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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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- Sarah Ferguson BASc, HonBSc, RD,
- Layla Al-Rehany BASc, RD,
- Cathy Tang BASc, RD,
- Lorraine Gougeon BA, RD,
- Katie Warwick BSc, RD, and
- Janet Madill PhD, RD
Purpose: Bariatric surgery is accepted by the medical community as the most effective treatment for obesity; however, weight regain after surgery remains common. Long-term weight loss and weight maintenance may be aided when dietitians who provide perioperative care understand the causes of weight gain leading to bariatric surgery. In this study, the most common causes for weight gain were examined among prebariatric surgery patients. Methods: A retrospective chart review was conducted for 160 patients enrolled in a bariatric surgery program. Data were collected for 20 variables : puberty, pregnancy, menopause, change in living environment, change in job/career, financial problems, quitting smoking, drug or alcohol use, medical condition, surgery, injury affecting mobility, chronic pain, dieting, others’ influence over diet, abuse, mental health condition, stress, death of a loved one, divorce/end of a relationship, and other causes. Frequency distribution and chi-square tests were performed using SPSS. Results: Sixty-three percent of participants selected stress as a cause of weight gain, while 56% selected dieting. Significant differences existed between women and men in the selection of dieting and change in living environment. Conclusions: This information may allow dietitians to better identify causes for weight gain leading to bariatric surgery, and to address these causes appropriately before and after surgery.- Flora F. Stephenson PhD,
- J. Cyne Johnston PhD,
- Theresa Riege BHumEc, RD,
- Farah Bandali MSc, RD, and
- Deborah A. McNeil PhD
Purpose: Healthy eating is a determinant of optimal growth, and schools provide an ideal setting in which to influence students’ diets. The Healthy Eating Guidelines Initiative (HEGI) was a partnership among education, health, and community stakeholders to develop and implement healthy eating guidelines across a school jurisdiction. An evaluation was conducted to examine the potential impact of the HEGI on the school food environment and students’ self-reported diets. Methods: All schools in the jurisdiction were invited to participate in the evaluation. Participating schools included elementary, middle, high, and mixed grades schools. A school environment assessment and a student questionnaire were used to collect data before and after the HEGI. Results: Twenty-two (71%) of 31 schools participated in the evaluation. The guidelines were successfully implemented in 17 of these 22 schools. Overall, a greater proportion of students reported healthier eating behaviours at the conclusion of the HEGI. In particular, a greater proportion of students in schools with cafeteria-style food service showed significantly improved self-reported dietary behaviours. These changes were not seen among students at schools with limited or no on-site food service. Conclusions: The findings are consistent with those of previous studies, and indicate that guidelines for a school jurisdiction can have a positive impact on the school food environment and students’ food intake. The HEGI shows promise as a strategy to promote healthy eating among students.- Purpose: The effect of an oral education intervention on nutrition knowledge was evaluated in new paramedic employees. The evaluation involved measuring knowledge of and attitudes toward nutrition and shiftwork before and after the directed intervention. Methods: A convenience sample of 30 new paramedic shiftworkers attended a 15-minute education session focused on nutrition management strategies. This matched cohort study included three self-administered surveys. Survey 1 was completed before education, survey 2 immediately after education, and survey 3 after one month of concurrent post-education and employment experience. Knowledge and attitude scores were analyzed for differences between all surveys. Results: Participants were primary care paramedics, 59% of whom were male. They reported that previously they had not received this type of information or had received only a brief lecture. Mean knowledge scores increased significantly from survey 1 to survey 2; knowledge retention was identified in survey 3. A significant difference was found between surveys 2 and 3 for attitudes toward meal timing; no other significant differences were found between attitude response scores. Conclusions: The education session was successful in improving shiftwork nutrition knowledge among paramedics. Paramedics’ attitudes toward proper nutrition practices were positive before the education intervention.
- Purpose: Engaging parents in interventions can be difficult because of various barriers. An engaging children’s program that runs parallel to a parent program may facilitate parent participation. In this study, we assessed parents’ perception of the children’s component of Parents and Tots Together (PTT), a family-based obesity prevention program. Methods: Fifteen of the 16 ethnically diverse parents who participated in an uncontrolled trial of PTT completed a survey assessing their satisfaction with the PTT children’s component. More detailed information was obtained from one-on-one qualitative interviews with seven parents. Results: Attendance at program sessions was relatively high; 69% of parents attended six or more of the nine sessions. Survey data revealed that 87% of parents were “very satisfied” with the children’s group. Approximately 73% of parents reported that the program was “very useful” in helping their child learn the importance of healthy eating and physical activity. In qualitative interviews, many parents identified the children’s program as a motivator for attendance at the program sessions. Conclusions: The interactive children’s program was well received by parents and may serve as a catalyst for parent participation. Larger, randomized trials are needed to determine the effectiveness of children’s programming for enhancing parent participation.
- Navita Viveky MSc,
- Jennifer Billinsky PhD,
- Lilian Thorpe MD, PhD,
- Jane Alcorn PhD,
- Thomas Hadjistavropoulos PhD, and
- Susan J. Whiting PhD
Purpose: Long-term care (LTC) homes plan menus based on Eating Well with Canada’s Food Guide (CFG) recommendations for older adults. To determine whether recommended CFG servings and nutrients were being provided, we analyzed the menu of a large LTC facility in a metropolitan area and compared our analysis with a similar one conducted in 2000. Methods: A full week’s menu from a large Saskatoon LTC facility was analyzed and compared with CFG and recent Dietary Recommended Intake nutrient recommendations. The menu was analyzed using The Food Processor SQL. The 2011 menu was compared with the similar 2000 menu analysis to permit an evaluation of changes over a decade. Results: The 2011 menu demonstrated a significant improvement in servings of vegetables and fruit (4.6 to 7.2 servings). Servings of grain products had declined from 4.9 to 3.6 and servings of milk and alternatives had declined from 2.4 to 1.2 since 2000. Servings of meat and alternatives, total carbohydrate, and protein were not significantly different. Foods on the 2011 menu were lower in fat and higher in dietary fibre and offered more vitamins and minerals. Conclusions: Greater attention to the planning of LTC menus may explain improvements in the 2011 LTC menu. The current menu, however, needs to overcome the challenges that prevent it from meeting CFG recommendations for older adults.- Purpose: This qualitative study involved describing the experiences of dietetic students who provided meal help to older adults. Of interest were benefits and challenges, and how training could be enhanced. Methods: Individual, face-to-face, semi-structured interviews were conducted with nine undergraduate dietetic students. In the preceding year, these students had volunteered as meal helpers in a long-term care home. Interviews were digitally recorded and transcribed verbatim. Qualitative thematic analysis was used to analyze the transcripts. Results: All participating students were female and from one undergraduate program. Three main themes emerged: growing into the role, learning outside the classroom, and providing quality assistance. Conclusions: This study provides an understanding of how meal helping can be a valuable experience for emerging dietitians. It also gives insights into training and the development of the meal helper role.
- Purpose: Differences in knowledge, perceptions, and consumption of whole grains were compared between students who had taken an introductory university nutrition course and those who had not. Methods: The sample consisted of two groups: 109 students who had completed a nutrition course and 61 who had not. The two samples were drawn from second-year nursing students and students in second-year psychology courses, respectively. All students completed a 25-item questionnaire. Chi-square tests were used to identify associations between completion of a nutrition course and responses. Results: Nutrition education students had more knowledge of whole grain recommendations, of whole grains available in stores, and of whole grains as a factor in disease risk reduction (p<0.05). In contrast, non-nutrition education students had more knowledge of whole grain health claims, reported a greater preference for the taste of whole grains, and had a greater than mean intake of whole grain cereals (p<0.05). Conclusions: This prelimary study indicates that completion of an introductory nutrition course has a greater influence on positive perceptions of whole grains than on students’ consumption frequency or knowledge of whole grains. Further study may provide more information on nutrition education and whole grains.
- Purpose: We explored dietetic students’ beliefs about what becoming a dietitian means. Methods: A phenomenological approach to inquiry was used. Thirteen undergraduate students enrolled in a dietetics program were interviewed, and data were analyzed thematically. Results: The overarching theme was students’ expectations of what being a dietitian means and how those expectations change throughout their education. Exposure to a variety of dietitians in practice helped shape participants’ understanding of being a dietitian. Conclusions: For dietetic students to develop a strong identity as dietitians and to strengthen the profession, they must be exposed to practising professionals early and often.
- Purpose: Dietetics students’ reservations about their career choice were investigated. Methods: In several dietetics programs in various provinces, an in-class or online survey was administered to students in the early or late stages of their education (n=397). Data were coded and analyzed, using descriptive statistics. Chi-square testing for independence was used to establish significant relationships. Results: Forty-three percent (n=149) of those responding to the research question (n=344) indicated they had reservations about a dietetics career, primarily because of internship, salary, and employment concerns. Students enrolled in a coordinated internship/degree program experienced no reservations about internship. Students experienced fewer career reservations when they had made their career decision before grade 12, were influenced by a dietitian, or were in the later stages of their education. Conclusions: Findings have implications for dietetics recruitment, retention, research, and education. An understanding of sources of reservations about career choice will allow policymakers, researchers, and educators to address issues to ensure that potential professionals are well informed about career components and that educational programs meet students’ needs.
- Purpose: The popularity of bottled water products (BWPs) is growing in Canada. Concentrations of minerals with important implications for health were compared in different types of BWPs. Methods: One sample of each brand and type of plain BWP (purified, remineralized, spring, mineral, and artesian), flavoured BWP, and nutrient-enriched BWP sold in major stores in Ottawa, Ontario, was purchased to allow determination of mineral concentrations by flame atomic absorption or emission spectroscopy. A total of 124 BWPs representing 37 brands were analyzed. Results: In general, spring and mineral water contained higher amounts of magnesium and calcium than did purified, remineralized, artesian, flavoured, or nutrient-enriched water. Most plain BWPs contained little sodium and potassium, whereas 15% to 35% of flavoured and nutrient-enriched products had considerably higher concentrations. Only magnesium and calcium concentrations were highly correlated (r=0.76, p<0.001). Calculation of the percentage of Dietary Reference Intakes that could be supplied by each product revealed that, if they are consumed habitually, many products can contribute substantially to recommended intakes of these minerals. Conclusions: Mineral concentrations in most types of BWP varied, but distinct differences between types of products were identified. Consumers should be aware of the mineral content of BWPs because some could influence intakes of certain minerals significantly.
- Purpose: Levels of adherence to pancreatic enzyme supplementation were investigated in Atlantic Canada adolescents with cystic fibrosis (CF). Methods: Participants were recruited from CF clinics at the Izaak Walton Killam Health Centre in Halifax, Nova Scotia, and the Janeway Children’s Health & Rehabilitation Centre in St. John’s, Newfoundland and Labrador. Self-report questionnaires were mailed to potential participants (n=51) by clinic staff and completed surveys (n=9) were mailed to the principal investigator. Results: Nine adolescents (mean age 15.2 ± 1.9 years) participated in the study. The adherence survey indicated that the majority perceived themselves to be adherent to taking enzymes with meals (67%), but only 44% perceived themselves to be adherent to taking enzymes with snacks. Recorded amounts of enzymes, taken over three days, indicated that 67% of participants were actually adherent to taking enzymes with meals and 56% with snacks. Including those who correctly predicted non-adherence, 56% and 44% of participants accurately predicted their adherence to taking enzymes with meals and snacks, respectively. Conclusions: Adherence rates in the literature vary because of differences in definition and measurement. In the CF population, adherence has been shown to have a positive effect on quality of life. Results for this small group of patients suggest that Atlantic Canada adolescents with CF are able to estimate correctly their adherence to taking pancreatic enzymes, but definite conclusions cannot be made because of the small number of respondents.
- Purpose: The effectiveness of different front-of-pack nutrition rating systems and symbols (FOPS) has not been studied among Canadians. We pilot tested an online FOPS survey with consumers. Methods: Members of the Guelph Food Panel were randomly exposed to traffic light, Percent Daily Value, Health Check, and Smart Pick logos on mock food packages and were asked to rate the FOPS on a Likert-type scale. The FOPS were rated on consumers’ ability to understand them, credibility, and influence on purchase decisions. Participants also provided feedback on the survey. Results: Participants (n=337) deemed the survey appropriate in length and language, and provided suggestions for improving survey clarity. More than 50% of the respondents believed that FOPS should be present on all food packages (65.1%) and should be government regulated (53.0%). The Percent Daily Value symbol was rated highest with respect to liking, credibility, helpfulness, and influence, but was the least understood. When they used direct comparison, consumers preferred the traffic light symbol (53.1%) over the Percent Daily Value (40.0%), Health Check (6.7%), and Smart Pick (0.3%) symbols. Conclusions: The survey was revised as a result of the pilot study feedback. Preliminary findings from this pilot study suggest that consumers prefer a single, government-regulated symbol, and value more complex FOPS, like the Percent Daily Value symbol, despite finding them harder to understand.
- Purpose: We explored the eating habits of Arab immigrants to determine whether they have maintained their traditional diet or have consumed a more Westernized diet since immigrating to Canada. Methods: Arab immigrants who had been in Canada for at least eight years and were currently living in the Greater Toronto Area were recruited. A sample of 24 Arab immigrants completed a mailed, self-administered questionnaire, and six participated in a focus group. The focus group discussion was transcribed verbatim and results were recorded. Latent content analysis was used to analyze, code, and categorize emerging themes. Results: Arab immigrants consumed a mixture of both Arabic and Western food and perceived their current diet to be healthier than it was before they immigrated to Canada. Factors that influenced their food choices included increased nutrition health awareness, differences in food preferences and preparation methods, and preservation of dietary practices in the new environment. Conclusions: Our findings will help dietitians who work with Arab immigrants to become more aware of factors that motivate this group's food choices, and to create nutrition programs that are more culturally sensitive.
- Purpose: An investigation was completed to determine how typical cooking procedures used in food preparation, such as baking and stir-frying, affect trans fats formation. Methods: Canola oil was used as the main fat ingredient. Zucchini cake and gingersnap cookies were baked at 180° C and 200° C, while stir-fried chicken was prepared at 200° C and 275° C. The lipids from the food were extracted following the Folch procedure, and analyzed for trans fatty acids according to ISO official method 15304. Results: Minimal changes were observed in the amount of trans fats during baking. Application of extreme temperatures during baking, which caused carbonization of the outer layer of products, yielded an insignificant increase in the amount of trans isomers. As with baking, stir-frying did not result in significant isomerization of the fatty acids, even when the oil was heated to 275° C and smoking heavily before the food was placed in it. Irrespective of the cooking procedure, linolenic acid was the most prone to isomerization with the highest amount of trans isomers formation. Conclusions: Baking and stir-frying at normal and/or extreme temperatures do not significantly affect the amounts of trans fats. Likewise, heating oil to the smoking point during stirfrying may decrease the amount of polyunsaturated fatty acids because of oxidative degradation.
- Purpose: Little is known about dietary intakes in toddlers of Low-German-Speaking Mennonites from Mexico, although some of these toddlers might be at risk for nutritional deficiencies. A 97-item, culturally sensitive, interviewer-administered food frequency questionnaire (FFQ) was developed and validated for health professionals to assess dietary intake in these children aged 12 to 36 months. Methods: Cultural foods on the FFQ were determined via focus groups; a pilot study tested content and formatting. The FFQ was administered to parents/caregivers of 22 toddlers in a southern Ontario community of Low-German-Speaking Mennonites from Mexico. Validity was determined by comparing nutrient intakes from the FFQ and from the 24-hour recalls, using Bland-Altman plots, Pearson correlations, and Student’s t-tests. Test-retest reliability was compared between two FFQ administrations (n=14) one month apart, via intraclass correlations (ICCs). Results: Bland-Altman plots showed good agreement between the FFQ and the 24-hour recall; Pearson correlations between methods were significant for protein, folate, calcium, and caffeine. Student’s t-tests were not significantly different between methods for 11 of 12 nutrients. Test-retest reliability was good on the basis of acceptable ICC for eight of 12 nutrients. Conclusions: The prevalence of nutrient inadequacies was low, except for folate. These results are promising for implementation of a simple, quick, culturally sensitive FFQ with the potential to provide reliable estimates of mean intakes in toddlers of Low-German-Speaking Mennonites from Mexico.
- Purpose: The study was conducted to evaluate whether body fat is a better measure than body mass index (BMI) for determining the relationship between body size and sweetness perception and preference. Methods: Seventy-two women were recruited and separated into two groups. First, BMI was determined and used to classify each woman as either normal weight (18.5 to 24.9 kg/m2) or overweight (>25.0 kg/m2). Body fat was determined from skinfold sites and used to categorize women into normal (<26.0%) or overweight body fat (≥26%) groups. Detection thresholds were determined using sucrose solutions. Four custard samples that varied in sweetness were evaluated to determine the women's liking for sweetness, and the perceived sweetness of the sample. Results: Women in the overweight BMI and body fat groups had higher sucrose threshold values than did women in the normal groups. When presented with custards of varying sucrose levels, the overweight BMI and body fat groups had a significantly increased liking for sweetness as sucrose concentration increased. Conclusions: Body fat measures were as effective as BMI measures in determining sweetness preference. Future research should be conducted to determine whether body fat and measures, such as waist circumference, can be predictive tools for sweetness preference.
- Kelly M. Matheson MSc, RD,
- Jennifer E. Cutting MSc,
- Vera C. Mazurak PhD,
- Lindsay E. Robinson PhD, and
- Andrea C. Buchholz PhD, RD
Purpose: Effects on energy metabolism of a test meal and a two-week dietary intervention were observed in men with metabolic syndrome (MetS). Both the meal and the intervention included foods containing fish-derived n-3 polyunsaturated fats (PUFA). Methods: Six men with MetS (46.7 ± 12.1 years, 37.2 ± 5.6 kg/m2, mean ± standard deviation) completed two test days, separated by a 14-day dietary intervention during which they consumed at least 2.0 g per day of n-3 PUFA from supplied foods. Pre- and post-intervention measurements included body composition, resting metabolic rate (RMR), and the thermic effect of food (TEF) measured for six hours after ingestion of a test meal consisting of 1.43 g of fish-derived n-3 PUFA. Results: Intakes of n-3 PUFA increased over the 14-day intervention, from 0.43 g per day ± 0.48 to 2.92 g per day ± 1.97 (p=0.013), while no changes were observed in total energy intakes, weight, body composition, or RMR (all p>0.05). The TEF increased by 51.3% (p=0.036), and the non-protein respiratory quotient decreased by 36.0% (p=0.700). Conclusions: Subjects increased their intake of fish-derived n-3 PUFA in an isocaloric manner while maintaining body weight and composition, and increased the TEF. More studies with larger sample sizes and longer intervention periods are required to confirm the use of fish-derived n-3 PUFA as a therapeutic dietary strategy for people with MetS.- Purpose: This study was conducted to explore whether preparing more complex meals was associated with higher food security status. Methods: This mixed-methods, community-based study involved the use of semistructured interviews to examine the cooking practices of a group of young, low-income women in Montreal. Fifty participants aged 18 to 35 were recruited at 10 locations in five low-income neighbourhoods. Food security status was the main outcome measure and the main exposure variable, “complex food preparation,” combined the preparation of three specific food types (soups, sauces, and baked goods) using basic ingredients. Results: Low-income women preparing a variety of meals using basic ingredients at least three times a week were more than twice as likely to be food secure as were women preparing more complex meals less frequently. Conclusions: Women who prepared more complex meals more frequently had higher food security. Whether this means that preparing more complex foods results in greater food security remains unclear, as this was an exploratory study.
- Shauna M. Downs MSc,
- Anna Farmer PhD, RD,
- Maira Quintanilha BSc,
- Tanya R. Berry PhD,
- Diana R. Mager PhD, RD,
- Noreen D. Willows PhD, and
- Linda J. McCargar PhD, RD
Purpose: In June 2008, the Alberta government released the Alberta Nutrition Guidelines for Children and Youth. We evaluated the awareness of and intent to use the guidelines in Alberta schools, and sought to determine whether organizational characteristics were a factor in adoption of the guidelines. Methods: Randomly selected schools from across Alberta completed a 19-question telephone survey, which included open- and closed-ended questions about the schools’ characteristics, the priority given to healthy eating, awareness of the guidelines, and the schools’ intent to use the guidelines. Of the 554 schools contacted, 357 (64%) completed the survey. Results: Overall, 76.1% of schools were aware of the guidelines and 65% were in the process of adopting them. Fifty percent of schools identified healthy eating as a high priority and 65.9% reported making changes to improve the nutritional quality of foods offered in the past year. Schools that were larger, public, and urban, and had a school champion and healthy eating as a high priority were more likely to be adopting the guidelines. Conclusions: Most schools were aware of the nutrition guidelines and many had begun the adoption process. Identifying a school champion may be an important first step for schools in terms of adopting health promotion initiatives.- Purpose: Regular, nontherapeutic menus were compared before and after an increase in the Ontario long-term care (LTC) raw food cost allowance (RFCA). The purpose was to determine whether any significant nutritional differences existed between the old and new menus and whether they met target values for adequacy, according to the Dietary Reference Intake (DRI) nutrient recommendations or other target values relevant to Ministry of Health and Long-Term Care standards. Methods: A southeastern Ontario LTC facility fall/winter 2006/2007 menu and fall/winter 2007/2008 menu were used for nutrient analysis with ESHA Food Processor SQL 10.1.0. Each menu was compared with target values based on Canada's Food Guide (CFG) for 1992 and 2007, and with DRI nutrient recommendations. Results: The 2007/2008 menu provided significantly more servings of vegetables and fruit, meeting the 2007 CFG recommendations, and significantly greater amounts of some nutrients (e.g., vitamin C, protein, magnesium, potassium, fibre, and total water). It also came closer to meeting DRI target recommendations. Conclusions: While some improvements have been made to the menu in this specific facility, further improvements, possibly through supplementation, must be made to ensure nutritional adequacy for all residents.