considered for implementation studies. Both patients and providers identified that multiple strategies and systems approaches will be needed to address obesity management in primary care.
Objectif : Étudier les comportements, motivations et attitudes des élèves du troisième cycle du primaire et du secondaire de la Commission scolaire de Montréal (CSDM) à l’égard de l’alimentation.Méthodes : La collecte de données s’est déroulée sur une période de six semaines par l’entremise de deux questionnaires auprès d’élèves de la CSDM. Les jeunes ont été questionnés sur leurs habitudes de fréquentation des services alimentaires, leurs motivations alimentaires, leur stade de changement à l’égard de la qualité de leur alimentation et leurs intérêts pour des activités culinaires et nutritionnelles.Résultats : Les résultats révèlent que le goût est l’aspect auquel un plus grand nombre d’élèves accordent de l’importance lorsqu’ils choisissent des aliments. Les élèves les moins âgés choisissent davantage leurs aliments pour contrôler leur poids. La majorité des jeunes accordent de l’importance à la qualité de leur alimentation depuis quelque temps, et l’opinion des pairs semble avoir peu d’influence sur les choix alimentaires des jeunes.Conclusions : Cette étude confirme la pluralité des facteurs d’influence sur les pratiques alimentaires des jeunes. Les résultats obtenus suggèrent des pistes d’action pour les services alimentaires de la CSDM.
Perspecitves in Practice
Researchers have found support for an inverse association between diet quality and depressive symptoms in middle-aged adults. This association has not been well examined among university students, a population at risk of developing both depression and unhealthy lifestyle habits. We sought to examine the cross-sectional association between depressive symptoms and diet quality in female university students. One hundred and forty-one females (19.1 ± 1.5 years, 22.3 ± 3.4 kg/m2) were recruited from a Canadian university in 2012 and 2013. Dietary intake data were collected using 3-day food records and analysed using the Canadian Healthy Eating Index. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. Results of a linear regression demonstrated an inverse association between depressive symptoms and diet quality score (β = −0.016, 95% CI = −0.029 to −0.003, P = 0.017). Elevated depressive symptoms were associated with consumption of diets of poor nutritional quality in our female university student sample. Thus, healthy eating may correspond with lower levels of depression in young adult females.
The impact on student development associated with being part of a competitive program is an emerging finding in dietetics research. As such, a narrative review of relevant literature was conducted pertaining to competition in post-secondary programs and the educational experience of students with respect to developing a career in dietetics. The review was guided by 2 questions: How is competition experienced by students? What strategies can reduce competition among dietetics students within the educational experience? A refined literature screening process justified including 32 articles in the review. The overall review findings suggested that, across dietetics programs, the outcomes of competition negatively impacted students’ personal identity, motivation in the learning process, and involvement behaviours, including collaboration among students, participation in academic opportunities, and student relationships with faculty. The implementation of strategies conducive to addressing the effects of excessive competition and building a supportive academic environment, for example increasing collegiality and engaging students in intrinsic learning, are important for continued growth of the dietetics profession. Educators can reflect on the complex nature of competition and how the effects of excessive competition may be in opposition with the competencies that students are expected to develop as professionals.
Report
Purpose: In Ontario, group programs to increase mindfulness of food choices are provided in Family Health Teams (FHTs), but evaluation is limited. We targeted patients with chronic conditions that could benefit from intensified management and evaluated an existing program.Methods: We included 3 FHTs. Patients were randomized to immediate participation in the intervention (n = 16) or to wait-list control (n = 14). Eligible participants were between 40 and 70 years old, living with diabetes and/or hypertension and had at least 2 of: elevated cholesterol (LDL >4 if hypertension or LDL >2 mmol/L if diabetes), blood sugar (A1c >7.5%), or blood pressure (systolic BP >140). The intervention was a 6-week group program of 2-hour weekly sessions addressing mindfulness of food choices facilitated by a trained dietitian and social worker. We used the Emotional Eating Questionnaire (EEQ) a validated 10-item questionnaire measuring the degree of interaction between food intake and emotion. The primary outcome was change in the EEQ over 6 weeks.Results: There was no difference in the change in EEQ in either unadjusted (P = 0.4) or adjusted (P = 0.3) analysis.Conclusions: We found no effect for this intervention, although the small sample size limits interpretation. The results were contrary to what was expected.
Objectif : Les objectifs de cette étude sont de mesurer auprès des parents d’élèves fréquentant les écoles de la Commission scolaire de Montréal (CSDM) les perceptions de la qualité des produits offerts dans les services alimentaires et d’identifier leurs attentes et motivations en lien avec l’alimentation de leur jeune à l’école.Méthodes : Un questionnaire électronique a été envoyé à environ 70 000 parents d’élèves dans 133 écoles primaires et 34 écoles secondaires. Des statistiques descriptives et des tests de chi-carré ont été réalisés (P < 0,05).Résultats : Un total de 1776 répondants au primaire et 858 au secondaire ont été inclus dans cette étude. Les parents perçoivent favorablement la satisfaction de l’enfant liée à la portion habituellement servie et le rapport qualité-prix. L’attitude du personnel et le fait que le repas soit un moment agréable dans la journée sont parmi les dimensions les plus importantes. L’attente principale envers l’école est de mettre à la disposition de l’enfant une alimentation saine et des activités de promotion de saines habitudes de vie.Conclusions : Cette étude soutient la nécessité de documenter les attentes et les motivations parentales et de s’attarder au rôle attendu de l’école dans la promotion des saines habitudes alimentaires.
Recognition
OPEN ACCESS
Why are you a dietitian doing what you do? Although we absolutely must keep food central in our conversations about nutritional well-being, our work is rarely ever about food alone. There’s always so much more than meets the eye. Reflecting on an entrepreneurial path over 3 decades, the meaning of it all became clearer with each role. Patricia shares perspective on how the more deeply we understand this “thing”, the more success we’ll have. It’s crucial to our effectiveness as communicators, counsellors, colleagues, and citizens of the world. To truly make a meaningful difference and have a tremendously positive impact on the health of Canadians, we must talk about it.
Canadian Foundation for Dietetic Research
OPEN ACCESS
St John’s, Newfoundland was the host city of the 2017 Dietitians of Canada Annual Conference.Through the support of Dietitians of Canada and CFDR, the 2017 event was both an exciting and informative exchange of research and experience-sharing efforts that inspired attendees. The submissions for this year’s Canadian Foundation for Dietetic Research (CFDR) event represented the diversity of dietetic research conducted within Canada. The topics highlighted from this year’s abstracts included: Clinical Research; Community-based Nutritional Care; Determinants of Food Choice; Dietary Intake; Dietetic Practice and Education; Food Security; Nutrition and Health Education; Nutritional Assessment and Therapy; Nutrition Attitudes; Nutrition Strategy Development Patient Services; Professional Development; Vulnerable Groups and their Nutritional Needs; and, Wellness and Public Health.Each presenter provided an 11-minute oral presentation (8 minutes for presenting and 3 minutes for questions). This allowed for meaningful interaction between the presenters and those attending the sessions. These presentations offered the newest insights into important research findings that apply to dietetic practice. Attendance at the research presentations was approximately 200 and 125 on June 9 and 10, respectively.This research event would not be possible without the commitment and dedication of many people. On behalf of DC and CFDR, we would like to extend a special thank you to members of our abstract review committee: Susan Campisi (University of Toronto); Elaine Cawadias (Dietitian, Retired); Andrea Glenn (St. Francis Xavier University); Mahsa Jessri (University of Ottawa); Jessica Lieffers (University of Alberta); and Janet Madill (Brescia College).We would also like to thank all of our moderators, Jane Bellman (DC), Pierrette Buklis (CFDR Board), Marcia Cooper (Health Canada), Jenny Gusba (CFDR Board), Brenda Hartman (Brescia College), Sarah Hewko (CFDR Board Chair), Lisa Mina (CFDR Board), Misty Rossiter (University of Prince Edward Island), Lee Rysdale (Northern Ontario School of Medicine), Pat Vanderkooy (DC), and Heather Wile (CFDR Board), who kept our research presentation sessions on time during the conference. Finally, a special thank you to Janis Randall Simpson and Michelle Naraine at CFDR for their assistance and support throughout the review process.I enjoyed interacting with many of you at the oral research presentations as we highlighted the findings from our dietetic colleagues across our country!Christina Lengyel, PhD, RDChair, 2017 Abstracts Review CommitteeAssociate ProfessorDirector of the Dietetics ProgramFoods & Human Nutritional SciencesUniversity of Manitoba