Comparison of Physical Activity Adult Questionnaire results with accelerometer data

BACKGROUND

Discrepancies between self-reported and objectively measured physical activity are well-known. For the purpose of validation, this study compares a new self-reported physical activity questionnaire with an existing one and with accelerometer data.

DATA AND METHODS

Data collected at one site of the Canadian Health Measures Survey in 2013 were used for this validation study. The International Physical Activity Questionnaire (IPAQ) was administered to respondents during the household interview, and the new Physical Activity for Adults Questionnaire (PAAQ) was administered during a subsequent visit to a mobile examination centre (MEC). At the MEC, respondents were given an accelerometer to wear for seven days. The analysis pertains to 112 respondents aged 18 to 79 who wore the accelerometer for 10 or more hours on at least four days.

RESULTS

Moderate-to-vigorous physical activity (MVPA) measured by accelerometer had higher correlation with data from the PAAQ (r = 0.44) than with data from the IPAQ (r = 0.20). The differences between accelerometer and PAAQ data were greater based on accelerometer-measured physical activity accumulated in 10-minute bouts (30-minute difference in MVPA) than on all minutes (9-minute difference). The percentages of respondents meeting the Canadian Physical Activity Guidelines were 90% based on self-reported IPAQ minutes, 70% based on all accelerometer MVPA minutes, 29% based on accelerometer MVPA minutes accumulated in 10-minute bouts, and 61% based on self-reported PAAQ minutes.

INTERPRETATION

The PAAQ demonstrated reasonable validity against the accelerometer criterion. Based on correlations and absolute differences between daily minutes of MVPA and the percentages of respondents meeting the Canadian Physical Activity Guidelines, PAAQ results were closer to accelerometer data than were the IPAQ results for the study sample and previous Statistics Canada self-reported questionnaire findings.

Household Food Insecurity Is a Stronger Marker of Adequacy of Nutrient Intakes among Canadian Compared to American Youth and Adults

BACKGROUND

The most recent statistics indicate that the prevalence of food insecurity in the United States is double that in Canada, but the extent to which the nutrition implications of this problem differ between the countries is not known.

OBJECTIVE

This study was undertaken to compare adequacy of nutrient intakes in relation to household food insecurity among youth and adults in Canada and the United States.

METHODS

Data from comparable nationally representative surveys, the 2004 Canadian Community Health Survey and the 2003-2006 NHANES, were used to estimate prevalences of inadequate intakes of vitamins A and C, folate, calcium, magnesium, and zinc among youth and adults in food-secure and food-insecure households. Potential differences in the composition of the populations between the 2 countries were addressed by using standardization, and analyses also accounted for participation in food and nutrition assistance programs in the United States.

RESULTS

Larger gaps in the prevalences of inadequate intakes between those in food-secure and food-insecure households were observed in Canada than in the United States for calcium and magnesium. For calcium, the prevalences of inadequate intakes among those in food-secure and food-insecure households in Canada were 50% and 66%, respectively, compared with 50% and 51%, respectively, in the United States. For magnesium, the prevalences of inadequate intakes in Canada were 39% and 60% among those in food-secure and food-insecure households, respectively, compared with 60% and 61%, respectively, in the United States. These findings were largely unchanged after we accounted for participation in food and nutrition assistance programs in the United States.

CONCLUSIONS

This study suggests that household food insecurity is a stronger marker of nutritional vulnerability in Canada than in the United States. The results highlight the need for research to elucidate the effects of domestic policies affecting factors such as food prices and fortification on the nutritional manifestations of food insecurity.

A comparison of self-reported leisure-time physical activity and measured moderate-to-vigorous physical activity in adolescents and adults

BACKGROUND

Systematic reviews and results of Statistics Canada surveys have shown a discrepancy between self-reported and measured physical activity. This study compares these two methods and examines specific activities to explain the limitations of each method.

DATA AND METHODS

Data are from cycle 1 (2007 to 2009) and cycle 2 (2009 to 2011) of the Canadian Health Measures Survey. The survey involved an interview in the respondent's home and a visit to a mobile examination centre (MEC) for physical measurements. In a questionnaire, respondents were asked about 21 leisure-time physical activities. They were requested to wear an Actical accelerometer for seven days after the MEC visit. The analysis pertains to respondents aged 12 to 79 who wore the accelerometer for 10 or more hours on at least four days (n = 7,158).

RESULTS

Averages of self-reported leisure-time physical activity and moderate-to-vigorous physical activity measured by accelerometer were within a couple of minutes of each other. However, at the individual level, the difference between estimates could exceed 37.5 minutes per day in one direction or the other, and around 40% of the population met physical activity thresholds according to one measurement method, but not according to the other. The disagreement is supported by weak observed correlations.

INTERPRETATION

The lack of a systematic trend in the relationship between the two methods of measuring physical activity precludes the creation of correction factors or being confident in using one method instead of the other. Accelerometers and questionnaires measure different aspects of physical activity.

Physical activity and sedentary behavior during the early years in Canada: a cross-sectional study

BACKGROUND

Physical activity and sedentary behavior habits are established during early childhood, yet only recently has objectively measured data been available on children aged 5 years and younger. This study presents data on the physical activity and sedentary behaviors of Canadian children aged 3-5 years.

METHODS

Data were collected as part of the Canadian Health Measures Survey between 2009 and 2011. A nationally-representative sample (n = 459) of children aged 3-5 years wore Actical accelerometers during their waking hours for 7 consecutive days. Data were collected in 60-sec epochs and respondents with ≥4 valid days were retained for analysis. Parents reported their child's physical activity and screen time habits in a questionnaire.

RESULTS

Eighty-four percent of 3-4 year old children met the physical activity guideline of 180 minutes of total physical activity every day while 18% met the screen time target of <1 hour per day. Fourteen percent of 5 year old children met the physical activity guideline of 60 minutes of daily moderate-to-vigorous physical activity (MVPA) while 81% met the screen time target of <2 hours per day. Children aged 3-4 years accumulated an average of 352 min/d of total physical activity and 66 minutes of MVPA while 5 year old children accumulated an average of 342 min/d of total physical activity and 68 minutes of MVPA. Children were sedentary for approximately half of their waking hours and spent an average of 2 hours per day in front of screens. Only 15% of 3-4 year olds and 5% of 5 year olds are meeting both the physical activity and sedentary behavior guidelines.

CONCLUSIONS

Promoting physical activity while reducing sedentary behavior is important at all stages of life. The findings of the present study indicate that there remains significant room for improvement in these behaviors among young Canadian children.

The association between accelerometer-measured patterns of sedentary time and health risk in children and youth: results from the Canadian Health Measures Survey

BACKGROUND

Self-reported screen time is associated with elevated health risk in children and youth; however, research examining the relationship between accelerometer-measured sedentary time and health risk has reported mixed findings. The purpose of this study was to examine the association between accelerometer-measured patterns of sedentary time and health risk in children and youth.

METHODS

The results are based on 1,608 children and youth aged 6 to 19 years from the Canadian Health Measures Survey (2007-2009). Sedentary time was measured using the Actical accelerometer. Breaks in sedentary time and prolonged bouts of sedentary time lasting 20 to 120 minutes were derived for all days, weekend days and during the after-school period (i.e., after 3 pm on weekdays). Regression analyses were used to examine the association between patterns of sedentary time and body mass index (BMI), waist circumference, blood pressure and non-HDL cholesterol.

RESULTS

Boys accumulated more sedentary time on weekdays after 3 pm and had a higher number of breaks in sedentary time compared to girls. Overweight/obese boys (aged 6-19 years) accumulated more sedentary time after 3 pm on weekdays (282 vs. 259 min, p < .05) and as prolonged bouts lasting at least 80 minutes (171 vs. 133 min, p < .05) compared to boys who were neither overweight nor obese. Prolonged bouts of sedentary time lasting at least 80 minutes accumulated after 3 pm on weekdays were positively associated with BMI and waist circumference in boys aged 11-14 years (p < .006). Each additional 60 min of sedentary time after 3 pm on weekdays was associated with a 1.4 kg·m-2 higher BMI and a 3.4 cm higher waist circumference in 11-14 year old boys. No sedentary pattern variables differed between girls who were not overweight or obese and those who were overweight/obese and none of the sedentary pattern variables were associated with any health markers in girls.

CONCLUSIONS

The findings confirm results of other studies that reported accelerometer-measured sedentary time was not associated with health risk in children and youth. Even when the pattern and timing of sedentary time was examined relative to health markers, few associations emerged and were limited to boys aged 11-14 years.

Nutritional risk among older Canadians

BACKGROUND

Nutritional risk screening is typically done in clinical settings to identify individuals at risk of malnourishment. This article presents the first population-level assessment of nutritional risk based on a large national sample representative of Canadian householders aged 65 or older.

DATA SOURCES AND METHODS

Data from the 2008/2009 Canadian Community Health Survey-Healthy Aging were used to estimate the prevalence of nutritional risk by selected characteristics. Factors associated with nutritional risk were examined with restricted and full logistic models. The distribution of responses on the SCREEN II-AB nutritional risk instrument is reported.

RESULTS

Based on the results of the 2008/2009 survey, 34% of Canadians aged 65 or older were at nutritional risk. Women were more likely than men to be at risk. Among people with depression, 62% were at nutritional risk, compared with 33% of people without depression. Level of disability, poor oral health, and medication use were associated with nutritional risk, as were living alone, low social support, infrequent social participation, and not driving on a regular basis. Lower income and education were also associated with nutritional risk.

INTERPRETATION

Nutritional risk is common among seniors living in private households in Canada. The characteristics of people most likely to be at nutritional risk provide evidence for targeted screening and assessment.

Physical activity, sedentary behaviour and sleep in Canadian children: parent-report versus direct measures and relative associations with health risk

BACKGROUND

The accurate measurement of time devoted to physical activity, sedentary pursuits and sleep is difficult and varies considerably between surveys. This has implications for population surveillance and understanding how these variables relate to health.

METHODS

This sample of children (n = 878) was from the 2007 to 2009 Canadian Health Measures Survey. Moderate- to-vigorous physical activity (MVPA), sedentary behaviour and sleep duration were assessed using both a questionnaire and an accelerometer. This article compared parent-reported and directly measured physical activity, sedentary behaviour and sleep, and examined their associations, alone or in combination, with selected health markers in children aged 6 to 11.

RESULTS

According to parent reports, the children in this study had an average of 105 minutes of MVPA, 2.5 hours of screen time and 9.7 hours of sleep per day; accelerometers recorded 63 minutes of MVPA, 7.6 hours of sedentary time and 10.1 hours of sleep per day. MVPA, measured by parent-report or accelerometry, was significantly associated with body mass index. In a regression model, directly measured MVPA and sleep were significantly associated with body mass index, and directly measured MVPA was significantly associated with waist circumference. Parent-reported screen time approached a significant association with body mass index.

INTERPRETATION

Time estimates and associations with health markers varied between parent-reported and directly measured physical activity, sedentary behaviour and sleep in children. These differences are important to understand before the two measurement techniques can be used interchangeably in research and health surveillance.

Daily patterns of physical activity among Canadians

The 2007 to 2009 Canadian Health Measures Survey (CHMS) collected directly measured physical activity on seven consecutive days for a representative sample of the population aged 6 to 79. Based on the CHMS, half of the active minutes in a day are accumulated between 11:00 a.m. and 5:00 p.m. For children, the most active period is lunch-time (11:00 a.m. to 1:00 p.m.), and for teenagers aged 15 to 19, the after-school period (3:00 p.m. to 5:00 p.m.). Children and youth are more active on weekdays than on weekends. Active children and youth tend to accumulate more minutes of moderate-to-vigorous physical activity after school, whereas active adults do so at lunch time.

Bone health: osteoporosis, calcium and vitamin D

BACKGROUND

Osteoporosis is a bone disease that predisposes to fractures. Sufficient intake of calcium and vitamin D is recommended for prevention and treatment.

DATA AND METHODS

Based on 28,406 respondents aged 50 or older to the 2009 Canadian Community Health Survey (CCHS)--Healthy Aging, the population who reported being diagnosed with osteoporosis is profiled. Analysis of calcium and vitamin D intake is based on 10,879 respondents aged 50 or older to the 2004 CCHS--Nutrition. Frequencies, averages and cross-tabulations were produced to estimate the prevalence of diagnosed osteoporosis, dietary intake of calcium and vitamin D, the use of supplements, and total calcium and vitamin D intake. Associations between a diagnosis of osteoporosis and socio-economic, dietary and lifestyle factors were examined with multiple logistic regression.

RESULTS

In 2009, 19.2% of women and 3.4% of men aged 50 or older reported having been diagnosed with osteoporosis; the 2004 rates were similar. Age, sex and household income were associated with the probability of reporting osteoporosis. In 2004, based on dietary and supplement intake, 45% to 69% of the population aged 50 or older had inadequate intake of calcium, and 54% to 66% had inadequate intake of vitamin D.

INTERPRETATION

A large percentage of people aged 50 or older, particularly women, have osteoporosis. The prevalence of inadequate intake of calcium and vitamin D is relatively high.

Sugar consumption among Canadians of all ages

According to the 2004 Canadian Community Health Survey-Nutrition, Canadians consumed an average of 110 grams (26 teaspoons) of sugar a day, approximately 20% of their total energy intake. While over 30% of this sugar came from vegetables and fruit, 35% came from the "other" foods category, which consists of items such as soft drinks, salad dressings and candy. The top ten sources of sugar accounted for approximately 85% of daily sugar intake. Beverages (milk, fruit juice, fruit drinks and regular soft drinks) represented 44% of the sugar consumed by children and adolescents, and 35% of that consumed by adults. Diabetics' average sugar intake was less than that of non-diabetics, but at 17%, exceeded the recommended 10% cut-off of total daily calories.

Physical activity of Canadian adults: accelerometer results from the 2007 to 2009 Canadian Health Measures Survey

BACKGROUND

Rising obesity rates and declining fitness levels have increased interest in understanding what underlies these trends. This article presents the first directly measured data on physical activity and sedentary behaviour on a nationally representative sample of Canadians aged 20 to 79 years.

DATA AND METHODS

Data are from the 2007 to 2009 Canadian Health Measures Survey (CHMS). Physical activity was measured using accelerometry. Data are presented as time spent in sedentary, light, moderate and vigorous intensity movement as well as steps accumulated per day.

RESULTS

An estimated 15% of Canadian adults accumulate 150 minutes of moderate-to-vigorous physical activity (MVPA) per week; 5% accumulate 150 minutes per week as at least 30 minutes of MVPA on 5 or more days a week. Men are more active than women and MVPA declines with increasing age and adiposity. Canadian adults are sedentary for approximately 9.5 hours per day (69% of waking hours). Men accumulate an average of 9,500 steps per day and women, 8,400 steps per day. The 10,000-steps-per-day target is achieved by 35% of adults.

INTERPRETATION

Before the CHMS, objective measures of physical activity and sedentary behaviour were not available for a representative sample of Canadians. The findings indicate that 85% of adults are not active enough to meet Canada's new physical activity recommendation.

Physical activity of Canadian children and youth: accelerometer results from the 2007 to 2009 Canadian Health Measures Survey

BACKGROUND

Physical activity is an important determinant of health and fitness. This study provides contemporary estimates of the physical activity levels of Canadians aged 6 to 19 years.

DATA AND METHODS

Data are from the 2007 to 2009 Canadian Health Measures Survey. The physical activity of a nationally representative sample was measured using accelerometers. Data are presented as time spent in sedentary, light, moderate and vigorous intensity movement, and in steps accumulated per day.

RESULTS

An estimated 9% of boys and 4% of girls accumulate 60 minutes of moderate-to-vigorous physical activity on at least 6 days a week. Regardless of age group, boys are more active than girls. Canadian children and youth spend 8.6 hours per day-62% of their waking hours-in sedentary pursuits. Daily step counts average 12,100 for boys and 10,300 for girls.

INTERPRETATION

Based on objective and robust measures, physical activity levels of Canadian children and youth are low.

Combining nutrient intake from food/beverages and vitamin/mineral supplements

BACKGROUND

To calculate total intake of a nutrient and estimate inadequate intake for a population, the amounts derived from food/beverages and from vitamin/mineral supplements must be combined. The two methods Statistics Canada has suggested present problems of interpretation.

DATA AND METHODS

Data collected from 34,386 respondents to the 2004 Canadian Community Health Survey-Nutrition were used to compare four methods of combining nutrient intake from food/beverages and vitamin/mineral supplements: adding average intake from supplements to the 24-hour food/beverage recall and estimating the usual distribution in the population (Method 1); estimating usual individual intake from food? beverages and adding intake from supplements (Method 2); and dividing the population into supplement users and non-users and applying Method 1 or Method 2 and combining the estimates based on the percentages of users and non-users (Methods 3 and 4).

RESULTS

Interpretation problems arise with Methods 1 and 2; for example, the percentage of the population with inadequate intake of vitamin C and folate equivalents falls outside the expected minimum-maximum range. These interpretation problems are not observed with Methods 3 and 4.

INTERPRETATION

Interpretation problems that may arise in combining food and supplement intake of a given nutrient are overcome if the population is divided into supplement users and non-users before Method 1 or Method 2 is applied.

Folic acid fortification above mandated levels results in a low prevalence of folate inadequacy among Canadians

BACKGROUND

Understanding folate intakes after folic acid fortification of the food supply will help to establish dietary and supplement recommendations that balance health benefits and risks.

OBJECTIVES

The objectives were to estimate the prevalence of folate inadequacy (POFI) and intakes above the Tolerable Upper Intake Level (UL) among Canadians and to estimate the supplemental dose that, with diet, provides reproductive-aged women with 400 μg folic acid/d to prevent neural tube defects.

DESIGN

Twenty-four-hour recall and supplement (prior 30 d) data from the 2004 Canadian Community Health Survey (n = 35,107) were used to calculate the POFI and intakes above the UL with and without adjustment for fortification overages. POFI was also estimated by risk factors thought to be related to low folate intake. The Software for Intake Distribution Evaluation (SIDE program; Department of Statistics and Center for Agricultural and Rural Development, Iowa State University) was used to estimate usual dietary intakes in all analyses.

RESULTS

Except for women aged >70 y, POFI was <20% after adjustment for fortification overages. For children aged <14 y, POFI approached zero, even when supplement use was excluded. POFI among adults was unaffected by supplement use, except for women aged >70 y. Only 18% of reproductive-aged women consumed 400 μg folic acid/d from diet and supplements. Modeling showed that supplements containing 325-700 μg folic acid would provide adult women with 400 μg/d but not more than the UL. Diabetes was associated with POFI.

CONCLUSIONS

Innovative strategies are needed to ensure that the subgroups of Canadians who could still benefit from improved folate intake are targeted. Consideration should be given to removing folic acid from supplements designed for young children and men.

The effect of supplement use on vitamin C intake

According to results from the 2004 Canadian Community Health Survey-Nutrition, Canadians get an average of 132 milligrams of vitamin C a day from food. About one adult in five has inadequate dietary intake of vitamin C. A third of Canadians take vitamin C supplements, which add 100 milligrams to total average daily intake. Supplement use lowers the overall percentage of adults with inadequate intake by 5 percentage points to 17%. Smokers, people who eat fruit and vegetables infrequently, and members of households with low income and low educational attainment tend to have relatively low vitamin C intake.

Diet composition and obesity among Canadian adults

BACKGROUND

The contribution of specific nutrients to obesity has not been definitively established. The objective of this study was to determine if an association exists between obesity and the relative percentages of fats, carbohydrates, protein and fibre in the diets of Canadians.

DATA AND METHODS

The data are from the 2004 Canadian Community Health Survey--Nutrition. The analysis pertains to 6454 respondents aged 18 or older who provided valid 24-hour dietary recall information and measured height and weight, and whose reported energy intake was considered plausible based on their predicted energy expenditure. Logistic regression models with obesity status as the main outcome were conducted, controlling for potential confounders. All analyses were based on weighted estimates.

RESULTS

When the effect of the control variables was taken into account, total kilocalories consumed increased the odds of obesity in men, and fibre intake decreased the odds. Among women, only total kilocalories consumed was significantly associated with increased odds of obesity.

INTERPRETATION

Higher consumption of kilocalories increased the odds of obesity, but the relative amounts of fats, carbohydrates and protein were generally not significant. The sole exception was an association between higher fibre intake and lower rates of obesity among men.

Diet quality in Canada

BACKGROUND

In addition to recommendations about the consumption of specific foods and nutriens, a measure of overall diet quality is useful. Over the years, a number of countries, but not Canada, have developed indexes to evaluate diet quality.

DATA AND METHODS

The American Healthy Eating Index was adapted to conform to recommendations in Canada's Food Guide. Data from 33,664 respondents to the 2004 Canadian Community Health Survey-Nutrition were used. Usual index scores were calculated with the Software for Intake Distribution Estimation program. Multiple linear regression models were used to examine associations between index scores and various characteristics, particularly the frequency of vegetable and fruit consumption.

RESULTS

For the population aged 2 or older, the average score on the Canadian adaptation of the Healthy Eating Index in 2004 was 58.8 out of a possible 100 points. Children aged 2 to 8 had the highest average scores (65 or more). Average scores tended to fall into early adolescence, stabiilizing around 55 at ages 14 to 30. A gradual upturn thereafter brought the average score to around 60 at age 71 or older. At all ages, women's scores exceeded those of men. The frequency of vegetable and fruit consumption was linked to index scores.

INTERPRETATION

The American Healthy Eating Index can be adapted to Canadian food intake recommendations. Canadian Community Health Survey questions about the frequency of vegetable and fruit consumption can be used as an approximation of diet quality.

Impact of identifying plausible respondents on the under-reporting of energy intake in the Canadian Community Health Survey

BACKGROUND

Under-reporting is common in nutrition surveys. The identification of plausible respondents is a way of measuring the impact of under-reporting on the relationship between energy intake and body mass index (BMI).

DATA AND METHODS

A 24-hour dietary recall from 16,190 respondents aged 12 or older to the Canadian Community Health Survey (CCHS)--Nutrition was used to determine energy and nutrient intake. To identify plausible respondents, a confidence interval was applied to total energy expenditure derived from equations developed by the Institute of Medicine. Estimates of energy and nutrient intake for plausible respondents were compared with estimates for all respondents. Linear regression was used to demonstrate the impact of under-reporting on the relationship between reported energy intake and weight. Logistic regression was used to determine the impact of under-reporting on modelling the characteristics of obese people.

RESULTS

With a confidence interval of 70% to 142% around energy expenditure, 57% of CCHS respondents were identified as "plausible respondents". Nutrient under-reporting varied between 1% and 10%. Analysis based only on plausible respondents re-establishes the theoretical relationship between energy intake and body weight, a relationship that is lost when analysis is based on the full sample.

INTERPRETATION

Identifying plausible respondents is an effective way of measuring the impact of under-reporting food intake. Conclusions based on plausible respondents, rather than on all respondents, are more in line with theoretical expectations, such as a positive association between high energy intake and obesity.

Beverage consumption of Canadian adults

According to results from the 2004 Canadian Community Health Survey-Nutrition, total beverage consumption among adults declined steadily with age. This reflects drops in the percentage of adults consuming most beverages and in the amounts consumed. While water was the beverage consumed most frequently and in the greatest quantity by adults, for many of them, coffee ranked second. Largely as a result of drinking coffee, more than 20% of men and 15% of women aged 31 to 70 exceeded the recommended maximum of 400 milligrams of caffeine per day. About 20% of men aged 19 to 70 consumed more than two alcoholic drinks a day. Owing to declines in the consumption of soft drinks and alcohol, the contribution of beverages to adults' total calorie intake falls at older ages. Regardless of age, men were generally more likely than women to report drinking most beverages, and those who did, drank more. There were, however, a few exceptions, with higher percentages of women than men reporting that they drank water and tea.

Beverage consumption of children and teens

According to results from the 2004 Canadian Community Health Survey--Nutrition, children and teens get about one-fifth of their daily calories from beverages. As they get older, boys and girls drink less milk and fruit juice, and more soft drinks and fruit drinks. By ages 14 to 18, boys' average daily consumption of soft drinks matches their consumption of milk, and exceeds their consumption of fruit juice and fruit drinks. Beverage consumption by children and teens varies little by province, except in Newfoundland and Labrador where it tends to be comparatively high, and in British Columbia where it tends to be low.

Under-reporting of energy intake in the Canadian Community Health Survey

BACKGROUND

Under-reporting of food consumption is a recurrent challenge for nutrition surveys. Past research suggests that under-reporting tends to be most pronounced among overweight and obese people.

DATA AND METHODS

Data from 16,190 respondents to the 2004 Canadian Community Health Survey (CCHS 2.2)-Nutrition were used to estimate underreporting of food intake for the population aged 12 or older in the 10 provinces. Multiple linear regression models were used to assess the impact of different characteristics on underreporting.

RESULTS

Average under-reporting of energy intake was estimated at 10%. Under-reporting was greater among people who were overweight or obese, those who were physically active, adults compared with teenagers, and women compared with men.

INTERPRETATION

Under-reporting of energy intake is not random and varies by key health determinants. Awareness of the characteristics associated with under-reporting is important for users of nutrition data from the CCHS 2.2.

Obesity and the eating habits of the Aboriginal population

OBJECTIVES

This article compares rates of overweight/obesity and obesity and food consumption patterns of off-reserve Aboriginal and non-Aboriginal people aged 19 to 50 in Ontario and the western provinces. DATA SOURCES; The data are from the 2004 Canadian Community Health Survey: Nutrition (cycle 2.2).

ANALYTICAL TECHNIQUES

Cross-sectional analyses were used to estimate the percentages of individuals who were overweight/obese or obese and average nutrient consumption, based on Aboriginal identity and other selected characteristics. Logistic regression was used to determine the independent influence of Aboriginal identity on overweight/obesity and obesity.

MAIN RESULTS

In 2004, the overweight/obesity and obesity rates of off-reserve Aboriginal people aged 19 to 50 were higher than those of the non-Aboriginal population. These overall differences primarily reflected higher rates of overweight/obesity and obesity among Aboriginal women. At ages 19 to 30, these differences can partly be explained by higher calorie intake by Aboriginal women, despite identical energy needs, based on height, weight, age and physical activity. Most of the excess calories are eaten as snacks and come from "other foods".

Canadians' eating habits

OBJECTIVES

This report is an overview of Canadians' eating habits: total calories consumed and the number of servings from the various food groups, as well as the percentage of total calories from fat, protein and carbohydrates.

DATA SOURCES

The data are from the 2004 Canadian Community Health Survey (CCHS) - Nutrition. Published results from the 1970-1972 Nutrition Canada Survey were used for comparisons over time.

ANALYTICAL TECHNIQUES

An initial 24-hour dietary recall was completed by 35,107 people. Asubsample of 10,786 completed a second recall 3 to 10 days later. Data collected in the first interview day were used to estimate, by selected characteristics, average calorie intake and average percentages of calories from fat, protein and carbohydrates. Usual intake of macronutrients was estimated with the Software for Intake Distribution Estimation (SIDE) program, using data from both interview days.

MAIN RESULTS

Although a minimum of five daily servings of vegetables and fruit is recommended, 7 out of 10 children aged 4 to 8 and half of adults did not meet this minimum in 2004. More than a third of 4- to 9-year-olds did not have the recommended two daily servings of milk products. Over a quarter of Canadians aged 31 to 50 obtained more than 35% of their total calories from fat. Snacks account for more calories than breakfast, and about the same number of calories as lunch.