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  • Web-based Food Behaviour Questionnaire: Validation with Grades Six to Eight Students
    Canadian Journal of Dietetic Practice and Research • Vol. 70 • No. 4 • pp. 172 - 178
    Purpose: The web-based Food Behaviour Questionnaire (FBQ) includes a 24-hour diet recall, a food frequency questionnaire, and questions addressing knowledge, attitudes, intentions, and food-related behaviours. The survey has been revised since it was developed and initially validated. The current study was designed to obtain qualitative feedback and to validate the FBQ diet recall. Methods: “Think aloud” techniques were used in cognitive interviews with dietitian experts (n=11) and grade six students (n=21).Multi-ethnic students (n=201) in grades six to eight at urban southern Ontario schools completed the FBQ and, subsequently, one-on-one diet recall interviews with trained dietitians. Food group and nutrient intakes were compared. Results: Users provided positive feedback on the FBQ. Suggestions included adding more foods, more photos for portion estimation, and online student feedback. Energy and nutrient intakes were positively correlated between FBQ and dietitian interviews, overall and by gender and grade (all p<0.001). Intraclass correlation coefficients were ≥0.5 for energy and macronutrients, although the web-based survey underestimated energy (-10.5%) and carbohydrate (-15.6%) intakes (p<0.05). Under-estimation of rice and pasta portions on the web accounted for 50% of this discrepancy. Conclusions: The FBQ is valid, relative to 24-hour recall interviews, for dietary assessment in diverse populations of Ontario children in grades six to eight.
  • Effect of Meal Environment On Diet Quality Rating
    Canadian Journal of Dietetic Practice and Research • Vol. 70 • No. 3 • pp. 118 - 124
    Purpose: Family meals have been associated with improved dietary quality in children and adolescents, and yet very little is known about family meals beyond their frequency. Specific aspects of the breakfast, lunch, and dinner meal environments were described and compared, and the associations with overall diet quality were investigated. Methods: Data on food intake andmeal environments were obtained in northern Ontario, southern Ontario, and Nova Scotia grades six, seven, and eight classrooms over the 2005 to 2006 school year. Specific aspects of themeal environments described were where themeal was consumed, with whomparticipants consumed eachmeal, who prepared themeal, and where the food was originally purchased. Diet quality was assessed using the Canadian version of the Healthy Eating Index. Cluster K-means procedures were used to classify into groups observations about the fourmeal environment variables. Results: Three, eight, and six clusters of meal environments were identified for breakfast, lunch, and dinner, respectively. Diet quality was negatively associated with consuming/purchasing meals outside the home, and with skipping breakfast, lunch, and/or dinner. Conclusions: Results have immediate relevance for familybased and/or school programs and policies aimed at educating and feeding children and adolescents.
  • Determinants of Diet Quality Among Canadian Adolescents
    Canadian Journal of Dietetic Practice and Research • Vol. 70 • No. 2 • pp. 58 - 65
    Purpose: Dietary intakes and nutrition behaviours were examined among different diet quality groups of Canadian adolescents. Methods: This cross-sectional study included 2850 Alberta and Ontario adolescents aged 14 to 17, who completed a self-administered web-based survey that examined nutrient intakes andmeal behaviours (meal frequency andmeal consumption away from home). Results:Meanmacronutrient intakes were within Acceptable Macronutrient Distribution Ranges; however,micronutrient intakes andmedian food group intakes were below recommendations based on Canada's Food Guide to Healthy Eating (CFGHE). Overall diet quality indicated that 43%, 47%, and 10%of students had poor, average, and superior diet quality, respectively. Adolescents with lower diet quality had significantly different intakes of macronutrients and CFGHE-defined “other foods.” In terms of diet quality determinants, those with poor diet quality had higher frequencies of suboptimalmeal behaviours. Students with poor diet quality consumed breakfast and lunch less frequently than did those with average and superior diet quality. Conclusions: Canadian adolescents have low intakes of CFGHE-recommended foods and high intakes of “other foods.” Those with poor diet quality had suboptimal macronutrient intakes and increased meal skipping and meal consumption away from home. Adherence to CFGHE may promote optimal dietary intakes and improve nutritional behaviours.
  • Development of a Nutrition Counselling Care Map For Dyslipidemia
    Canadian Journal of Dietetic Practice and Research • Vol. 68 • No. 4 • pp. 183 - 192
    Purpose: Care maps or clinical pathways for nutrition therapy of dyslipidemia could add to current practice guidelines, by providing templates for feasible and recommended diet counselling processes. A care map was therefore developed by engaging expert and generalist dietitians and external experts from across Canada in a multi-stage consensus process. Methods: First, a qualitative study was undertaken with a convenience sample of 12 practitioners to identify possible diet care options, using hypothetical client scenarios and cognitive analysis. Second, these care options were rated for five case scenarios considered typical (overweight clients, with or without clinical cardiovascular disease and other comorbidities, potentially motivated to change, consuming high-fat diets, and facing various major barriers to eating behaviour change). The rating was conducted through a survey of participants. Highly appropriate, recommended, and feasible options for counselling were ranked through a two-round modified Delphi process, with teleconference discussions between rounds. Results: Forty-nine professionals started the consensus process; 39 (80%) completed all aspects. Numerous care processes were appropriate for all clients, with additional focus on barriers for low-income clients, sodium intake for clients with hypertension, and smoking cessation in smokers. Conclusions: The resulting care map, “Dietitians’ Quick Reference Guide for Clinical Nutrition Therapy for Overweight Clients with Dyslipidemia,” provides a basis for current practice and new effectiveness studies.
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