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  • Quality Improvement Pilot Study of the Living Your Best Weight Program: A Health at Every Size Approach
    Canadian Journal of Dietetic Practice and Research • Vol. 81 • No. 2 • pp. 91 - 93
    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.
  • Effect of a Protected Mealtime Pilot on Energy and Protein Intake in a Canadian Hospital
    Canadian Journal of Dietetic Practice and Research • Vol. 81 • No. 2 • pp. 94 - 96
    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.
  • Use of Nutrition Information and Understanding of “Percent Daily Value” on Nutrition Facts Tables: Evaluating the Impact of a National Public Education Campaign among Youth and Young Adults in Canada
    Canadian Journal of Dietetic Practice and Research • Vol. 80 • No. 4 • pp. 200 - 204
    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.
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    Predictors of Food Skills in University Students
    Canadian Journal of Dietetic Practice and Research • Vol. 80 • No. 4 • pp. 205 - 208
    Purpose: 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.
  • Men who are Dietitians: Deconstructing Gender within the Profession to Inform Recruitment
    Canadian Journal of Dietetic Practice and Research • Vol. 80 • No. 4 • pp. 209 - 212
    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.
  • Exploring Food Guidance Approaches for Seniors in Antigonish, NS: Is There Still Gold at the End of the Rainbow?
    Canadian Journal of Dietetic Practice and Research • Vol. 80 • No. 3 • pp. 137 - 139
    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.
  • Diversity and Equity in Dietetics and Undergraduate Nutrition Education in Manitoba
    Canadian Journal of Dietetic Practice and Research • Vol. 80 • No. 1 • pp. 44 - 46
    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.
  • Employment Outcomes among Registered Dietitians following Graduation in Manitoba
    Canadian Journal of Dietetic Practice and Research • Vol. 80 • No. 2 • pp. 87 - 90
    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.
  • Are Dietitians Documenting Malnutrition Based on Subjective Global Assessment Category?
    Canadian Journal of Dietetic Practice and Research • Vol. 80 • No. 2 • pp. 91 - 94
    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.
  • Dietary Changes Albertan Women Make During Pregnancy: Thematic Analysis of Self-reported Changes and Reasons
    Canadian Journal of Dietetic Practice and Research • Vol. 80 • No. 1 • pp. 39 - 43
    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.
  • Changes in Energy Metabolism from Prepregnancy to Postpartum: A Case Report
    Canadian Journal of Dietetic Practice and Research • Vol. 79 • No. 4 • pp. 191 - 195
    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.
  • Moving from Policy to Practice: A Report of School Nutrition Policy Adherence in Nova Scotia
    Canadian Journal of Dietetic Practice and Research • Vol. 79 • No. 4 • pp. 196 - 199
    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.
  • Size Matters: Package Size Influences Recognition of Serving Size Information
    Canadian Journal of Dietetic Practice and Research • Vol. 79 • No. 4 • pp. 200 - 202
    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.
  • Ontario Menu Calorie Labelling Legislation: Consumer Calorie Knowledge Six Months Post-Implementation
    Canadian Journal of Dietetic Practice and Research • Vol. 79 • No. 3 • pp. 129 - 132
    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.
  • Prevalence and Correlates of Food Insecurity among Students Attending a Small, Rural Canadian University
    Canadian Journal of Dietetic Practice and Research • Vol. 79 • No. 3 • pp. 125 - 128
    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.
  • Measuring Food Security in Canadian Homeless Adult Men
    Canadian Journal of Dietetic Practice and Research • Vol. 79 • No. 1 • pp. 42 - 45
    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.
  • A Comparison of Characteristics and Food Insecurity Coping Strategies between International and Domestic Postsecondary Students Using a Food Bank Located on a University Campus
    Canadian Journal of Dietetic Practice and Research • Vol. 78 • No. 4 • pp. 208 - 211
    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.
  • Estimating the Sugars Content of Diets that Follow Eating Well with Canada’s Food Guide
    Canadian Journal of Dietetic Practice and Research • Vol. 78 • No. 4 • pp. 204 - 207
    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.
  • Examining Lifestyle Information Sources, Needs, and Preferences among Breast Cancer Survivors in Northern British Columbia
    Canadian Journal of Dietetic Practice and Research • Vol. 78 • No. 4 • pp. 212 - 216
    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.
  • Perceptions, attentes et motivations de parents québécois à l’égard des services alimentaires en milieu scolaire
    Canadian Journal of Dietetic Practice and Research • Vol. 78 • No. 3 • pp. 141 - 144
    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.
  • Effect of a Group Behavioural Management Program on Emotional Regulation of Food Choices: A Pilot Randomized Controlled Trial
    Canadian Journal of Dietetic Practice and Research • Vol. 78 • No. 3 • pp. 137 - 140
    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.
  • Prévenir la dénutrition des personnes âgées dysphagiques institutionnalisées avec une alimentation à textures adaptées : essai clinique randomisé
    Canadian Journal of Dietetic Practice and Research • Vol. 78 • No. 1 • pp. 45 - 49
    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.
  • Food and Culinary Knowledge and Skills: Perceptions of Undergraduate Dietetic Students
    Canadian Journal of Dietetic Practice and Research • Vol. 78 • No. 1 • pp. 42 - 44
    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.
  • How and Where Parents of Infants and Young Children Want to Receive Nutrition Information
    Canadian Journal of Dietetic Practice and Research • Vol. 77 • No. 4 • pp. 203 - 205
    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.
  • Assessing the Efficacy of a Group Mediated Nutritional Knowledge Intervention for Individuals with Obesity
    Canadian Journal of Dietetic Practice and Research • Vol. 77 • No. 4 • pp. 206 - 209
    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.
  • Bone Mineral Density and Fat-Soluble Vitamin Status in Adults with Cystic Fibrosis Undergoing Lung Transplantation: A Pilot Study
    Canadian Journal of Dietetic Practice and Research • Vol. 77 • No. 4 • pp. 199 - 202
    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.
  • Calcium Supplementation Does Not Contribute to Constipation in Healthy Women
    Canadian Journal of Dietetic Practice and Research • Vol. 77 • No. 2 • pp. 103 - 105
    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.
  • Dietary Intake among Grade 7 Students from Southwestern Ontario Attempting to Gain Weight
    Canadian Journal of Dietetic Practice and Research • Vol. 77 • No. 2 • pp. 106 - 109
    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.
  • Body Composition, Strength, and Dietary Intake of Patients with Hip or Knee Osteoarthritis
    Canadian Journal of Dietetic Practice and Research • Vol. 77 • No. 2 • pp. 98 - 102
    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.
  • Estimating Serving Sizes for Healthier and Unhealthier Versions of Food According to Canada’s Food Guide
    Canadian Journal of Dietetic Practice and Research • Vol. 76 • No. 4 • pp. 204 - 207
    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.
  • Awareness and Knowledge of Recommendations from Canada's Food Guide
    Canadian Journal of Dietetic Practice and Research • Vol. 76 • No. 3 • pp. 146 - 149
    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.
  • How do Student Clients of a University-based Food Bank Cope with Food Insecurity?
    Canadian Journal of Dietetic Practice and Research • Vol. 76 • No. 4 • pp. 200 - 203
    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.
  • Changing Dietary Habits of Alberta Nutrition Students Enrolled in a Travel Study Program in Italy
    Canadian Journal of Dietetic Practice and Research • Vol. 76 • No. 2 • pp. 93 - 96
    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.
  • Review of Food and Nutrition Services Provided by Community-based Organizations Serving People with HIV in Canada
    Canadian Journal of Dietetic Practice and Research • Vol. 76 • No. 2 • pp. 97 - 99
    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
    Canadian Journal of Dietetic Practice and Research • Vol. 75 • No. 4 • pp. 202 - 205
    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.
  • Breakfast Cereal Consumption Moderates the Association Between Body Composition and Body Esteem in Young Women but not in Young Men
    Canadian Journal of Dietetic Practice and Research • Vol. 75 • No. 4 • pp. 214 - 217
    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.
  • Gastrointestinal Tolerance to Daily Canned Chickpea Intake
    Canadian Journal of Dietetic Practice and Research • Vol. 75 • No. 4 • pp. 218 - 221
    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.
  • Nutrition Knowledge and Practices of Varsity Coaches at a Canadian University
    Canadian Journal of Dietetic Practice and Research • Vol. 75 • No. 4 • pp. 210 - 213
    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.
  • Pilot Evaluation of an In-Store Nutrition Label Education Program
    Canadian Journal of Dietetic Practice and Research • Vol. 75 • No. 4 • pp. 206 - 209
    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.
  • Availability, Location, and Format of Nutrition Information in Fast-food Chain Restaurants in Ontario, Canada
    Canadian Journal of Dietetic Practice and Research • Vol. 76 • No. 1 • pp. 44 - 48
    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.
  • Self-reported Causes of Weight Gain: Among Prebariatric Surgery Patients
    Canadian Journal of Dietetic Practice and Research • Vol. 74 • No. 4 • pp. 189 - 192
    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.
  • Healthy Eating Guidelines for a School Jurisdiction: Collaborative Design and Implementation
    Canadian Journal of Dietetic Practice and Research • Vol. 74 • No. 4 • pp. 193 - 197
    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.
  • Nutrition and Shiftwork: Evaluation of New Paramedics’ Knowledge and Attitudes
    Canadian Journal of Dietetic Practice and Research • Vol. 74 • No. 4 • pp. 198 - 201
    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.
  • An Approach to Improve Parent Participation: In a Childhood Obesity Prevention Program
    Canadian Journal of Dietetic Practice and Research • Vol. 74 • No. 3 • pp. 143 - 145
    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.
  • Challenges in Planning Long-term Care Menus: That Meet Dietary Recommendations
    Canadian Journal of Dietetic Practice and Research • Vol. 74 • No. 2 • pp. 84 - 87
    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.
  • Dietetic Students’ Experiences: Providing Meal Assistance in Long-term Care Facilities
    Canadian Journal of Dietetic Practice and Research • Vol. 74 • No. 2 • pp. 88 - 91
    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.
  • Knowledge, Perceptions, and Consumption of Whole Grains: Among University Students
    Canadian Journal of Dietetic Practice and Research • Vol. 74 • No. 2 • pp. 92 - 95
    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.
  • Dietetic Students’ Understanding: Of What Becoming a Dietitian Means
    Canadian Journal of Dietetic Practice and Research • Vol. 74 • No. 2 • pp. 96 - 97
    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.
  • University Students’ Reservations: About Dietetics as a Career Choice
    Canadian Journal of Dietetic Practice and Research • Vol. 74 • No. 1 • pp. 42 - 45
    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.
  • Mineral Concentrations in Bottled Water Products: Implications for Canadians’ Mineral Intakes
    Canadian Journal of Dietetic Practice and Research • Vol. 74 • No. 1 • pp. 46 - 50
    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.
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