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- Willows, Noreen D PhD7
- Lordly, Daphne MA PDt4
- Buchholz, Andrea C PhD RD3
- Farmer, Anna PhD RD3
- Hammond, David PhD3
- Ball, Geoff D C PhD RD2
- Bell, Rhonda C PhD2
- Dahl, Wendy J PhD RD2
- Elliott, Sarah A PhD2
- Glanville, N Theresa PhD PDt2
- Hekmat, Sharareh PhD2
- MacLellan, Debbie PhD RD2
- Mager, Diana R PhD RD2
- Maximova, Katerina PhD2
- Mazurak, Vera C PhD2
- McCargar, Linda J PhD RD2
- Mudryj, Adriana PhD2
- Ricciuto, Laurie MHSc RD2
- Rioux, France M PhD2
- Slater, Joyce RD PhD2
- Suh, Miyoung RD PhD2
- Tyler, Robert T PhD2
- Vagianos, Kathy RD MSc2
- Whiting, Susan J PhD2
- Wismer, Wendy PhD2
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- Anna Angelinas BSc, RD, CDE,
- Roseann Nasser MSc, RD, CNSC, FDC,
- Amanda Geradts BSc, RD,
- Justine Herle BSc, RD,
- Kristen Schott BSc, RD, and
- Michelle Classen BSc, RD
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.- Purpose: In Canada, approximately 45% of hospitalized patients are moderately or severely malnourished upon admission. The protected mealtime policy was designed to address malnutrition in institutions. This pilot study aimed to provide preliminary results examining the effect of this policy on patient energy and protein intake.Methods: A 1-group, pre–post observation design was conducted in a Canadian hospital. Pre- and post-observations included the frequency and type of interruptions, type of interrupter, and patient energy and protein intake at each meal.Results: The average number and length of interruptions decreased, and the average length of mealtime assistance provided to patients (n = 12) increased in the post-observation period. Energy and protein consumption showed a slight increase during the post-observation period.Conclusion: A protected mealtime policy may be an effective policy to address malnutrition among hospitalized Canadian adults. Further studies are warranted in Canada to determine the effects and feasibility of this policy implementation.
- Purpose: In 2010, Health Canada implemented a national campaign to improve understanding of “percent daily value” (%DV) in Nutrition Facts Tables (NFTs). This study examined sources of nutrition information and knowledge of %DV information communicated in the campaign.Methods: Respondents aged 16–30 years completed the Canada Food Study in 2016 (n = 2665). Measures included sources of nutrition information, NFT use, and %DV knowledge based on the campaign message (“5% DV or less is a little; 15% DV or more is a lot”). A logistic regression examined correlates of providing “correct” responses to %DV questions related to the campaign messaging.Results: Overall, 7.2% (n = 191) respondents correctly indicated that 5% is “a little”, and 4.3% (n = 115) correctly indicated 15% DV was “a lot”. Only 4.0% (n = 107) correctly answered both. Correct recall of %DV amounts was not associated with number of information sources reported, but was greater among those who were female, were younger, and reported greater NFT understanding and serving size information use (P < 0.05 for all).Conclusions: Results show low awareness of messaging from the Nutrition Facts Education Campaign among young Canadians. Such a mass media campaign may be insufficient on its own to enhance population-level understanding of %DV.
- OPEN ACCESSPurpose: To determine predictors of food skills in university students, specifically, the relative effects of a food and nutrition (FN) course; sex, age, and body mass index; food-related behaviours in the parental home; and food-related behaviours in university.Methods: Undergraduate students (n = 30 310) at Western University were invited to complete an online cross-sectional survey that assessed 7 components of food skills, from mechanical (e.g., peeling/chopping) to conceptual (e.g., weekly meal planning). The primary outcome measure was Total Food Skills Score (TFSS). All variables that were statistically associated with TFSS (P < 0.05) were analyzed hierarchically in 4 regression models.Results: The sample was comprised of 3354 students living independently for 2.6 ± 1.1 years. Students who had taken an FN course had higher food skills than those who had not (B = 30.72; P < 0.001), and this relationship remained significant through all subsequent models. The strongest predictor of food skills was meal preparation as a teen (B = 25.66; P < 0.001). Frequency of using a grocery list, packing a lunch, and time spent preparing meals on weekends were positively associated with food skills (P < 0.001), whereas frequency of buying pre-prepared meals was negatively associated with food skills (P < 0.001).Conclusions: Food skill development should occur well before young adults begin living independently.
- Purpose: In Canada, few men are dietitians. Literature is sparse regarding why so few men are drawn to dietetics. This study, part of a larger qualitative study, explores the experiences of men who are dietitians throughout their training and careers using a phenomenology framework. The study examines the meanings participants make about dietetics in relation to recruitment.Methods: Semi-structured individual interviews with 6 men who are dietitians were completed, transcribed, and analyzed.Results: An overarching theme, “experiences and outcomes of a gendered profession”, was related to the participants’ perspectives concerning recruitment into the dietetic profession. Four sub-themes are reported: (i) societal gender division, (ii) gender division within the profession, (iii) isolation from men who are mentors and other men, and (iv) the need to deconstruct and change. The results provide insight into recruitment barriers and potential approaches for increasing the number of men within dietetics, including changing the perceptions of the profession, increasing role models for men, and dismantling gendered practices.Conclusion: Participants believed that increasing men within dietetics would be beneficial and would increase diversity. It is unlikely that recruitment of men will increase if the status quo and gender norms of the profession are not disrupted and challenged.
- Purpose: As Canada rethinks approaches to food guidance, insights into the needs of seniors in rural communities are important to ensure their nutrition issues are addressed. This study aimed to explore the food guidance needs and wants of a group of seniors living in Antigonish, Nova Scotia.Methods: Three focus groups were held with a total of 12 participants over the age of 65 years, living independently in the community. Seniors were asked about their views on Canada’s Food Guide (CFG) and the Brazilian Dietary Guidelines (BDG).Results: Participants identified CFG as a trusted source of information and related well to the food groups and directive statements. Portion sizes were confusing and advice on food choices was not seen as being realistic in terms of cost and availability. The holistic nature of the BDG was appealing but guidance on processed food and social eating was not seen as relevant. Neither guidance tool addressed concerns about sustainability and environmental issues. Point of purchase nutrition information was preferable to receiving it from health professionals.Conclusion: CFG was seen as a trusted source of advice; however, locally accessible guidance on affordability and environmental issues related to food choice is needed for this group.
- Natalie D. Riediger PhD,
- Oribim Kingson BSc,
- Adriana Mudryj PhD,
- Kayla L. Farquhar RD,
- Kerry A. Spence RD, MSc,
- Kathy Vagianos RD, MSc, and
- Miyoung Suh RD, PhD
Purpose: The objectives of this study were (i) to describe ethnicity, tuition funding sources, and living arrangements during degree among Registered Dietitian (RD) and non-RD alumni of the University of Manitoba’s undergraduate nutrition program and (ii) to describe barriers to obtaining an internship among those who did not become an RD.Methods: A 31-item, self-administered, online questionnaire was distributed to nutrition graduates. Binary logistic regression was used to test for predictors of RD status (vs. non-RD).Results: Of the 195 participants who completed the survey (37% response rate), 68% identified as an RD and 31% did not. White students had 3.8 times higher odds of being an RD (P < 0.001) compared with students of an ethnic minority. Those who had received a student loan (P = 0.033) or lived with their parents during their degree (P = 0.004) also had significantly lower odds of being an RD. The most common barrier for not completing the dietetic internship by non-RDs was that the application process was too stressful.Conclusions: Results from this study highlight the need for the dietetics field to address systemic barriers for students of ethnic minorities and low socioeconomic backgrounds, including barriers during the degree program and in the internship selection process.- Adriana Mudryj PhD,
- Kayla Farquhar RD,
- Kerry Spence RD, MSc,
- Kathy Vagianos RD, MSc,
- Miyoung Suh RD, PhD, and
- Natalie Riediger PhD
Purpose: The study objectives were to (i) describe employment outcomes among Registered Dietitians (RDs) who graduated from the University of Manitoba, (ii) test for differences in employment outcomes according to graduation year, and (iii) compare preferred area of practice and geography prior to employment with past and current employment. Methods: Graduates of the Human Nutritional Sciences program (2006–2015) were invited to participate in an online survey. Data on respondent demographics, education, and employment outcomes were collected. Results: Overall, 133 (68%) respondents self-identified as RDs. RDs who had graduated between 2006 and 2011 were significantly more likely to secure employment within 6 months post-graduation compared with RDs that graduated between 2012 and 2015. Geographically, although 56% of RDs did not wish to gain experience in rural/remote communities upon graduating, 44% of these respondents reported working part- or full-time in a rural/remote location at some point during their career. Conclusion: Findings indicate that a substantial number of RDs in Manitoba are employed in a rural or remote location despite acknowledging that it is not a preferred location. Future research is needed to explore the views and experiences of new and established RDs toward rural or remote practice, including preparedness for practice.- Liz da Silva MS, RD,
- Christina Edmunds MS, RD,
- Talise Grossman BSc, RD,
- Lynn Kelly BSc, RD,
- Cathryn Nattrass BSc, RD, and
- Delara Saran MS, RD
Purpose: This study reports on dietitian use of the Nutrition Care Process Terminology (NCPT) diagnosis of malnutrition based on Subjective Global Assessment (SGA). Methods: Nutrition assessment reports for adults in medical, surgical, and cardiac units in 13 Canadian hospitals were retrospectively examined for a 6-week period in 2014. Reports with a SGA and NCPT diagnosis were included regardless of why the patient was seen by the dietitian. Results: Of the 932 nutrition assessment reports, 857 (92%) included an SGA. Based on SGA, the prevalence of mild to moderate malnutrition (SGA B) and severe malnutrition (SGA C) was 53.4% (n = 458) and 10.0% (n = 86), respectively. When categorized as severely malnourished, the most common NCPT diagnoses were “malnutrition” (n = 55, 72.4%), “inadequate oral intake” (n = 11, 14.5%), and “inadequate protein-energy intake” (n = 10,13.1%). Among those with SGA B and C, the assignment of the NCPT malnutrition diagnosis was 19.8% (n = 95). Conclusions: Dietitians play a key role in the prevention, identification, and treatment of malnutrition in the hospitalized patient and are well positioned to take a leadership role in improving its documentation. Ongoing audits, staff support, and training regarding NCPT use may improve the application of the malnutrition diagnosis. Future research examining dietitian barriers to using the malnutrition diagnosis would be valuable.- Sarah Frank Nichols MPH, RD,
- Suzanne Galesloot MSA, RD,
- Dolly Bondarianzadeh MSc, PhD, and
- Susan Buhler PhD (c), RD
Purpose: To explore dietary changes Albertan women make during pregnancy, reasons they make changes, and alignment with prenatal nutrition recommendations.Methods: Women up to 6 months postpartum were recruited in public health centres and Primary Care Networks. Qualitative data were collected through a self-administered survey including 2 open-ended questions that asked about changes made to food/beverage intake during pregnancy and why these changes were made.Results: A majority (n = 577) of the 737 women completing the survey described changes they made to their food/beverage intake during pregnancy and 193 respondents provided reasons for these changes. Increased intake of fruits/vegetables, meat, milk, and their alternatives (n = 600); limiting or avoidance of foods/beverages known to be harmful during pregnancy (n = 445); and increased food/fluid intake or meal/snack frequency (n = 405) were commonly reported dietary changes. Motivations relating to health and to control physiological changes/manage health conditions were the most frequent reasons provided.Conclusions: Women make diverse dietary changes and have various motivations for food choices during pregnancy. A majority make dietary changes to support a healthy pregnancy. However, the motivation to control discomforts and respond to hunger and thirst sensations reflect a stronger influencer on women’s choices than is currently addressed in prenatal nutrition messages.- Leticia C.R. Pereira MSc,
- Sarah A. Elliott PhD,
- Linda J. McCargar PhD, RD,
- Rhonda C. Bell PhD, and
- Carla M. Prado PhD, RD
Purpose: Energy metabolism is at the core of maintaining healthy body weights. Likewise, the assessment of energy needs is essential for providing adequate dietary advice. We explored differences in energy metabolism of a primigravid woman (age: 30 years) at 1 month prepregnancy (“baseline”), during pregnancy (33 weeks), and at 3 and 9 months postpartum. Measured versus estimated energy expenditure were compared using equations commonly used in clinical practice.Methods: Energy metabolism was measured using a state-of-the-art whole body calorimetry unit (WBCU). Body composition (dual-energy X-ray absorptiometry), energy intake (3-day food records), physical activity (Baecke questionnaire), and breastmilk volume/breastfeeding energy expenditure (24-hours of infant test–retest weighing) were assessed.Results: This case report is the first to assess energy expenditure in 3 different stages of a woman’s life (prepregnancy, pregnancy, and postpartum) using WBCU. We noticed that weight and energy needs returned to prepregnancy values at 9 months postpartum, although a pattern of altered body composition emerged (higher fat/lean ratio) without changes in physical activity and energy intake. For this woman, current recommendations for energy overestimated actual needs by 350 kcal/day (9 months postpartum).Conclusion: It is likely that more accurate approaches are needed to estimate energy needs during and postpregnancy, with targeted interventions to optimize body composition.- Purpose: School food and nutrition policies have the potential to encourage healthier eating among children and youth to address rising concerns of poor diet quality. Despite their widespread implementation, there is little reported monitoring of policy adherence. This short report describes adherence to the provincial school food and nutrition policy in Nova Scotia (NS) that was implemented in 2006.Methods: An online survey was distributed to NS public schools in 2014–2015 to assess adherence to the directives and guidelines of the policy. Descriptive information was obtained for schools and indicators for policy adherence were explored.Results: A total of 242 schools completed the survey (73% response rate) and policy adherence was variable across the different components. Few schools adhered to the policy standard related to the sale of unhealthy foods and there was inconsistency in school adherence reported for other policy indicators.Conclusions: This research suggests that further action is need to ensure “minimum nutrition” food and beverages are not available in schools and that healthy eating is reinforced through prioritizing key policy actions like pricing strategies, discontinuing fundraising with unhealthy food, and ensuring food programs are available in a nonstigmatizing manner.
- Purpose: To identify the impact of package size on an individual’s use of serving size information. The hypothesis was that participants would make more serving size assumption errors on a nutrition facts table (NFT) interpretation task when assessing packages that appear as a single serving but contain multiple servings, compared with products that appear as a multi-serving and contain multiple servings.Methods: Sixty participants were randomized into 1 of 3 conditions (n = 20 each); products that appeared as a single serving and contain a single serving (SSSS), products that appeared as a single serving and contain multiple servings (SSMS), and products that both appear as a multi-serving and contain multiple servings (MSMS). All 3 conditions were tested on a NFT interpretation task while participants were being presented food items that were appropriate to their given condition.Results: Participants in the SSMS (9.55 ± 7.78) condition made significantly more serving size assumption errors than the SSSS (0.00 ± 0.00; P < 0.001) and MSMS (0.40 ± 0.75; P < 0.001) conditions.Conclusions: Participants did not address serving size information when they perceived a product to be a single serving. This resulted in people misinterpreting nutritional and caloric content of foods that were single unit foods with multiple servings.
- Purpose: In the province of Ontario, a new law requires restaurants and food service providers, with more than 20 locations in Ontario, to prominently list the calorie content of their food items on the menu. This study examined if the new calorie information shifted the Ontario consumer’s ability to more accurately estimate calories.Methods: Using an online survey, consumers (n = 665 non-Ontario control and n = 694 Ontario) were asked to estimate the calories of a popular menu item (a cheeseburger) prior to this new legislation and 3 months and 6 months after the introduction of the mandated calorie labels on menus.Results: Early results suggest that one cannot yet see a clear overall change in the Ontario consumer’s ability to estimate calories (based on 1 popular food item) since the introduction of mandated calorie labels on menus, although the most recent survey data suggest promise.Conclusions: Consumers, not just in Ontario, are poor at estimating calories. Repeated exposure to the calorie information now posted on most Ontario fast-food menus is an educational initiative expected to show benefits in the future, but additional time is required for measurable increases in consumer knowledge.
- Erica Reynolds MHSc, PDt,
- Christine Johnson MSc, PDt,
- Jennifer A. Jamieson PhD, and
- Hannah Mawhinney BSc
Purpose: University students may be at risk for food insecurity (FI) due to low income coupled with rising tuition, housing, and food costs. This study aimed to determine the prevalence of FI and potential correlates among students at a small, rural Canadian university.Methods: Health Canada’s 10-item household food security survey module (HFSSM) was adapted to assess food security status within the postsecondary student population. An additional 11 items measured food access and demographics. The validated, web-based survey was distributed by email and completed by 218 students (15.6% response rate). Participants were classified as food secure, moderately food insecure, or severely food insecure using the HFSSM Adult scale.Results: An overall FI rate of 37.2% was observed. This included 25.7% moderately food insecure and 11.5% severely food insecure. Students in higher years of study and who lived off campus had higher rates of FI.Conclusions: FI appears to be a significant concern for university students and has potential health and academic implications. Further research is needed to clarify the determinants and extent of FI for postsecondary students and to develop strategies to mitigate the prevalence and effects of food insecurity in these young adults.- 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.
- Mahitab Hanbazaza PhD,
- Geoff D.C. Ball PhD, RD,
- Anna P. Farmer PhD, RD,
- Katerina Maximova PhD,
- Jasmine Farahbakhsh MSc, and
- Noreen D. Willows PhD
Purpose: We compared food insecurity status, coping strategies, demographic characteristics, and self-rated health of international and domestic postsecondary students requesting emergency food hampers from a campus food bank (CFB).Methods: We collected data from a cross-sectional convenience sample of domestic and international students who accessed the CFB at the University of Alberta.Results: Food insecurity was prevalent (international students: n = 26/27 (96.2%), domestic students: n = 31/31 (100%)). Compared with their domestic peers, international students were less likely to rate their mental health negatively (14.8% vs 38.7%, P = 0.04). The primary income source was government loans (54.8%) for domestic students and research assistantships (33.3%) for international students. To cope with not having enough money for food, the majority of both student groups delayed bill payments or buying university supplies, applied for loans or bursaries, purchased food on credit, or worked more. International students were less likely to ask friends or relatives for food (48.1% vs 77.4%, P = 0.02).Conclusions: Domestic and international students mostly used similar coping strategies to address food insecurity; however, they paid for their education using different income sources. Distinct strategies for international and domestic students are required to allow more students to cover their educational and living expenses.- Purpose: This research aimed to estimate the percent energy (%E) contribution from total and free sugars in the Eating Well with Canada’s Food Guide (CFG) dietary pattern.Methods: The sugar-containing foods in the Canadian Nutrient File were assigned to 1 of 2 categories: total sugars or free sugars based on the source. The total sugars content of foods containing any amount of free sugars was assigned to the free sugars category. We estimated free sugars content from 8000 simulated diets (500 for each of the 16 age and sex groups), consistent with the CFG dietary pattern. Descriptive statistics were used to examine distributions of %E from total and free sugars by age and sex.Results: The mean %E from total and free sugars of all simulated diets was 21%E and 7%E, respectively. For simulated diets for males and females, 9–18 years of age, the %E from free sugars exceeded 10% at the 75th percentile. Simulated diets for all other age and sex groups exceeded 10%E from free sugars at the 95th percentile.Conclusions: The majority of the simulated CFG diets met the WHO recommendations to limit free sugars consumption to <10%E. These results will be used to inform future dietary guidance policy development.
- Lindsay Vander Meer MHS, RD,
- Jeff K. Vallance PhD,
- Geoff D.C. Ball RD, PhD, and
- Steven T. Johnson PhD
Purpose: Little is known about the lifestyle (e.g., physical activity, nutrition) information needs among breast cancer survivors living in nonurban settings. This study determined lifestyle information sources, needs, and preferences among breast cancer survivors in Northern British Columbia (BC), Canada.Methods: A cross-sectional, paper-based survey was distributed to a random sample of breast cancer survivors (n = 300) in Northern BC, which was generated through the BC Cancer Registry.Results: A total of 132 breast cancer survivors responded (true response rate = 49%; 132/270 received surveys). Two-thirds lived in rural and remote locations. The most commonly reported need was diet and physical activity (58%) to decrease risk of recurrence or improve survival. The most frequently identified sources of lifestyle information included physicians, family or friends, the internet, and magazines. A majority of breast cancer survivors (64%) preferred face-to-face interactions when considering potential lifestyle-related programs or services; distance-based formats (e.g., videoconferencing) were least preferred (11%).Conclusions: There is strong interest in information about lifestyle behaviours among breast cancer survivors in nonurban settings such as Northern BC. Future research is needed to investigate how best to deliver evidence-based lifestyle-related information to breast cancer survivors residing in nonurban settings.- 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.
