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- Seabrook, Jamie A PhD10
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- Brauer, Paula PhD RD5
- Buchholz, Andrea C PhD RD5
- Dietrich, Linda MEd RD5
- Hammond, David PhD5
- Hanning, Rhona M PhD RD FDC5
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- Nasser, Roseann MSc RD CNSD4
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- Purpose: School lunches are of poor nutritional quality in Canada. Parents play an important role in the preparation of school lunches for young children. This study aimed to evaluate the acceptability and helpfulness of the Healthy Lunch Box Booklet (HLBB) to support parents in packing healthy school lunches for their children.Methods: The HLBB was distributed at four schools in London, Ontario to students in full-day Kindergarten to Grade three. Parents were asked to complete an online survey from April to November 2019.Results: Parents (n = 58) reported the HLBB to be helpful (96.3%) and found the sections on new school lunch and snack ideas and nutritional information (e.g., label reading) particularly useful. Some parents also stated that the HLBB created opportunities to interact with their children regarding school lunch preparation. In terms of perceived impacts, parents reported increased confidence (68.6%) and learning something new (79.6%) about school lunch preparation and felt that their children’s diet was impacted accordingly.Conclusions: The HLBB was found to be an acceptable and useful nutrition resource that supports parents in packing healthy school lunches for their children and therefore warrants further study.
- Noémie Charpentier RD, MSc,
- Alex Dumas PhD,
- Anne-Sophie Morisset RD, PhD, and
- Bénédicte Fontaine-Bisson RD, PhD
Olo nutritional follow-up care offers vulnerable pregnant women food vouchers, multivitamin supplements, tools, and nutritional counselling to support healthy pregnancy outcomes.Purpose: To evaluate the contribution of Olo follow-up care to nutritional intakes and eating practices, as well as to assess the programme-related experience of participants.Methods: Participants (n = 30) responded to questionnaires and web-based 24-hour dietary recalls and participated in a semi-structured interview (n = 10).Results: Olo follow-up care reduced the proportion of participants below the recommended intake for groups for many micronutrients, with the greatest reduction for folate (by 96.7%), vitamin D (by 93.3%), iron (by 70.0%), calcium (by 50.0%), and zinc (by 30.0%), mainly due to the prenatal multivitamin supplements. Most participants (96.7%) did not follow Olo’s typical recommendations but, if they had, hypothetically they would have consumed an average of 746 additional calories per day and be above the recommendations for excessive intakes of folic acid and iron (100% and 33.3%, respectively). More than half of the participants were moderately to severely food insecure. Olo contributed to reducing the impact of isolation and increased food accessibility and budget flexibility among participants.Conclusion: Olo follow-up care helped reduce the proportion of women below the recommended intake for micronutrients, but revising the food offered and strategies to address food insecurity may be necessary.- M. Susan Caswell MHSc, MSc, PhD(c),
- Jessica R. Lieffers PhD, RD,
- Jennifer Wojcik MSc, RD,
- Corinne Eisenbraun MA, FDC,
- Jennifer Buccino MEd, RD, and
- Rhona M. Hanning PhD, RD, FDC
Purpose: Self-reported coronavirus 2019 (COVID-19) pandemic effects on dietetic job search, employment, and practice of recent graduates were explored within a national workforce survey.Methods: Graduates (2015–2020) who were registered/licensed dietitians or eligible to write the Canadian Dietetic Registration Exam were recruited through dietetic programmes, Dietitians of Canada’s communication channels, and social media. The online survey, available in English and French from August through October 2020, included questions about pandemic experiences. Descriptive statistics and thematic analysis were applied to closed and open-ended responses, respectively.Results: Thirty-four percent of survey respondents (n = 524) indicated pandemic effects on job search and described delayed entry into dietetics, fewer job opportunities, and challenges including restricted work between sites. The pandemic affected employment for 44% of respondents; of these, 45% indicated working from home, 45% provided virtual counselling, 7% were redeployed within dietetics, 14% provided nondietetic COVID-19 support, and 6% were furloughed or laid off. Changed work hours, predominantly reduced, were identified by 29%. Changes in pay, identified by 12%, included loss (e.g., raises deferred) or gain (e.g., pandemic pay). Fear of infection and stress about careers and finances were expressed.Conclusion: The COVID-19 pandemic profoundly affected both acquiring positions and employment in 2020 for recent dietetic graduates.- Purpose: To investigate the experiences of dietetic students in a faculty-supervised, noncourse-based service-learning (NSL) opportunity called Nutrition Ignition! (NI!) to understand how NSL activities contribute to dietetic education.Methods: This study used focus group methodology. A convenience sample was recruited from current members of NI!. Participants completed a brief demographic questionnaire and then engaged in a focus group discussion led by a trained moderator who followed a semi-structured guide. Six focus group discussions were transcribed, and a common theme template was developed by researchers.Results: Out of 46 eligible members of NI!, 33 agreed to participate. The main reasons participants joined NI! were to develop professional skills and to help children in the community. Participants discussed many outcomes from their participation in NI!, including enhanced communication skills, especially in terms of knowledge translation; increased ability to be flexible and adapt to “real-world” situations; deeper awareness of the research process; and expanded world view.Conclusion: This study suggests that NSL is an effective way to build dietetic students’ personal and professional skills and provide an additional opportunity in academic settings to prepare dietetic students for entry-level practice.
- It is important that breast cancer patients know where they can access evidence-based nutrition information because misinformation may lead to confusion for patients regarding dietary requirements, as well as potentially causing harm to health. There are gaps in knowledge about where and when patients seek nutrition information. Our exploratory study used telephone interviews to investigate where patients with breast cancer obtained nutrition information pre and postdiagnosis, and their preferred sources and timing for receiving nutrition information. We interviewed 29 women diagnosed with breast cancer who had attended the Cross Cancer Institute in Edmonton, Alberta. The structured interview included 13 closed-ended questions and 1 open-ended question. Interviews revealed that motives for seeking nutrition information changed between pre and postdiagnosis, but the sources did not. The majority of participants did not access a registered dietitian (RD) postdiagnosis but did specify that meeting with a RD would be their preferred source of information. Responses varied for the preferred sources and timing of nutrition information provision. Our study suggests that further research is necessary to know how to best meet the nutrition information needs of patients diagnosed with breast cancer.
- Cystic fibrosis (CF) is a chronic condition requiring continued input from the CF dietitian as an integral part of the CF multidisciplinary team. In recent years, the longer life expectancy experienced by people with CF (PwCF) means that nutrition advice and therapy are evolving from a focus on nutrition support to prevention and management of comorbidities. Little has been reported regarding the perceived role of the CF dietitian amongst PwCF. We report the responses to 11 questions that were part of a larger international survey distributed to members of national CF charities in 2018-2019. These questions evaluated PwCFs’ perspectives on (i) the importance of the CF diet, (ii) how often PwCF obtain dietary/nutritional advice from their dietitian, (iii) the perceived reliability of information given by the dietitian, (iv) other sources of CF information and their perceived reliability, and (v) how CF nutrition/diet, as well as CF-related diabetes, ranked as research priorities. There were 295 respondents from 13 countries. Almost half of the respondents (46.8%) contacted their CF dietitian on a frequent/more regular basis, compared to medical/scientific journals/medical/scientific search engines. The CF dietitian was considered a reliable source of information, as 84% of the respondents indicated that the information provided was very/generally reliable. At a time when CF care and expectations are changing rapidly, PwCF are in need of trusted and reliable information to make positive changes in lifestyle and habits. Dietitians working with PwCF should appreciate the pivotal and valued role they perform as purveyors of robust evidence-based information to this chronic disease population.
- Katherine Lamps MS,
- Henna Muzaffar PhD, RD, FAND,
- Nancy Prange RDN, LDN,
- Julie Ann Patterson PhD, MBA, RDN, LDN, and
- Andrea Hein MS
The Coordinated Approach to Child Health (CATCH) programme is an accredited obesity prevention programme in the United States, teaching children about nutrition, physical activity, and screen time limits. This study aimed to evaluate the perceptions of undergraduate and graduate student leaders’ about their experience delivering the CATCH programme in elementary schools in Northern Illinois school districts during the 2019–2020 school year and its impact on their personal and professional skills and on programme participants. An email questionnaire was sent to eligible students. Grounded theory was used to analyze the students’ responses. Two researchers assigned codes to the data and identified themes. Twenty-one students responded (50% response rate). Six identified themes include “purpose of CATCH programme,” “school facilities and resources,” “university students experience with CATCH lessons and activities,” “benefits to university student,” “benefits to children and teachers,” and “identified weaknesses and suggested improvements to CATCH.” University students delivering the CATCH programme appreciated the opportunity to practice in a real-world setting, gained transferable professional skills, increased programme content knowledge, identified CATCH programme benefits/strengths, and planned to apply lessons learned to future practice.- Lydi-Anne Vézina-Im Ph.D,
- Dominique Beaulieu inf., Ph.D,
- Stéphane Turcotte M.Sc,
- Catherine Savard inf., B.Sc,
- Simone Lemieux Dt.P., Ph.D,
- Danielle Boucher inf., Ph.D,
- Maria-Cecilia Gallani inf., Ph.D, and
- Marie-Claude Paquette Dt.P., Ph.D
Objectif : Vérifier la stabilité temporelle et validité relative de la version française adaptée d’un questionnaire auto-déclaré en anglais mesurant la consommation de diverses boissons (BEVQ) chez les adolescents.Méthodes : L’adaptation française du BEVQ (AF-BEVQ) comprenait notamment la conversion des unités impériales en unités métriques et l’ajustement de certains formats selon ceux disponibles au Canada. Ensuite, 60 adolescents provenant de deux régions du Québec ont complété l’AF-BEVQ et deux rappels de 24 heures Web (R24W) (un jour de semaine et un de fin de semaine) à deux reprises à deux semaines d’intervalle.Résultats : L’AF-BEVQ avait des coefficients intra-classe (ICC) modérés pour les quantités de boissons sucrées (ICC : 0,68; intervalle de confiance [IC] 95 % : 0,46–0,81), de jus de fruits (ICC : 0,54; IC 95 % : 0,23–0,72) et d’eau (ICC : 0,66; IC 95 % : 0,38–0,81) consommées. Les quantités de boissons sucrées (rs = 0,49; p < 0,0001), de jus de fruits (rs = 0,38; p = 0,0024) et d’eau (rs = 0,65; p < 0,0001) rapportées dans l’AF-BEVQ étaient significativement corrélées à celles des deux R24W.Conclusions : L’AF-BEVQ présentait majoritairement des propriétés métrologiques adéquates. Il est un outil d’intérêt pour mesurer rapidement la consommation de boissons sucrées, de jus de fruits et d’eau d’adolescents francophones.- It is not known if nutrition risk screening of older adults should be a standard practice in primary care. The evidence in support of nutrition risk screening of older adults in primary care was examined and critically analyzed using an umbrella review. The peer reviewed and grey literature were searched for clinical practice guidelines (CPGs) and systematic reviews (SRs). Titles and abstracts were independently screened by the two authors. Resources were excluded if they did not apply to older adults, did not discuss nutrition/malnutrition risk screening, or were in settings other than primary care. Full texts were independently screened by both authors, resulting in the identification of six CPGs and three SRs that met the review criteria. Guidelines were appraised with the AGREE II tool and SRs with the AMSTAR 2 tool. The quality of the CPGs was high, while the quality of the SRs was low. The CPGs and SRs acknowledged a lack of high-quality research on the benefits of regular nutrition risk screening for older adults in primary care; however, CPGs recommended annual screening for older adults in primary care practices or other community settings. High-quality research investigating nutrition risk screening of older adults in primary care is needed.
- Christine Marie Mills RD, MPH, PhD(candidate),
- Simone Parniak BHSc, MA,
- Vincent G. Depaul PT, PhD, and
- Catherine Donnelly OT Reg (Ont.), PhD
Older adults are the fastest-growing demographic group in Canada, and the majority of older adults want to age-in-place within their communities. Many older adults live in naturally occurring retirement communities (NORCs), unplanned communities with a high proportion of older residents. NORC supportive services programs can help older adults successfully age-in-place. One such program is Oasis Senior Supportive Living, a partnership between older adults, building owners and managers, community partners, funders, and researchers. Using a qualitative approach, interviews were conducted with Oasis participants to understand their experiences of Oasis. This article will describe the three pillars upon which Oasis programming is based and provide insights from Oasis participants. It will discuss nutrition programming implemented in these NORCs and suggest how dietitians can support NORC residents.- Mariam R. Ismail PhD,
- Jason A. Gilliland PhD,
- June I. Matthews PhD RD PHEc,
- Jennifer Beverley MSc RD, and
- Danielle S. Battram PhD, RD, PHEc
Purpose: This study aimed to explore children’s lived experiences with the Ontario Student Nutrition Program (OSNP), a free, school-based snack program implemented in elementary schools in Southwestern, Ontario, Canada, to gain insights into future school food programs (SFP).Methods: Focus group discussions (n=17) were conducted with 105 children in Grades 5 to 8 in seven elementary schools. Focus groups were audio-recorded, transcribed, and coded for themes using inductive content analysis.Results: Overall, children appreciated the OSNP and felt that it filled a need in students. Children also reported a willingness to try novel food items. For future SFPs, participants recommended that input be sought from children to ensure food preferences were considered. Children also discussed wanting more appealing food offerings that may include some choice. Finally, children also mentioned wanting a fair and equitable distribution of food in classrooms.Conclusions: Children appreciated the OSNP and reported benefits to themselves and their peers. They also provided some valuable recommendations for future SFPs. If a nationally funded SFP is to be considered in Canada, children expressed the need to make the program equitable, while still allowing schools the flexibility to meet their unique needs and preferences.- Sunita Ghosh Ph.D. P.Stat.,
- Sarah A. Purcell Ph.D,
- Ken Martin M.Sc,
- Isac Lima Ph.D, and
- Carla M. Prado Ph.D. R.D
Purpose: This study compared anthropometric and body fat percent (BF%) equations in relation to measures of metabolic health.Methods: BF% calculations (Bergman, Fels, and Woolcott) and anthropometric measurements were used to determine obesity among a sample of patients attending primary care in Alberta, Canada. Anthropometric variables included body mass index (BMI), waist circumference, waist:hip ratio, waist:height ratio, and calculated BF%. Metabolic Z-score was computed as the average of the individual Z-scores of triglycerides, total cholesterol, and fasting glucose and the number of standard deviations from the sample mean.Results: Five hundred and fourteen individuals were included (41.2% male, age: 53 ± 16y, BMI: 27.4 ± 5.7 kg/m2). BMI ≥ 30 kg/m2 detected the smallest number of participants (n = 137) as having obesity, while Woolcott BF% equation categorized the largest number of participants as having obesity (n = 369). No anthropometric or BF% calculation predicted metabolic Z-score in males (all p ≥ 0.05). In females, age-adjusted waist:height ratio had the highest prediction power (R2 = 0.204, p < 0.001), followed by age-adjusted waist circumference (R2 = 0.200, p < 0.001) and age-adjusted BMI (R2 = 0.178, p < 0.001).Conclusions: This study did not find evidence that BF% equations more strongly predicted metabolic Z-scores than other anthropometric values. In fact, all anthropometric and BF% variables were weakly related to metabolic health parameters, with apparent sex differences.- Purpose: To describe the breastfeeding experiences of a dietitian and mother so as to expose dominant discourses reinforcing expert-driven imperatives to breastfeed.Methods: Professional experiences and personal challenges related to breastfeeding promotion are described, analyzed, and interpreted using autoethnography. The social ecological model (SEM) is used as a sensitizing concept to guide the organization, presentation, and analysis of experiences.Results: Data were organized into two discussion themes: breastfeeding promotion practices and “failure” to breastfeed. Dominant discourses reinforcing expert-driven imperatives to breastfeed are revealed, including health as a duty, intensive motherhood, and mother blame. Discourses promoting or reinforcing breastfeeding simultaneously judge and denormalize formula-feeding.Conclusions: Contemporary breastfeeding promotion messages and strategies are quiet coercions used to influence infant-feeding decisions and do not support the principles of evidence-based practice, person-centred care, and informed choice.
- OPEN ACCESS
- Abigail Clarke,
- Jessica Mannette MA,
- Barb Hamilton-Hinch PhD,
- Mary Lynch MD, FRCPC,
- Patricia Williams PhD, PDt,
- Shannan Grant PhD, PDt, and
- Phillip Joy PhD, PDt
Purpose: FoodNOW (Food to eNhance Our Wellness) engaged in assessment of simulated households that include a person living with HIV/AIDS (PLWHA) in Nova Scotia to determine if a basic nutritious diet is affordable.Methods: We used supermarket websites to cost food and beverage items listed in the National Nutritious Food Basket (NNFB) for simulated households, each with a PLWHA. Food costing methodologies were co-developed and adapted with community members in response to barriers presented by the COVID-19 pandemic.Results: We found that simulated households, each with one PLWHA, that had a potential deficit after monthly expenses were a household of four on Income Assistance (−$1,058.70), a lone mother with two children on Income Assistance (−$973.65), a lone man on Income Assistance (−$677.40), and a household of four with one minimum-wage earner (−$383.45).Conclusions: Nova Scotia households with a PLWHA living on Income Assistance or with a minimum-wage earner cannot reasonably afford a nutritious diet in addition to basic household expenses. Using these food costing data can allow dietitians to efficiently inform government action and policy change to improve the health and wellness of individuals and families. - Purpose: This study investigated the potential influence of the 2019 Canada’s Food Guide (CFG) on the eating environment and food provided in early learning and childcare centres across Canada.Methods: Directors of childcare centres were invited to complete an online survey about their awareness and adoption of the 2019 CFG and submit their menus for analysis.Results: Twenty-five directors completed the survey, and eighteen cycle menus were analyzed. Frequency and the types of foods offered in childcare centres were assessed. Ninety-two percent reported being aware of the changes in the food guide. Many challenges including the lack of support and resources, cost of food, and food reluctance could affect their ability to apply the changes, especially the incorporation of plant-based protein and the uncertainty around the amount of dairy products to provide. Menu analysis indicated frequency of offering items from the various food groups. Vegetables were mostly offered during lunchtime with an average offering rate of 4.83 ± 0.24 times per week.Conclusion: Representatives of early learning and childcare centres identified having difficulties in interpreting and applying the changes in the 2019 CFG. Dietitians have the knowledge and skills required to support childcare centres through training opportunities, workshops, toolkits, and advocacy.
- OPEN ACCESS
- Antonia Harvey PDt, MScAHN,
- Gillian Chu RD, MScAHN,
- Daphne Lordly PDt, DEd,
- Judy Fraser Arsenault PDt, MAHE,
- Sue Conlan PDt, MAHN,
- Tess Laidlaw PhD,
- Laurie A. Wadsworth PDt, PhD, and
- Shannan Grant PDt, MSc, PhD
Gaps in communication training have been identified in Canadian and international academic and practicum dietetics programs. A workshop was developed to pilot supplementary media training to nutrition students/trainees studying in Nova Scotia. Students, interns, and faculty from two universities participated in the workshop. Data on perceived learning, media knowledge/skill use, and workshop feedback were collected immediately post-workshop using a mixed-form questionnaire. A modified questionnaire was administered eight months post-workshop to obtain information on utility of the perceived acquired knowledge/skills. Closed-ended responses underwent descriptive analysis, while open-ended responses underwent thematic analysis. Twenty-eight participants completed the questionnaire post-workshop, and six completed it at follow-up. All participants rated the workshop positively (7-point Likert scale) and reported learning something new (perceived). Perceived learning emphasized general media knowledge/skills and communication skills. Follow-up data suggested participants had applied perceived media knowledge/skills in message development and media and job interviews. These data suggest that nutrition students/trainees may benefit from supplementary communications and media training and provide a stimulus for ongoing curriculum review and discussion. - Purpose: Describe food/beverage intake among all patients and those with low meal intake and determine if the Hospital Food Experience Questionnaire (HFEQ), or its shorter version (HFEQ-sv), predicts food intake while considering patient (e.g., gender) and hospital characteristics (e.g., foodservice model).Methods: Cross-sectional study of 1087 adult patients from 16 hospitals in Ontario, Canada. The valid and reliable HFEQ assessed patients’ meal quality perceptions. Visual estimation determined overall meal and food/beverage intake using the Comstock method. Binary logistic regressions tested the association between patient and hospital characteristics and whether HFEQ or HFEQ-sv scores added utility in predicting overall meal intake (≤50% vs. ≥75%).Results: Approximately 29% of patients consumed ≤50% of their meal. Models assessing patient and hospital characteristics and either the HFEQ or the HFEQ-sv were significant (LRT(43) = 72.25, P = 0.003; LRT(43) = 93.46, P < 0.001). Men and higher HFEQ or HFEQ-sv scores demonstrated significantly higher odds of ≥75% meal consumption. Considering HFEQ or HFEQ-sv scores explained greater variance in meal intake and resulted in better model fits.Conclusions: The HFEQ and HFEQ-sv predict patient meal intake when adjusting for covariates and add utility in understanding meal intake. Either version can be confidently used to support menu planning and food delivery to promote food intake.
- The objective of this evaluation was to determine Northern Ontario School of Medicine (NOSM) undergraduate medical education (UME) students’ perceptions of the curriculum related to their nutrition knowledge, attitudes, and counseling self-efficacy/confidence. A 16-item electronic survey (Qualtrics©) was developed, and it included nutrition competency statements, adult and pediatric nutrition assessment and counseling confidence, and nutrition curriculum satisfaction. Students in Years 2, 3, and 4 (n = 192, 66%–73% female) were invited to answer the survey. Of the 61 respondents, 50.8% were Year 2, 34.9% Year 3, and 10.6% Year 4. Overall, 72.1% of the respondents were dissatisfied. Respondents perceived they were least competent in strategies to prevent and treat disease (72.1%), in applying basic dietary strategies (65.6%), and in ethics and nutrition management (62.3%), whereas 52.5% felt competent in the team approach to nutrition care. Respondents reported lowest confidence (less than 10%–15%) in specialized nutrition support, cancer care, renal nutrition, and mental health/eating disorders for both populations. NOSM medical learners reported curriculum dissatisfaction, nutrition incompetence, and poor levels of perceived confidence in nutrition management. Results will be used to inform nutrition curriculum enhancements and future outcome evaluations. Current and future physicians with enhanced nutrition knowledge, awareness of the Registered Dietitian (RD) roles, and an understanding of when to refer patients to an RD can provide better patient-centred care.
- Continuing care (CC) facilities have been impacted by a growing demand for services, insufficient resources for the provision of quality food and nutrition care, and, most recently, the COVID-19 pandemic. This study explored the roles and responsibilities of dietitians working in CC facilities in Nova Scotia (NS) before and after the COVID-19 first wave. Using ethics-approved questionnaires, the estimated 75 dietitians working in CC facilities in NS were surveyed in Fall 2019 and Fall 2020 about their roles and responsibilities. Twenty responded to the first questionnaire and 15 to the second. Analysis of data included simple statistical and qualitative description methods. The findings highlighted the complexities and challenges faced by these dietitians in the provision of resident nutrition care, overseeing foodservices, training staff and dietetic interns, and contributing to facility specific care committees before and after the COVID-19 first wave. There is a need to advocate for minimum standards for dietetic and foodservice funding in CC facilities based on higher acuity and complex care needs of residents and considering the multifaceted roles of dietitians in CC. Efforts to improve awareness about the roles of dietitians working in CC among resident families, other dietitians, and dietetic interns are also needed.
- Ultra-processed foods (UPFs) have become a major contributor to the diets of Canadians, with a recent report from Statistics Canada suggesting Canadians are consuming almost one-half of their calories from UPFs. Research has linked UPF consumption with increased risk for chronic diseases such as cardiovascular disease and type 2 diabetes, among others. This paper sought to investigate the popularity of UPFs, particularly among children and teens, utilizing the socioecological model as a framework to illustrate how influences at multiple levels (i.e., public policy, organizational, community, interpersonal, and individual) have played a role in the proliferation of UPFs. Evidence from previous studies is used to identify how factors at different levels may influence UPF consumption and discuss potential strategies for reducing UPF consumption. To meaningfully reduce UPF consumption among Canadians, all levels should be considered, with the goal of creating a healthier Canadian population.