Table of Contents

Purpose: Prenatal multivitamins are recommended in pregnancy. This study assessed food and supplement intakes of folate, vitamin B12 (B12), vitamin D, and choline in pregnant women living in Southern Ontario in comparison with current recommendations.Methods: Women recruited to the Be Healthy in Pregnancy RCT (NCT01693510) completed 3-day diet/supplement records at 12–17 weeks gestation. Intakes of folate, B12, vitamin D, and choline were quantified and compared with recommendations for pregnant women.Results: Folate intake (median (min, max)) was 1963 μg/day dietary folate equivalents (153, 10 846); 90% of women met the Estimated Average Requirement (EAR) but 77% exceeded the Tolerable Upper Intake Level (UL) (n = 232). B12 intake was 12.1 μg/day (0.3, 2336); 96% of women met the EAR with 7% exceeding the EAR 100-fold (n = 232). Vitamin D intake was 564 IU/day (0.0, 11 062); 83% met the EAR, whereas 1.7% exceeded the UL (n = 232). Choline intake was 338 mg/day (120, 1016); only 18% met the Adequate Intake and none exceeded the UL (n = 158).Conclusion: To meet the nutrient requirements of pregnancy many women rely on prenatal vitamins. Reformulating prenatal multivitamin supplements to provide doses of vitamins within recommendations to complement a balanced healthy diet would ensure appropriate micronutrient intakes for pregnant women.

The type 2 diabetes epidemic is a global crisis threatening the health and economies of many nations. This study aimed to evaluate a prediabetes intervention program designed for rural adults in southwestern Ontario based on the feedback of participants. Rural adults with prediabetes were referred by physicians to an intervention program developed to assist with unique barriers rural adults face related to the built environment and socioeconomic status when adopting a healthy lifestyle. After 6 monthly education sessions offered by a dietitian and a nurse, participants completed a questionnaire to share their program experience. In addition, 6 focus groups consisting of 5–9 participants were conducted to assess program acceptability, feasibility, and practicality. Of 49 enrolled, 35 participants aged 60.8 ± 7.1 (mean ± SD) evaluated the program. Participants reported finding the program to be acceptable, feasible, and practical due to the interactive nature of the sessions, the group setting and the availability of health professionals. This prediabetes lifestyle intervention program was perceived as successfully addressing rural adults’ needs in terms of adopting a healthy lifestyle. Feedback received through program evaluation, which included a participant experience survey and focus groups has helped improve this program and may benefit other prediabetes education intervention programs.

Purpose: Living Your Best Weight (LYBW) is an outpatient program based on Health at Every Size (HAES) principles for adults interested in managing their weight. The purpose of this pilot study was to determine perceptions of participants and their satisfaction with the LYBW program.Methods: A survey was developed to determine participant satisfaction of the LYBW program. Fifty-six participants who completed the LYBW program from June 2017 to February 2018 were contacted via telephone and invited to participate in the study. Forty-five participants agreed to receive the survey by mail or email.Results: Thirty-four participants completed the survey for a response rate of 61%. The average age of respondents was 52 years. Seventy-nine percent of respondents agreed that the program helped them to focus on health instead of weight. Eighty-two percent agreed that the program helped them respond to internal cues of hunger and fullness, and 94% were satisfied with the program.Conclusion: Participants reported that they were satisfied with the LYBW program and perceived improvements in their health. Future programming may benefit from using a HAES-based approach with adults.

Exclusive breastfeeding to 6 months with continued breastfeeding up to 2 years and beyond are well-established infant feeding recommendations based on evidence that breastfeeding has unparalleled maternal and infant health benefits as well as environmental and economic benefits. As with many high-income countries, breastfeeding rates remain suboptimal with only a quarter of Canadian and European infants receiving breast milk exclusively for the first 6 months. Breastfeeding promotion efforts have largely targeted caregivers in the prenatal and postnatal period; however, breastfeeding outcomes have been shown to be associated with broader sociocultural factors. Noncaregivers play an influential role in infant feeding at both an individual level (e.g., cues and input from health care practitioners and caregivers’ social networks; as future parents) as well as a broader population level (sociocultural norms and policy decisions). This paper outlines recent research on breastfeeding knowledge and attitudes of noncaregivers by population subgroup. Positive correlations have been identified between breastfeeding attitudes, infant feeding knowledge, breastfeeding exposure, and breastfeeding intention among different subgroups; however, key knowledge gaps, lack of exposure to breastfeeding, and negative public perceptions of breastfeeding persist. Dietitians can advocate for breastfeeding promotion strategies that consider the role of noncaregivers to address sociocultural norms around breastfeeding.