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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.
- Danuta Southgate MSW,
- Michelle Greiver MD, MSc, CCFP,
- Greg Hubka MSW, RSW,
- Kori Kostka RD,
- Rahim Moineddin PhD,
- Marjan Moienedin BHS, MSc,
- James Pencharz MD, CCFP,
- Heather Bogetta RD,
- Claudia Mazariegos RD,
- Jo-Anne Guindon MSW, RSW, and
- Andrea Petroff BA (Hon), MIR
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 : L’objectif de cette étude était d’évaluer l’effet d’une offre d’aliments à textures adaptées (Épikura©) sur les apports nutritionnels et le poids de résidents âgés demeurant en centre d’hébergement et présentant une dysphagie.Méthodes : Un essai clinique randomisé avec groupe témoin d’une durée de 24 semaines a été réalisé auprès de résidents dysphagiques de trois centres d’hébergement. Le groupe expérimental a reçu les aliments Épikura© (dîner et souper) et le groupe témoin, les aliments à textures adaptées institutionnels. Les apports nutritionnels de deux jours consécutifs ainsi que le poids des participants ont été mesurés au début de l’étude, puis après 10 et 20 semaines. L’insu n’était pas possible.Résultats : Parmi les 27 participants recrutés (expérimental, n = 14; témoin, n = 13), huit sont décédés et deux ont été retirés. Après 20 semaines d’intervention, les personnes nourries avec les aliments Épikura© (n = 7) ont augmenté leurs apports énergétiques (P = 0,004), glucidiques (P = 0,04) et lipidiques (P = 0,001), comparativement au groupe témoin (n = 10). Il n’y a pas eu de changement significatif en regard du poids.Conclusions : La présente étude suggère que les aliments Épikura© permettent d’augmenter les apports énergétiques et nutritionnels et pourraient prévenir la dénutrition. D’autres études de plus grande envergure sont nécessaires.
- Purpose: The objective of the current study was to examine food and culinary skills and knowledge of dietetic students.Methods: An online bilingual survey was created using Survey MonkeyTM to explore the skills, knowledge, and perceptions of undergraduate dietetic students regarding food and cooking. Chi-square and logistic regression analyses were used to compare skills and knowledge of food and culinary concepts.Results: The final sample included second- (n = 22) and third-year (n = 22) students within the Baccalauréat specialisé en sciences de la nutrition program at the University of Ottawa. There were no significant differences (P > 0.05) on 3 of 4 skills (preparing a cake, whipping egg whites, or baking a yeast bread) or knowledge concepts (fold, baste, braise, grill, and poach) amongst second- and third-year students. Third-year students perceived more skill in preparing a béchamel sauce. There was a trend for third-year students (59%) to have higher food and cooking skills and knowledge compared with second-year students (32%).Conclusions: Perceived knowledge and confidence was proportional with the academic year, whereas overall knowledge and skills of food and culinary concepts were moderate among both groups of students. This research suggests that more dedicated time may need to be spent on food and cooking competencies in undergraduate dietetic education.
- Purpose: To understand how and where parents of infants and young children (children ≤5 years old) prefer to receive nutrition information.Methods: A 1-page survey was developed and pilot tested at 2 community agencies. The final survey was distributed at 18 community health centres (CHCs) in Calgary and surrounding rural areas. Any parent attending a well-child visit (child ≤5 years old) was able to participate.Results: Five hundred and twenty-nine surveys were completed. The majority of respondents at every CHC identified online reading (79.2%) in their home (86.0%) as the preferred method and location to receive nutrition information. Almost all (99.4%) participants had internet access. Handouts (38.6%) were the second most popular way to receive nutrition information. In-person and online classes were only a preferred method by a small percentage of respondents, 10.6% and 8.1%, respectively.Conclusions: Appropriate, evidence-based nutrition websites should be promoted to parents with young children. Health professionals should be aware that parents likely access nutrition information online, and they need to provide an opportunity for parents to discuss what they found. Future research is needed to understand which websites parents access for online nutrition information and how they discern whether it is credible.
- Purpose: This study reports on the effect of a group-based nutrition and physical activity intervention program on nutrition knowledge and eating habits in a cohort of people with obesity.Methods: A quasi-experimental design with pre- and post-test measures. The intervention consisted of physical activity led by certified exercise physiologists and a nutritional education component led by registered dietitians over a 6-month period followed by 6 months of self-management. Participants’ nutrition knowledge and eating habits were assessed using the modified Nutrition Assessment, the Nutrition Knowledge Survey, and the Food Choice Questionnaires at baseline, after the 6-month intervention, and after 6 months of self-management.Results: Complete data were available for 59 (40%) of participants after 12 months because of attrition. Nutritional knowledge and behaviours improved. Participants reported increasing their consumption of healthy foods during the active intervention and maintained these changes through the self-management phase. Knowledge of healthy foods was improved and a greater likelihood of choosing food for weight control and health properties was reported.Conclusions: Knowledge and reported consumption of healthier nutrition improved during the active intervention and was maintained during the self-management period for individuals who completed the program. Registered dietitians can play an important role in managing patients with obesity in group settings.
- Grace Hubert RD BSc,
- Theresa Tam Chung RD BSc,
- Connie Prosser PhD FCACB,
- Dale Lien MD,
- Justin Weinkauf MD,
- Neil Brown MD,
- Marianne Goodvin RN BNSc,
- Kathy Jackson RN BNSc,
- Joan Tabak RN,
- Josette Salgado RN BNSc,
- Abeer Salman Alzaben MSc, and
- Diana R. Mager PhD MSc RD
Purpose: Patients with cystic fibrosis (CF) often experience low bone mineral density (BMD) pre- and post-lung transplantation (LTX). The study purpose was to describe BMD and micronutrient status in adults with CF pre- and post-LTX.Methods: Twelve patients with CF (29 ± 8 years) were recruited from the CF clinic at the University of Alberta Lung Transplant Program. BMD and vitamins A, D, E, K status, and parathyroid hormone were measured pre- and post-LTX.Results: No significant differences pre- and post-LTX were observed at the different bone sites measured (lumber–spine, femoral–neck (FN), hip, and femoral–trochlea) (P > 0.05). BMD T-scores (<−2) was present in lumbar–spine, FN, hip, and femoral–trochlea in 33%, 17%, 17%, and 25% of individuals pre-LTX and 58%, 33%, 58%, and 33% of individuals post-LTX, respectively. More than 50% of patients had suboptimal vitamin K levels (PIVKA-II values >3 ng/mL) pre- and post-LTX.Conclusion: Adults with CF pre- and post-LTX had reduced BMD and suboptimal vitamin K status.- Purpose: It is commonly suggested that calcium supplementation contributes to constipation; however, little research has explored the effects of calcium supplementation on gut motility.Methods: In an 8-week, randomized, double-blind, crossover pilot study, healthy females (n = 27, aged 43.0 ± 10.6 years) received a split dose of 500 mg/d of elemental calcium from calcium carbonate or calcium phosphate each for 2 weeks, after a 2-week baseline and separated by a 2-week washout. Participants completed daily questionnaires of stool frequency, Bristol Stool Form Scale (BSFS), and supplement intake compliance.Results: There were no differences among periods. Mean ± SE stool frequency averaged 1.3 ± 0.1 stools/d in each period. Participants reported 34%, 34%, 37%, and 29% of stools were indicative of slow transit or constipation (BSFS of 1 or 2) during baseline, calcium carbonate, calcium phosphate, and washout periods, respectively. Participants also reported from 6% to 10% of stools as fast transit or diarrhea (BSFS of 6 or 7) during the periods.Conclusion: This study suggests that neither calcium carbonate nor calcium phosphate, providing 500 mg/d of calcium, affects stool frequency or form. Although stool frequency was normal, the healthy females participating in the study experienced stools indicating slow (constipation) and fast (diarrhea) transit.
- Sarah J. Woodruff PhD,
- Bradley J. Harrop MHK,
- Katherine Campbell EdD, RN,
- Ty Campbell MEd Candidate, and
- Mary Cole MSc, RN
Purpose: To describe dietary intake associated with intentional weight gain among grade 7 students.Methods: Data were collected using the Waterloo web-based Eating Behaviour Questionnaire (WEB-Q) and measured heights/weights were taken to assess Body Mass Index (BMI). Dietary intake and the Canadian Healthy Eating Index-2009 were compared among participants who ate more to gain weight.Results: Among 1015 participants, approximately 9% of participants were actively attempting to gain weight with more males than females (P < 0.001) and more underweight and normal weight than overweight/obese (P < 0.001) participants. Unadjusted analyses revealed that weight gainers versus non-weight gainers consumed more grain products (P < 0.001), meat and alternatives (P = 0.005), and other foods (P < 0.001), in addition to more total energy (P < 0.001). Although greater amounts of carbohydrates, fat, and protein were consumed among the weight gainers, no differences in the percentage of each macronutrient were observed once corrected for total energy intake. The adjusted model revealed that weight gainers were more likely to consume grain products in line with current recommendations, yet they were further from the recommendations for total fat intake.Conclusion: Health promotion strategies need to consider intentional weight gain among young adolescents to ensure that appropriate weight gaining strategies are being followed to avoid potential detrimental health effects.- Sarah Purcell MSc,
- Robert Thornberry MD,
- Sarah A. Elliott PhD,
- Lynn Panton PhD,
- Michael J. Ormsbee PhD,
- Edgar R. Vieira PhD,
- Jeong-Su Kim PhD, and
- Carla M. Prado PhD
Purpose: To describe body composition (fat mass (FM) and fat-free mass (FFM)), strength, and nutritional characteristics of patients with hip or knee osteoarthritis undergoing total joint arthroplasty.Methods: In this prospective pilot study, osteoarthritic patients underwent body composition assessment using bioelectrical impedance analysis, grip strength measurement, and completed a 24-h dietary recall during their pre-operative assessment.Results: Fifty-five patients were included (∼66% females, age 43–89 years). Mean ± SD body mass index (BMI) was 32.79 ± 6.48 kg/m2 and 62% were obese. Compared with hip osteoarthritis patients, knee osteoarthritis patients had a higher BMI (P = 0.018) and males with knee osteoarthritis had a lower grip strength (P = 0.028). There was a wide range in FM and FFM values across the BMI spectrum. Patients with a higher FM index (FMI, FM/height in m2) had higher levels of pain (P = 0.036) and females with higher FMI had a lower grip strength (P = 0.048). Dietary under-reporting was common and many patients did not meet recommendations for protein, vitamins C and E, or omega-3 fatty acids. Those who consumed less protein than the recommended dietary allowance were older (P = 0.018).Conclusions: A wide variability of body composition and dietary intake was observed which may impact strength and ultimately affect physical function. As such, patients with osteoarthritis may benefit from targeted nutrition and physical activity interventions before and after surgery.- Purpose: Canada’s Food Guide (CFG) defines food serving sizes and recommends a specific number of servings from each of the 4 food groups. However, there is no differentiation in serving sizes for different versions of foods that may differ in nutritional value.Methods: Participants (n = 20) estimated serving sizes of “healthier” and “unhealthier” versions of milk, bread, cereal, potatoes, chicken, fish, and juice and reported the amount normally consumed in 1 sitting.Results: Participants estimated unhealthier servings of cereal and juice to be smaller than healthier servings, but estimated unhealthier servings of chicken to be larger than healthier versions (P < 0.05). There were no differences for bread, milk, potatoes, and fish. Accordingly, estimated servings of juice (P < 0.01) had more calories than the unhealthier orange drink. There were no caloric differences for cereal (P = 0.12), but an estimated serving of bran flakes had more fat and fibre than frosted flakes cereal.Conclusions: In contrast with CFG, which does not account for different versions of food, certain unhealthier foods were estimated to be smaller or larger than the healthier versions. However, both healthy and unhealthy serving sizes still tended to be larger than what is prescribed in CFG. Thus, better education or revision of serving sizes in future editions of CFG may warrant consideration.
- Purpose: To examine use and content knowledge of Canada's Food Guide recommendations.Methods: A total of 1048 intercept exit surveys were conducted with adults who had purchased food that day at 2 hospital cafeterias in Ottawa, Ontario.Results: Most respondents (85.9%) reported looking at Canada's Food Guide over their lifetime; however, less than half reported looking at the food guide in the past year. Milk and Alternatives were the most commonly recalled food group (80.1%) and Grain Products were least commonly recalled (66.0%). Of the entire sample, 42.8% correctly recalled all 4 food groups. Overall, 0.8% correctly recalled the correct number of servings for all 4 food groups. Females, younger respondents, white respondents, respondents with higher annual income, and respondents who had reported looking at Canada's Food Guide recalled more food groups (P < 0.05 for all).Conclusions: Despite high levels of awareness, the study found relatively low levels of reported use and very low levels of knowledge of Canada's Food Guide, particularly among population subgroups that face health disparities. Improving awareness, knowledge, and use of Canada's Food Guide may contribute to improving the nutrition profile of Canadians.
- Jasmine Farahbakhsh BSc,
- Geoff D.C. Ball PhD,
- Anna P. Farmer PhD,
- Katerina Maximova PhD,
- Mahitab Hanbazaza MSc, and
- Noreen D. Willows PhD
Purpose: To describe the food security status, food insecurity coping strategies, characteristics, and experiences of student clients of the Campus Food Bank (CFB) at the University of Alberta in Edmonton, Alberta, Canada.Methods: A convenience sample of 58 students completed a survey from April 2013 to April 2014. Food security status was determined using the “Adult Food Security Survey Module”.Results: Ninety percent of CFB student clients who participated in this study were food insecure, which included both moderately and severely food insecure groups. The most prevalent coping strategies for food insecurity included applying for a loan or bursary (86.2%), seeking employment or working more hours (84.5%), and purchasing food using a credit card (77.6%). Participants were a diverse mix of students, including graduate students (50.0%), international students (46.6%), and caregivers of children (24.1%). The most common primary sources of income were government student loans (29.3%) and research assistantships (20.7%). Most participants (82.8%) liked the food they received from the food bank.Conclusions: Food insecurity is highly prevalent among student clients of this university-based food bank. Students used a variety of coping strategies to increase their disposable income, highlighting the need for additional strategies to alleviate food insecurity among vulnerable students.- Cynthia Strawson MSc,
- Rhonda C. Bell PhD,
- Anna Farmer PhD, RD,
- Shauna M. Downs PhD,
- Dana L. Olstad PhD, RD, and
- Noreen D. Willows PhD
Purpose: This study describes dietary changes among university students who completed a travel study program.Methods: Seventeen undergraduate nutrition students travelled from Edmonton to Italy for 6 weeks to take 2 courses on the Mediterranean diet. In both locations students completed a 24-h dietary recall and a Food Frequency Questionnaire to assess their Mediterranean Diet Quality Index Score (MDQIS). A MDQIS of 48 indicates perfect adherence to eating patterns of the Traditional Healthy Mediterranean Diet Pyramid (THMDP).Results: While in Italy students altered their diets in positive ways (increased consumption of fish and seafood (P = 0.002), wine (P < 0.0001), and olive oil (P = 0.001)) and negative ways (increased consumption of sweets (P = 0.027), poultry (P = 0.001), and meat (P = 0.049)) relative to the THMDP. Students had a significant increase in the percentage of energy from polyunsaturated and monounsaturated fatty acids and alcohol. The MDQIS was low in Edmonton (21.9 ± 3.7) and Italy (22.9 ± 3.9).Conclusions: The overall dietary pattern of students did not adhere to the THMDP. Education about the THMDP and living in Italy for 6 weeks was insufficient to change students’ dietary patterns to one characterized as traditional Mediterranean. The findings highlight the challenges of implementing dietary changes even with nutrition education and increased food access.- Purpose: To assess the status of food and nutrition programming in community-based HIV organizations in Canada.Methods: A telephone survey was administered to 80 community-based HIV organizations asking about characteristics of food and nutrition programs and the perceived program gaps.Results: The majority of organizations had programs directed at improving food access through meals, food banks, community kitchens or cooking classes, food vouchers, gardens, and street vans. Almost half of the organizations (n = 39) provided nutrition counselling by a registered dietitian or nurse, and the majority also provided referrals to other food and nutrition services in the community. Most organizations would like to have more food-related programming, including: more frequent provision of nutritious and fresh food options, methods to make better use of available food, transportation and grocery vouchers, more staff dedicated to food programs, and improved food preparation and storage infrastructure.Conclusion: Although community-based HIV organizations provide a range of food and nutrition programs, they face challenges due to inadequate resources. Decision makers should provide more funding for these programs; however, they must be augmented with other supports such as adequate housing, income, and addiction counselling. Dietitians can help organizations maximize the impact of their limited resources and can advocate for systemic changes to enhance determinants of health for people living with HIV.
Reflections on Perceived Preparedness of Dietetic Internship Graduates Following Entry into Practice
Purpose: To report on the perceived level of preparedness of dietetic internship (DI) graduates for entrance into practice as dietitians.Methods: Graduates of an Ontario based, nonintegrated DI program from 2007–2011 who were at least 1 year postgraduation were surveyed to determine their level of perceived preparedness for practice using an electronic, content validated, self-administered questionnaire.Results: Of 38 eligible graduates, 23 (61%) responded. Seventy-five percent of respondents were working as clinical dietitians, and 30% were working as community dietitians. Eighty-five percent of graduates reported feeling well or very well prepared for practice. Clinical and professional practice tasks were scored highest in terms of preparedness (ratings above 4.5/5) and research-related tasks such as using the research literature (4.1/5), making evidence-based decisions (4.2/5), and engaging in practice-based research (4.1/5) scored lower. Training gaps identified by 32% of respondents included community nutrition and management skill training.Conclusions: Overall, results indicate that this DI program provides a positive training experience that prepares its graduates for entrance into practice as dietitians. Qualitative comments identifying gaps and improvements have guided changes to the curriculum including strengthening community-based placements. Post-graduate surveys represent an important tool in assuring that training programs evolve to meet the needs of students entering the workforce.- Holly-Anne Scott BASc,
- Michelle Marcinow MSc, PhD(C),
- Rachel Hicks BASc, and
- Andrea C. Buchholz PhD, RD
Purpose: To explore the role of breakfast cereal consumption on the relationships among BMI, percent fat mass (%FM), and body esteem in young adults.Methods: Weight, height, and %FM (by air displacement plethysmography) were measured in 29 males (aged 25.1 ± 4.0 years) and 28 females (aged 24.6 ± 4.0 years). Body esteem was measured using the Body Esteem Scale for Adolescents and Adults (BESAA). Three-day food records classified participants as breakfast cereal consumers (n = 27, any amount of ready-to-eat or cooked cereal consumed at breakfast) versus nonconsumers (n = 30, no cereal consumed at breakfast).Results: The %FM was significantly (P ≤ 0.05) inversely correlated with weight esteem (r = −0.769), appearance esteem (r = −0.723), and external attribution (r = −0.620) in female noncereal consumers. BMI was similarly correlated with BESAA scores. These relationships were not significant in female cereal consumers (all r < 0.426), despite no difference in confounding variables between female cereal consumers and nonconsumers. Neither BMI nor %FM were correlated with measures of body esteem (all r < 0.466, NS) in either male cereal consumers or nonconsumers.Conclusions: Breakfast cereal consumption may moderate the relationship among BMI, %FM, and body esteem in young adult women and may be useful for improving body esteem without focusing on weight loss.- Purpose: Consumption of pulses is recommended to improve diet quality and decrease the risk of chronic disease. However, their constituent α-galactosides, including raffinose, are commonly thought to contribute to unpleasant gastrointestinal symptoms.Methods: Using a random crossover design, healthy adults (n = 12) received control foods, control foods with 5 g raffinose, and foods with 200 g of canned chickpea (11 g fibre per day), each for three weeks following a 3-day diet rotation. Gastrointestinal symptoms (rating 0 = none to 3 = severe), compliance, and stool frequency were recorded daily.Results: No change in daily stool frequency (mean ± SD) was found with chickpea (1.7 ± 0.3) or raffinose (1.7 ± 0.4) compared with control (1.5 ± 0.3). Reported flatulence (mean ± SD) was rated higher with chickpea (1.0 ± 0.2, P < 0.001) and raffinose (0.7 ± 0.2, P < 0.001) compared with control (0.4 ± 0.1). Although bloating was infrequent, ratings were higher with chickpea (0.2 ± 0.1, P < 0.001) and raffinose (0.3 ± 0.1, P < 0.001) compared with control (0.0). No differences were found for diarrhea or abdominal pain.Conclusions: As gastrointestinal symptoms were mild for most participants, canned chickpea may be a feasible way of increasing pulse intake and improving overall diet quality.
- Purpose: Coaches’ sports nutrition knowledge and subsequent nutrition recommendations can have an impact on athletes’ health and performance. The purpose of this study was to determine sports nutrition knowledge and nutrition recommendation practices of varsity coaches at one Canadian university and to determine if the coaches’ nutrition knowledge influenced nutrition recommendations to athletes. The coaches’ accessibility to sports dietitians was also examined.Methods: Coaches (n = 5) completed a modified psychometrically validated nutrition knowledge questionnaire and a semi-structured interview. Mean scores were calculated for questionnaire answers based on the correct answer and the coach's degree of certainty in their answer. Interviews were analyzed using thematic analysis.Results: Results showed a low nutrition knowledge, yet all coaches made nutrition recommendations to their athletes for fluid needs, dietary supplementation, and weight management; areas that may be potentially detrimental to the health of athletes. In addition, they made recommendations with regard to fluid needs, training diet, precompetition diet, recovery diet (i.e., post training or competition), dietary supplementation, and weight management; areas that could have potentially negative performance consequences to the athlete.Conclusions: It was determined that coaches had low nutrition knowledge scores and still made nutrition recommendations to athletes. The importance of sports dietitian involvement in varsity athletics is emphasized.
- Purpose: To describe and provide recommendations for the implementation of an evaluation for an already existing, in-store Nutrition Label Education Program (NLEP).Methods: We describe the development and implementation of an evaluation consisting of a pre- and postsurvey and one month follow-up. The evaluation was designed to assess satisfaction with the NLEP as well as changes in participant nutrition label knowledge, confidence in using nutrition labels, and actual changes in nutrition label use.Results: Nineteen participants took part in the pilot evaluation. The evaluation was successful in demonstrating high levels of satisfaction with the NLEP as well as positive changes in participant confidence and some increased knowledge in using nutrition labels. However, only 3 people participated in the follow-up, limiting the ability to assess behaviour change.Conclusions: Ideally, NLEPs should include ongoing evaluation that extends beyond just assessing participant satisfaction. Recommendations are provided for conducting such evaluations, including the importance of incorporating the evaluation into the program itself, using existing questionnaires when possible, and employing pre- and postsurveys as well as follow-up interviews to assess change.
- Purpose: To assess the availability, location, and format of nutrition information in fast-food chain restaurants in Ontario.Methods: Nutrition information in restaurants was assessed using an adapted version of the Nutrition Environment Measures Study for Restaurants (NEMS-R). Two raters independently visited 50 restaurants, 5 outlets of each of the top-10 fast-food chain restaurants in Canada. The locations of the restaurants were randomly selected within the Waterloo, Wellington, and Peel regions in Ontario, Canada. Descriptive results are presented for the proportion of restaurants presenting nutrition information by location (e.g., brochure), format (e.g., use of symbols), and then by type of restaurant (e.g., quick take-away, full-service).Results: Overall, 96.0% (n = 48) of the restaurants had at least some nutrition information available in the restaurant. However, no restaurant listed calorie information for all items on menu boards or menus, and only 14.0% (n = 7) of the restaurants posted calorie information and 26.0% (n = 13) of restaurants posted other nutrients (e.g., total fat) for at least some items on menus boards or menus.Conclusions: The majority of the fast-food chain restaurants included in our study provided at least some nutrition information in restaurants; however, very few restaurants made nutrition information readily available for consumers on menu boards and menus.
- 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.
- Purpose: Dual energy X-ray absorptiometry (DXA) and air displacement plethysmography (ADP) are commonly used to assess body composition. Accurate body fat measures are valuable in a variety of populations. Because DXA, the reference standard, is expensive and labour-intensive, determining whether these two methods are interchangeable is important. Methods: Forty-five female undergraduate students aged 21 to 33 with body mass indexes of 18.3 to 28.6 kg/m2 were recruited from the University of Guelph. Each participant underwent one full-body DXA scan and one ADP assessment, to determine total percent fat mass (%FM). Results: The Pearson's correlation between %FMDXA (27.1 ± 4.8) and %FMADP (26.1 ± 5.5) indicated good association (r=0.88, p<0.01). While Bland–Altman analysis revealed no systematic bias between the two methods (R2=0.07, p=0.08), large intraindividual variation occurred (95% confidence interval: -5.86% to 4.11%); this was related to height, weight, body-surface area, and lung volume. Conclusions: The two methods were significantly correlated. Mean %FM was not significantly different and no systematic bias between methods was observed. These findings indicate that ADP and DXA may be used interchangeably for determining %FM at the group level in healthy young women; a large intraindividual variation between the methods precludes interchangeability at the individual level.
- Purpose: The study was undertaken to evaluate the education and training background of Canadian registered dietitians (RDs) practising in sport and exercise nutrition, as well as learning opportunities in the practice area. Methods: A secondary analysis of a 2009 Dietitians of Canada (DC) Sport Nutrition Network survey of members (n=70) was conducted to describe members’ educational background. Through the use of publicly available information, Canadian dietetic internship, undergraduate, and graduate sport nutrition educational opportunities were identified. Results: Most (72.9%) respondents indicated they had some type of formal education in sport nutrition; learning from undergraduate courses and conference sessions was cited most frequently. The majority (86.7%) of accredited universities offered undergraduate courses in sport/exercise nutrition. No DC-accredited internship program offered sport nutrition as a mandatory rotation, while 15.8% of graduate programs in Canada had faculty with research interests in the area. Among respondents, 91.4% felt sport nutrition education in Canada was inadequate; all expressed interest in participating in more formal learning experiences, and 97.1% were interested in a specialized credential. Conclusions: Canadian dietitians working in sport and exercise nutrition have diverse educational backgrounds and must direct their own learning. Improved career development pathways and more available formal education are desired and needed.
- Carole Mayer PhD candidate, MSW,
- Kerri Loney RD, MEd, BASc,
- Suzanne Lamoureux RD, BSc, and
- Denise Gauthier-Frohlick PhD candidate, MA, BEd
Purpose: An oncology nutrition referral priority rating system (NRPRS) was developed and evaluated as a tool to classify patients into nutrition risk categories and allocate reasonable wait times. Methods: A retrospective chart audit (n=112), patient focus groups (n=14), and a prospective chart audit (n=179) were conducted to refine the tool. Using the NRPRS, the dietitians assigned a priority rating from the information on the referral and then compared it with a second rating after the first visit. Education to referring staff was provided to improve the completeness of referrals. Results: Patients rated at highest nutrition risk (priorities 1 and 2 [P1 and P2]) had a rating similar to the dietitian's after the first visit (P1, 97%; P2, 84%). Incomplete referrals were assigned a P3 rating. This may explain the discrepancy in ratings for P3 referrals (64%). After education, essential information on the referral form increased by 26%. Conclusions: The NRPRS is an effective tool for prioritizing high-risk patients when referrals are completed fully. The next step is to validate the NRPRS now that computerized order entry is implemented in the cancer clinic.- Kay Watson-Jarvis RD, MNS, FDC,
- Deborah McNeil RN, PhD,
- Tanis R. Fenton RD, PhD, and
- Kristina Campbell RD, MSc
Purpose: Identifying nutrition-related problems during the early years may provide an opportunity to enhance parents’ abilities to support healthy growth and development. The Nutrition Screening Tool for Every Preschooler (NutriSTEP®) is a validated, parent-administered questionnaire designed to identify preschool children at nutritional risk. Parents can complete NutriSTEP® in under five minutes. Parents’ and staff's views of NutriSTEP® implementation feasibility were assessed in two community health centres. Methods: Parents attending preschool immunization clinics were recruited. Parents, staff, and physicians were asked for their opinions on screening. Results: The 412 (34%) parent questionnaires completed indicated that parents found NutriSTEP® easy to complete and helpful for identifying areas of nutrition concern. Staff estimated screening distribution took one to three minutes. Clerks and nurses expressed concern about additional workload and demands on parents. Managers believed NutriSTEP® was easy to implement. Physicians considered nutrition screening of preschoolers important, and felt that health centres were the best location for screening. Conclusions: NutriSTEP® was relatively easy to implement in two community health clinics. While staff expressed concern about increased workload, parents found it easy to complete and helpful.- Purpose: Portion size measurement aids (PSMAs) are used extensively by dietitians. In this cross-sectional, descriptive study, we explored the degree of consistency and concordance between measured and putative volumes of selected household and sport-related PSMAs that are commonly used for nutrition education and dietary assessment. Methods: An online search of portion size resources yielded several governmental and academic descriptions of household PMSAs (e.g., a compact disc, a nine-volt battery) and sportrelated PMSAs (e.g., a golf ball) and their purported dimensions. The spherical items were purchased locally and measured using electronic digital calipers; measurements were then converted to volumes, in millilitres. Results: Overall, we observed a high degree of heterogeneity in how different educational resources related sport-related PSMAs to portion sizes of food. The mean percentage of error between the measured and putative volumes of PSMAs varied considerably. Conclusions: Our findings indicate that the inaccurate use of PSMAs can lead to systematic bias in nutrition education and misreporting of dietary intake during dietary assessment. Dietitians should exercise caution when using PSMAs because these may not reflect the true portion size they are meant to represent.
- Cédée-Anne LeClair PhD, RD,
- Marie Marquis PhD, RD,
- Lita Villalon PhD, RD, and
- Irene Strychar EdD, RD
Purpose: Healthy adolescents’ awareness of diabetes was explored, and gender and grade-level differences in understanding were determined. Methods: Adolescents without diabetes in grades five, eight, and 10 (n=128) at four New Brunswick schools wrote down all words/expressions that came to mind when they heard the word “diabetes” (i.e., they used the free association technique). Answers were classified into categories using content analysis. Results: Eighty-eight girls and 40 boys completed the activity (n=44, 52, and 32 in grades five, eight, and 10, respectively). Nine principal categories were identified: 66% of the adolescents cited sugar (e.g., eating too much sugar, not enough sugar), 48% treatment (e.g., needles, injections), 45% the nature of diabetes (e.g., a disease, types of diabetes, heredity), 41% nutrition (e.g., diet, sugar-containing foods, other foods), 38% blood (e.g., too much/not enough sugar in blood), 18% complications (e.g., death), 11% physiological manifestations/ symptoms (e.g., fainting), 6% obesity, and 6% physical activity. No differences were found in category citation frequency between boys and girls and grade levels, except that grade 10 students more frequently cited the categories of treatment, blood, and obesity (p≤0.05). Conclusions: Students thought of diabetes in terms of sugar and injections. Words related to obesity, prevention, and complications were cited infrequently.- Purpose: The likelihood of experiencing poor nutrition status increases as people age. Sampling new foods may promote a continued interest in food and enjoyment of eating. This pilot study was designed to describe and provide a preliminary evaluation of food-tasting activities integrated into nutrition displays directed at community-living older adults. Methods: Three consecutivemonthly nutrition displays incorporating a food-tasting activity were presented at a Guelph, Ontario, recreation centre for seniors. Seniors had an opportunity to taste two recipes at each of three displays; 226 food samples and 155 copies of recipes were taken. Feedback forms were used to determine participants’ interest inmaking the recipes, and whether tasting influenced their interest in preparing the food. Results: Among 54 participants who completed feedback forms about the program, 75.9%indicated that they intended to prepare one or both of the recipes tasted at the display; 70.4%indicated that they would not ormay not havemade the recipe without tasting it beforehand. Conclusions:Dietitians working with community-living older adults could use food tastings to help translate key educational messages into practice, and to encourage eating enjoyment as people age.
- Purpose: Few authors have investigated the institutional character of charitable food programs and their capacity to address food security in Canada. Methods:We surveyed food programmanagers at charitable agencies in Greater Victoria, British Columbia.We discuss the structure of the “system” of charitable food provision, the value of sourced food, types of services provided, clients’ demographic profile, and the estimated healthfulness ofmeals served.We also describe the proportion ofmajor food types purchased and donated to agencies. Results: Thirty-six agencies served approximately 20,000meals a week to about 17,000 people. Food valued at $3.2million was purchased or donated; approximately 50%was donated,mainly by corporations. The largest value of food purchased and donated was frommeat and alternatives (40.9%) and nonperishable food items (16%). Dairy productsmade up the smallest share of donated foods. Conclusions: Charitable food programs in Victoria depend on food donations. The proportion of dairy products and produce is low, which raises questions about the healthfulness of foods currently fed to homeless and poor people in the city.
- Purpose: Dietary vitamin D intake was assessed among residents in a long-term care (LTC) facility, so that recommendations could be made about vitamin D supplementation. Methods: Three-day tray audits were completed for allmeals and snacks, including nutritional supplements (Boost™and/or high-protein pudding). Total daily and three-day vitamin D intake was calculated for each resident, and the total sample was compared with the recommended Adequate Intake (AI) of 600 IU. Vitamin D content was calculated using the Canadian Nutrient File and product labels. Resident charts were reviewed for micronutrient supplements and diagnoses. Results: The daily average vitamin D available to and consumed by 30 residents was 414 IU and 295 IU, respectively. Those provided with nutritional supplements received an average of 480 IU and consumed 357 IU, while those without received an average of 245 IU and consumed 207 IU. Thirty-three percent of residents were diagnosed with osteoporosis, osteoarthritis, and falls and/or fractures. Vitamin Dmicronutrient supplementation varied from above 600 IU (43%) to below 600 IU (30%) to no supplementation (27%). Conclusions:None of the study participantsmet the recommended AI of 600 IU through dietary sources alone. Study results suggest that all LTC residents require vitamin Dmicronutrient supplementation of at least 400 IU to achieve the recommended AI of 600 IU.
- Objectif: Étudier l’association entre la pneumonie d’aspiration (PA) et la dénutrition chez des patients d’unités gériatriques actives (UGA) et décrire le profil des patients ayant développé une PA. Méthodes: Les cas de PA ont été repérés parmi les patients radiés de deux UGA entre 2001 et 2007 (n=2238). La prévalence des atteintes neurologiques, de la dysphagie et de la dénutrition a été comparée chez les patients selon qu’ils aient développé ou non une PA. Le profil des cas de PA a été déterminé à partir des dossiersmédicaux. Résultats: L’incidence cumulée des PA est faible dans les deux unités (1,1%). La PA était fortement associée aux atteintes neurologiques (accident vasculaire cérébral etmaladie de Parkinson) et à la dysphagie (p<0,01), et tendait à être plus prévalente parmi les patients dénutris (p<0,10). Selon l’évaluation diététique, environ 80%des cas de PA étaient dénutris, résultat appuyé par une prévalence élevée d’indicateurs du risque nutritionnel. Conclusions: Les résultats obtenus soutiennent l’hypothèse d’un rôle possible de la dénutrition dans le développement des PA chez les patients âgés hospitalisés. La prévention et la prise en charge de la dénutrition, particulièrement chez les personnes dysphagiques, pourraient contribuer à la prévention des PA dans cette population.
- Purpose: The Healthy Eating Champions Award for Elementary Schools (HEC) is a public health initiative that recognizes and rewards schools for their outstanding commitment to the promotion of nutrition, for nutrition education, and for making healthy foods and beverages available. This process evaluation assessed HEC implementation, identified benefits and barriers, and solicited suggestions for program improvement. Methods: In-person interviews with principals or their designates from 28 HEC participating schools were conducted in fall 2006. Results: Participants had positive feelings about the HEC program and shared many success stories. Perceived program benefits included increased student awareness about healthy eating, more student involvement in healthy eating initiatives, the creation of opportunities for goal setting and spirit boosting, and improved hygiene practices. The challenge of getting parents and teachers involved and the significant financial needs of schools in low-income areas were identified as challenges. Conclusions: Participants view the HEC program as having a positive impact on the healthy eating environment in schools.
- Purpose: Obesity in childhood has become a major public health concern because of increasing rates of overweight and obesity. To address this epidemic, effective dietetic interventions must be developed. We examined parent/caregiver and/or patient reasons for not returning for follow-up clinical care in the Alberta Health Services, Edmonton Area's Nutrition Services Pediatric Weight Management Program (NS PWMP) in Edmonton, Alberta. Methods: A qualitative telephone survey was developed to identify reasons for non-return to the NS PWMP. Face validity was evaluated by five pediatric registered dietitians (RDs). Results: The survey was administered to parents/caregivers of children or adolescents aged 2.5 to 14.2 years (n=21) who attended fewer than two appointments in the NS PWMP. The major reasons for non-return included physical barriers (scheduling, parking, location), organizational barriers (clinic environment), and program educational content (type of educational tools, the focus of lifestyle education on the individual rather than the family, physical activity interventions, and appropriateness of information for the parent or child). Conclusions: Development and delivery of effective dietetic interventions for children and adolescents at risk of overweight and obesity may be achieved by emphasizing skill building within the child and the family. Analysis of child and family feedback on clinical RD services is critical to optimization of care in a pediatric weight management program.
- Purpose: Beverage consumption by poor, lone mother-led, “milk-friendly” families living in Atlantic Canada was characterized over a one-month income cycle. Methods: Beverage intake and food security status were assessed weekly, using a 24-hour dietary recall and the Cornell- Radimer food insecurity questionnaire. Families were classified as “milk friendly” if total consumption of milk was 720 mL on a single day during the month. Beverage intake was assessed using t-tests, analysis of variance (ANOVA), repeated measures ANOVA with post hoc comparisons, and chi-square analysis. Results: Milk consumption by milk-friendly families (76; total sample, 129) was highest at the time of the month when they had the most money to spend. During all time intervals, mothers consumed the least amount of milk and children aged one to three years consumed the most. Mothers consumed carbonated beverages disproportionately, while children of all ages consumed more fruit juice/drink. Mothers’ coffee consumption was profoundly increased when either they or their children were hungry. Conclusions: The quality of beverage intake by members of low-income households fluctuates in accordance with financial resources available to purchase foods. Mothers’ beverage intake is compromised by the degree of food insecurity the family experiences.
- Purpose: Middle-aged women have the highest levels of obesity and comprise the largest group of dieters. Few investigators have examined how women apply weight-loss diet principles in an unsupervised setting. Dietary intakes and attitudes toward carbohydrates were examined in women who were selfreported low carbohydrate dieters (SRLCDs); these intakes and attitudes were compared with those of women who were following their normal diet (non-dieters [NDs]). Methods: A convenience sample of 29 postmenopausal women aged 45 to 65 was recruited. Data were obtained by interview, questionnaire, and direct anthropometric measurement. Descriptive statistics, chi-square analysis, and analysis of variance were used to compare groups. Results: Although total energy and protein intakes were similar, SRLCDs consumed significantly more fat and less carbohydrate (expressed as a percentage of total energy) and more cholesterol and less fibre than did NDs. Both groups had unfavourable attitudes toward carbohydrates. Conclusions: The SRLCDs ate more fat than recommended. Women who are considering following a low carbohydrate diet need to know the nutritional risks of unbalanced self-designed low carbohydrate diets. Negative attitudes toward carbohydrates were not confined to dieters. Nutrition education is necessary to help consumers understand basic nutrition principles and to be more skeptical of fad diets.
- Purpose: Current prevention-focused nutrition policy for community-dwelling older adults in Canada is discussed. Methods: Government websites were searched and key informants asked to identify relevant documents and policies specific to older adults. These were reviewed to find specific legislation on community nutrition programs for older adults. Results: Despite this population’s known nutritional risk, policies guiding community nutrition programs are extremely limited. Current policies and significant documents and organizations that could influence legislation are acknowledged. Conclusions: Dietitians in diverse settings need to advocate for specific policy concerning preventive nutrition programs for older adults in Canada.
- Purpose: An n-3 polyunsaturated fatty acid (PUFA) supplement was incorporated into three food products previously determined to be preferred by cancer patients, and overall acceptability of these foods was evaluated. Methods: Preliminary testing was performed; an internal panel determined initial acceptability of foods with the supplement added. Taste panel evaluations were held at the Cross Cancer Institute in Edmonton, Alberta. Each participant completed a questionnaire rating aroma, flavour, and overall acceptance on a seven-point hedonic scale (1 = dislike extremely, 7 = like extremely), as well as ability to consume each food daily. Results: Foods were well-liked by patients and non-patients. Mean ± standard deviation acceptance scores for the three foods were pasta sauce 5.9 ± 0.94 (n = 90), oatmeal 6.1 ± 0.88 (n = 79), and smoothie 5.9 ± 1.12 (n = 126). Overall, 94% of patients and non-patients gave tomato pasta sauce, oatmeal, and the smoothie an acceptance score of at least 5. Conclusions: The supplement was incorporated successfully into three foods, which were highly accepted by patients with cancer. Further research should focus on incorporating the supplement into flavoured or sweet foods, as these appear most effective. Microencapsulated fish oil in food products may be used as an alternative to fish oil capsules for delivering n-3 PUFA in clinical trials.
- Purpose: The relationship between body composition and resting energy expenditure (REE) was investigated in two boys and two men with Duchenne muscular dystrophy (DMD) (ages 11 to 22.4 years) and two boys with Becker muscular dystrophy (BMD) (ages 7.75 and 13.75 years). Methods: The REE was assessed by indirect calorimetry; body composition indices (weight, height, skinfolds, and mid-arm circumference) were measured using standardized techniques and compared with healthy reference data. Results: Those with DMD had reduced corrected mid-upperarm muscle area (C-MUMA) in comparison with healthy peers, and approximately twice the subcutaneous fat levels of subjects with BMD and healthy peers. Boys with BMD had remarkably lower muscle status than did boys with DMD and healthy peers. In both groups, REE was lower than in healthy peers; REE was associated with body weight (r=0.85), height (r=0.92), mid-upper arm fat area (MUFA) (r=0.97), and C-MUMA (r=0.65). Conclusions: Individuals with muscular dystrophy (MD) exhibit considerable disease-specific alterations in body composition. The REE had a stronger relationship with growth (weight and height) and subcutaneous body fat composition and a weaker association with C-MUMA. Understanding the effect of MD on body composition and REE will allow dietitians to individualize energy recommendations.
- Purpose: A food frequency questionnaire (FFQ) and an attitude/behaviour questionnaire (ABQ) were developed, and their validity and reliability were tested to determine adolescents’ vegetable and fruit (VF) intakes and factors influencing their food choices. Methods: High school students living in the lower mainland of British Columbia participated. The FFQ was adapted from the National Cancer Institute VF By-Meal screener, which was designed to be used with adults. After several focus groups with adolescents, the FFQ was revised to make it more user-friendly. The ABQ was developed after a literature review of factors influencing youth VF intake, and was based on the constructs within the Health Belief Model. Results: The FFQ was validated against a written 24-hour dietary record (correlation coefficient = 0.52). The test-retest reliability coefficient for the FFQ was 0.46. A panel of experts tested the ABQ construct validity, and changes were made as a result of the recommendations. Internal consistency reliability and test-retest reliability of the ABQ were 0.71 and 0.59, respectively. Both questionnaires were tested for face validity with students and revised accordingly. Conclusions: Further validation of these two questionnaires against other standardized tools is required. Future studies with adolescents using these tools can guide program and resource development.
- Purpose: Prince Edward Island adolescents’ food use was examined, as were possible associations between food use and grade, sex, and academic performance. Methods: Participants (n=325) were purposively selected from four junior high schools. Dietary data were collected using an adaptation of the 2003 Youth Risk Behavior Survey. Demographic information and self-reported academic performance were also assessed. Vegetable and fruit (VF) and milk scores were created, and multivariate analysis was performed to identify which combination of grade, sex, VF score, and milk score predicted academic performance best. Results: Mean daily intakes of VF (4.3 ± 2.9 servings) and milk (1.7 ± 1.4 servings) were below recommended levels. Students with higher academic performance (average grades above 90%) were more likely to consume milk, vegetables, and fruit daily than were those who reported lower grades. There was no significant difference in the proportion of adequate milk intakes between students reporting higher and lower academic performance. Conclusions: The association between VF intake and academic performance supports the need for further research with a larger, more representative sample.
- Purpose: The treatment of celiac disease is a strict gluten-free diet for life. This diet is assumed to be more expensive, although no studies confirm this assumption. In the current study, the prices of gluten-free foods and regular (gluten-containing) foods were compared to determine if and to what extent gluten-free products are more expensive. Methods: Prices were compared for all food products labelled “gluten-free” and comparable gluten-containing food items in the same group available at two large-chain general grocery stores. The unit cost of each food, calculated as the price in dollars per 100 grams of each product, was calculated for purposes of comparison. Results: All 56 gluten-free products were more expensive than regular products. The mean (± standard deviation) unit price for gluten-free products was $1.71 (± 0.93) compared with $0.61 (± 0.38) for regular products (p<0.0001). On average, gluten-free products were 242% more expensive than regular products (± 212; range, 5% to 1,000%). Conclusions: All the commercially available products labelled gluten-free were significantly more expensive than comparable products. This information will be useful to dietitians who counsel individuals and families with celiac disease, and to celiac advocacy groups for lobbying the government about financial compensation.
- Purpose: Food consumption was investigated in children attending three elementary schools in urban Hamilton, Ontario. Methods: Dietary data were collected from 92 children in grades 2 to 4 through 24-hour dietary recalls (39% participation rate). Servings of four food groups were compared with recommended daily servings in Canada’s Food Guide. Results: The majority of students did not consume the recommended five daily servings of vegetables and fruit. On average, they consumed a high number of servings of “other foods,” which were not included in the four food groups. More than 50% of the students did not consume the recommended daily servings of milk products, and only a small proportion (21%) drank milk during school lunch. Conclusions: We recommend that primary school educators promote the consumption of vegetables and fruits and milk products at school, either through healthy snack programs or educational programs.
- Purpose: To evaluate initiation and duration of breastfeeding of infants born to mothers who participated in the Early Childhood Initiative (ECI) program. Factors affecting the initiation and the early cessation of breastfeeding were also explored. Methods: Twenty-five pregnant women participating in the ECI program completed this prospective study. At 36 weeks’ gestation, a questionnaire was administered to assess socioeconomic status, intention to breastfeed and breastfeeding experience. When the infants were three and six months of age, feeding practices were assessed with a questionnaire. Results: The breastfeeding initiation rate was 62.5%. At one and three months postpartum, exclusive breastfeeding rates were 39% and 4%, respectively. At six months, none of the women was exclusively breastfeeding. Primiparity, prenatal classes, having been breastfed and intention to breastfeed at 36 weeks’ gestation were positively associated with breastfeeding initiation. Father’s education, intention to breastfeed at 36 weeks’ gestation, no water or formula given to the infant during hospitalization and higher maternal hemoglobin level at 36 weeks’ gestation were positively associated with the duration of breastfeeding. Conclusions: The rate of initiation and duration of breastfeeding for ECI participants were low. To achieve successful interventions, it is important to target modifiable factors known to influence the initiation and duration of breastfeeding within this population.
- Purpose: The notion of transferable skills is part of the comprehensive education model for dietetic practice. Dietitians’ perspectives were collected to determine their understanding of the concept and which dietetic skills they considered transferable in long-term and acute care environments. Methods: The study included a purposive sample of 14 dietitians representing long-term and acute care internship training and employment. The dietitians completed a questionnaire and were interviewed. Results: All respondents demonstrated an understanding of the concept of transferability of skills. Results indicated that the majority believed dietetic entry-level competencies could be achieved in both long-term and acute care environments. While the majority believed competencies could be transferred from one environment to another, issues were raised about transfer from long-term care to acute care. These issues included limited client communication, fewer resources, and less opportunity for exposure to skill areas. Interpretation of the term “skill,” one-way transferability, and level of competence required for the particular working environment emerged as challenges to operationalization of the concept. Conclusions: Transferability of skills within dietetic practice requires further investigation if it is to be fully understood and used to its full potential.
- Purpose: To compare dietary intakes of individuals with and without familial history of obesity (FHO) with recommendations from Canada’s Food Guide to Healthy Eating (CFGHE). Methods: This cross-sectional study recruited 197 women and 129 men with a body mass index of less than 30kg/m2 from the Quebec City metropolitan area. A dietitian obtained their dietary intakes, using a food frequency questionnaire. Results: Daily energy, macronutrient, and fibre intakes were not significantly different between individuals with and without FHO. No significant differences in the proportion of individuals who achieved the minimum CFGHE recommendations were observed between individuals with and without FHO. Conclusions: Findings of our study suggest that individuals with and without FHO have comparable dietary intakes when compared to Canadian dietary guidelines.
- Purpose: Parents’ health literacy skills include food and nutrition knowledge, as well as the ability to read, comprehend, and use information related to their children’s health. The evaluation of a nutrition education booklet within the NutriSTEP™ (Nutrition Screening Tool for Every Preschooler) Project was conducted. Parents’ nutrition education needs and their sources of nutrition information were also assessed. Methods: Eight dietitians from four provinces conducted in-person interviews with a sample of 322 parents. Parents were asked their perception of the booklet and reported learning. Dietitians’ written feedback on the booklet and their recorded comments and nutrition advice to parents were gathered. Results: Collated feedback led to significant revisions to the booklet. Parents reported increased knowledge from the booklet; 38% wanted more information on nutrition, while 25% wanted to know more about preschoolers and physical activity. The top three sources of nutrition advice for this parent sample were physicians, dietitians, and public health units. Conclusions: Written materials must be evaluated with the target audience to improve readability and comprehension. Further nutrition education efforts should be targeted through parents’ main sources of nutrition information. Further research is needed on nutrition education intervention effectiveness to promote positive health outcomes.
- Theresa Lirette RD, MSc candidate,
- Jennifer Podovennikoff RD,
- Wendy Wismer PhD,
- Liz Tondu BSc, and
- Linda Klatt
Purpose: To investigate Edmonton Meals on Wheels (MOW) recipients’ food preferences and meal satisfaction. Methods: A preliminary study of 13 lunch club participants divided into two focus groups was conducted to determine overall themes in clients’ menu preferences and suggestions. A questionnaire was developed, based on previous MOW client comments, and delivered to all clients (n=271) receiving hot meal service from the Edmonton MOW program; 140 surveys (52% response rate) were returned. Results: The majority (72% to 88%) of hot meal clients were satisfied with the taste, texture, value, variety, and portion size of their meals. Popular menu items were barbecued chicken, perogies, and desserts. Up to 25% of participants indicated that meats were too tough and vegetables were too firm. Vegetables such as broccoli and Brussels sprouts were the most commonly disliked items. Conclusions: Overall, clients find the Edmonton MOW menu foods appealing and enjoyable. MOW programs should advertise the availability of texture-modified foods and offer a variety of vegetables. Meal services for the elderly must continue to monitor meal acceptance as client needs change with our aging population.- Purpose: To determine whether fortification allowed older adults in the Kingston, Frontenac, and Lennox & Addington (KFL&A) Public Health area to obtain adequate amounts of food folate, and the proportion at risk of consuming more than the upper limit (UL) of folic acid (1,000 mcg). Methods: Dietary intake of a convenience sample of 103 healthy, active older adults (age range: 65 to 95 years) was measured using three 24-hour recalls. Dietary folate preand post-fortification was estimated. Results: Mean dietary folate increased from pre- to postfortification, but 43.4% of women and 20% of men still consumed less than the Estimated Average Requirement of 320 mcg dietary folate equivalent. No intakes exceeded the UL. Participants whose diet met grain products and vegetable and fruit recommendations of Canada's Food Guide to Healthy Eating consumed significantly more folate. Conclusions: Despite fortification, some older adults in the KFL&A area may not be obtaining enough folate to meet their nutritional needs, and may be at risk for health problems associated with folate deficiency. However, without concomitant serum folate measurements, the proportion is not known. Dietitians need to continue promoting foods naturally rich in folate, along with folic acid-fortified foods. While none of the older adults consumed more than the UL, some could exceed this amount if folic acid supplements were added to a folic acid-rich diet.
- Purpose: Iron deficiency anemia (IDA) during pregnancy and infancy is still common in developed countries, especially in low-income groups. We examined the prevalence of anemia and IDA in healthy low-income pregnant women participating in the Early Childhood Initiatives (ECI) program, and in their infants when they reached six months of age. Methods: Pregnant women were recruited by nutritionists. In mothers, hemoglobin (Hb), mean corpuscular volume, and serum ferritin (SF) were measured at 36 ± 2 weeks of gestation. In infants, Hb, mean corpuscular volume, SF, serum iron, total iron binding capacity (TIBC), and transferrin saturation (TS) were measured at six months of age. Thirty-one mother-infant pairs participated. Results: Among the 31 pregnant women participating in the ECI program, six (19.4%) were anemic (Hb <110 g/L) and five (16.1%) suffered from IDA (Hb <110 g/L and SF <10 µg/L). Among infants, seven of 23 (30.4%) were anemic (Hb <110 g/L) and five of 23 (21.7%) suffered from IDA (Hb <110 g/L plus two of the following: TIBC >60 µmol/L, SF <10 µg/L, serum iron <5.3 µmol/L, TS ≤15%). Conclusions: The prevalence of anemia in this group of lowincome pregnant women is comparable to that in privileged women. The prevalence of IDA in infants is comparable to that observed in other high-risk groups. Effective strategies are needed to prevent IDA in vulnerable groups.
- Purpose: A dietitian-administered, shortened form of the Apple and Agras cognitive-behavioural therapy (CBT) method was evaluated in a group setting to determine its effect on improving obese women's self-esteem and reducing binge-eating behaviours, depression, and negative body image. Methods: Participants were recruited through newspaper and radio advertisements. Respondents who met study selection criteria were randomly assigned to either a CBT group (n=13) or a delayed group (D-CBT) (n=9). The treatment was administered over six weekly sessions to the CBT group, and then twice weekly over three weeks to the D-CBT group. Two measures of bingeing behaviour (severity and frequency), three measures of mood (depression, body image, and self-esteem), and body weight were assessed. Results: The intervention did not result in any changes in body weight. There were statistically significant and clinically important changes after treatment (p<0.05) for all five measures. Binge-eating severity and frequency decreased, depression decreased, body image improved, and self-esteem improved. All changes were greater in the six-week treatment group. Conclusions: The dietitian-administered, group setting CBT program is effective for reducing binge eating and improving emotional state in obese women.
- Barbara V. Roebothan PhD, RDt,
- Joy Carmichael BSc, DDS,
- Valerie Barter BSc, RDt,
- Jane Aucoin MSc, RDt, and
- Madonna Murphy BSc
Purpose: Dietary folic acid (FA) intakes were analyzed in random samples of 302 young women (aged 18 to 34) and 337 seniors (aged 65 to 74) residing in Newfoundland and Labrador (NL). The analyses were an attempt to estimate the amount of FA they would consume solely because of mandatory fortification of foods. Methods: Secondary analysis was performed on raw data collected through single 24-hour recalls as part of a larger study. Results: The dietary FA contributed by fortified foods eaten in the specified amounts was estimated to be 136 to 148 mcg/day (226 to 247 DFE/day) for young women and 151 to 160 mcg/day (252 to 267 DFE/day) for seniors. Most of this FA was contributed to the diet by enriched white flour. Conclusions: Mandatory fortification of foods appears to have improved the total mean intake of folate by young women and seniors residing in NL.- Kathleen Lindhorst MSc,
- Lynda Corby MSc, MEd, RD, FDC,
- Susan Roberts MEd, BSc, and
- Sharon Zeiler MBA, BSc, RD
Purpose: Consumer workshops in rural and remote locations were evaluated for their efficacy in changing participants’ selfperceived attitudes and behaviours related to nutrition labelling. Methods: Project-trained community health educators used pilot-tested workshop resources to facilitate 18 workshops across the country. Participants completed pre-workshop questionnaires to permit the identification of demographic characteristics and attitudes and behaviours related to nutrition labelling at pointof- purchase. Results: The majority of the 259 consumers who submitted questionnaires were women (81%), and aged 35 to 54 (35%); 51% reported more than a high school education and 34% had less than $25,000 as a yearly family income. Self-perceived attitudes and behaviours related to nutrition labelling differed only slightly by family income before the workshop. Workshops were rated positively (mode=4 [range 2 to 5]). Thirty-five consumers were surveyed three months after the workshop; the majority were women (89%), were aged 35 to 54 (43%), and had completed high school (51%). Self-perceived attitudes and behaviours for all respondents (n=35) had improved. Use of acquired knowledge and skills at point-of-purchase was high for all respondents (mode=4 [range 2 to 5]; five-point Likert scale). Conclusions: Providing in-person consumer workshops with pilot-tested materials in rural and remote locations had positive impacts on attitudes and behaviours related to the use of nutrition labelling.- Purpose: A new dietary zinc assessment tool (ZAT) was evaluated to determine its usefulness in estimating zinc intakes among college students. Methods: A food frequency questionnaire specifically designed for calculating average zinc intakes was administered to university students who had also completed three-day food records. Zinc intakes from the two instruments were compared. Results: Among 171 participants (38 male, 133 female) aged 20.2 ± 1.6 years (mean ± standard deviation), the two dietary assessment methods were positively correlated (r=0.33, p<0.001). The ZAT correctly identified 76% of the women who were obtaining less than the National Academy of Sciences Recommended Dietary Allowance for zinc (8 mg/day for females, 11 mg/day for males). Conclusions: This convenient tool may assist in the identification of problematic dietary patterns at an early stage. Further design modifications and expanded studies are warranted.
- Purpose: Students entering university often lack knowledge about fats; whether students gain such information during four years at university is unclear. Students’ knowledge of fat in the first and fourth years was measured and compared. The effect of a nutrition course on knowledge was also examined. Methods: A total of 215 science students at a small undergraduate university completed a 15-item, closed-ended questionnaire concerning knowledge of fats in the diet. Results: Fourth-year science students have greater nutrition knowledge of fats than do first-year science students (p<0.005). Given that the majority of first-year students reside on campus and the majority of fourth-year students reside off campus, the purchasing of food and preparation of meals may explain the senior students’ greater knowledge of fat. Students who have taken a nutrition course know more about fats than do those who have not (p<0.001). Conclusions: Taking even one course in nutrition greatly increases nutrition knowledge. Universities could encourage undergraduate students to take a basic nutrition course, which should emphasize the identification and understanding of different types of dietary fats.
- Talia Hassan MSc, RD,
- Gail Marchessault PhD, PHEc, RD,
- Marian Campbell PhD, RD, and
- Bruce Huhmann PhD
Purpose: Osteoporosis affects 1.4 million Canadians. Maximizing bone mass by age 30 may reduce this risk. Because calcium intake and body weight are both associated with bone mass, and many Canadian women report that they obtain nutrition information from magazines, we compared the frequency of calcium and body weight messages in Chatelaine and Flare, Canadian magazines for mature versus younger women, respectively. Methods: Using keywords, we identified relevant advertisements and articles in all issues of Chatelaine and Flare for 2000 to 2001. Data were analyzed using paired t-tests and Wilcoxon signed-rank sum tests. Results: Chatelaine had more calcium and weight messages per 100 pages than did Flare (significant only for calcium, p ≤0.0001). Within Chatelaine, there were no significant differences between the frequency of calcium and weight messages; however, almost 90% of Flare's messages focused on weight (p ≤0.0001), with only eight messages in two years addressing calcium. Conclusions: Magazines with limited calcium and many weight messages inadvertently promote a lifestyle that may increase the risk for osteoporosis. The opportunity exists to provide improved calcium and osteoporosis coverage for women at the prime age for maximizing bone density. Awareness of information gaps may help dietitians strategize in promoting nutrition messages to women.- Lisa Needham MSc, RD,
- John J.M. Dwyer PhD,
- Janis Randall-Simpson PhD, RD, and
- Elizabeth Shaver Heeney MSc, RD
Purpose: The child care setting can help preschoolers develop healthy eating habits. Establishing such habits may increase preschoolers’ likelihood of carrying them into adulthood, which can decrease the risk of nutrition-related chronic diseases. Challenges in supporting preschoolers’ healthy eating were investigated among child care staff. Methods: Three focus group interviews were conducted with 29 child care staff members. Audiotapes of the sessions were transcribed. Results: Several themes were identified from the analysis of the transcripts. An intrapersonal (individual) factor was children's picky eating. Interpersonal factors (interactions) included perceptions that parents do not encourage their children to eat in a healthy way, and that child care staff's use of practices were inconsistent with health professional recommendations. Physical environment factors included perceptions that healthy food was not accessible at child care centres and that children have unhealthy food at home. Conclusions: Program planners and health professionals can develop and implement strategies to overcome some of the identified challenges to supporting preschoolers’ healthy eating.- Purpose: Texture-modified diets offered in long-term care (LTC) facilities are often prepared from the regular menu, planned using Canada's Food Guide to Healthy Eating. The appropriateness of protein levels of puréed diets in LTC facilities was determined. Methods: Protein content was measured in 29 duplicate diets, collected from 20 urban LTC facilities in Saskatchewan (SK) and Ontario (ON). Mealtime puréed food intakes of 20 LTC residents were assessed. The target protein levels were calculated as estimated average requirements plus one or two standard deviations of intake, thus allowing for moderate (16%) or low (2.5%) risk of inadequacy, respectively. Results: The duplicate diets provided 57.9 ± 7.9 and 85.4 ± 31.1 g/day of protein in SK and ON, respectively. Protein intake of SK LTC residents consuming puréed food averaged 54 ± 19 g/day. Only 43% of the SK puréed diets provided more than 59 g/day of protein and none provided more than 78 g/day; in contrast, 87% and 40% of ON puréed diets provided more than 59 and 78 g/day of protein, respectively. Conclusions: In-house prepared puréed diets do not consistently provide sufficient protein levels to ensure a low risk of inadequacy for the LTC residents consuming these diets.
- Purpose: The relationships are explored between food choices of school-aged children and eating in the bedroom, while watching television, or in front of the computer. Methods: Data were collected using a self-administered questionnaire that 534 subjects completed in class. Participants were ten- to 12-year-old children from Québec. Results: Significant positive correlations were found between the act of eating in the bedroom and eating in front of the television or the computer (p<0.05). Significant positive correlations were also found between eating in the bedroom, or eating in front of the television or the computer, and the consumption of low-density food, foods high in sugar and fat, and foods low in fibre (p<0.05). Data also revealed more negative food habits for boys than for girls (p<0.05). Conclusions: Because of the prevalence of childhood obesity, these findings support the need to document children's food consumption patterns and gender differences.
- Purpose: The impact of consuming processed versus fresh fruits and vegetables on the galactose intake of galactosemic patients was compared. Methods: The galactose content of processed fruits was determined when the following processing methods were used: freezing, drying, blanching, microwaving, canning, and a combination of blanching and freezing. Then three-day food intakes of five subjects with galactosemia were recorded. The records were used to estimate galactose intake, according to previously reported galactose levels for fresh fruits and vegetables and the potential reduction in galactose intake when only processed fruits and vegetables are consumed. Results: The average galactose reduction was approximately 45% for all the fruits and all processing methods, excluding drying. Intakes varied from 17 to 108 mg/day when fresh values were used and 11 to 103 mg/day when only processed fruits and vegetables were consumed. This reduction was statistically significant for four out of five patients. Conclusions: When the reduction is compared with reported daily fluctuations in galactosemic patients’ endogenous galactose production, the clinical significance of reduced free galactose consumption on long-term outcome is unclear. However, metabolic dietitians now have objective data that the processing methods described will lower the free galactose content of the fruits analyzed.
- Canadian dietitians specializing in pediatric practice were surveyed to provide a preliminary profile of the strategies they use to manage overweight youth. The survey was mailed to 298 dietitians belonging to the Dietitians of Canada's (DC) Pediatric Nutrition and Consulting Dietitians’ Networks and to the head dietitians in Canadian pediatric hospitals across the country. It was also posted on the DC website and sent by electronic mail. Of the 164 respondents, 65 reported that they provide an intervention program to overweight youth. Growth charts, ideal body weight, and body mass index were mostly used to assess and monitor overweight. However, about 20% of the respondents did not define overweight in their client population. The majority of the clients were girls aged seven to 18. Most respondents used the healthful lifestyle approach via one-on-one consultation, included parents and collaborated with two or more health professionals for the management of these children. As the discussion on best practices for the prevention and treatment of overweight youth continues, we need further evidence to determine what strategies, if any, support positive outcomes in this group.
- The rotary diversified diet, used in the management of environmental illness, consists of eliminating prohibited foods from the diet and rotating remaining non-prohibited foods and their “food families” within a regular cycle. We assessed the adequacy of nutrient intakes in 22 women prescribed the diet, described the nature of supplement use, and assessed the relationship between adherence and nutrient intake levels. Except for calcium and folacin intakes, mean nutrient intakes met or exceeded recommended levels. No subjects had calcium intakes above the adequate intake for calcium; 72.7% had folate intakes below the estimated average requirement. Intakes of other nutrients, except thiamin and magnesium, were below the estimated average requirement in less than 25% of the sample; 31.8% and 45.5% of subjects, respectively, had thiamin and magnesium intakes at this level. Those who adhered more closely to the rotary diversified diet had higher intakes of vitamin C, vitamin B6, folate, and fibre than did those who followed the diet less closely. Supplements conferred some nutritional benefits; however, supplemental niacin and magnesium intakes exceeded tolerable upper intake levels. Those prescribed the rotary diversified diet require nutrition counselling from dietitians to cope with the complexity and restrictiveness of the diet.