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Woods N, Seabrook JA, Schaafsma H, Burke S, Tucker T, Gilliland J. Dietary Changes of Youth during the COVID-19 Pandemic: A Systematic Review. J Nutr 2024; 154:1376-1403. [PMID: 38408731 PMCID: PMC11007747 DOI: 10.1016/j.tjnut.2024.02.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 01/24/2024] [Accepted: 02/21/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has taken the lives of millions and disrupted countless more worldwide. Simply living through the pandemic has had drastic effects on the health of citizens. Diet, an important aspect of health, has been uniquely affected by the pandemic, although these changes have not been sufficiently studied among youth. OBJECTIVES The objective of this systematic review was to investigate dietary changes of youth during COVID-19. METHODS A prespecified literature review was conducted using MEDLINE, EMBASE, Scopus, and CINAHL to identify studies from January 2020 to May 2023 that assessed dietary changes among youth aged ≤20 y compared with before the pandemic. Only quantitative observational studies that were published in English were included. Two authors completed all screening/study selection independently, with disagreements being resolved via discussion. Data extraction was completed by 1 author. Dietary changes were categorized into food groups and habits for analysis purposes. RESULTS In total, 67 studies met inclusion criteria. Most studies used recall to assess changes (48/67; 71.6%). Most studies found an increase in fruits and vegetables (24/46; 52.2%), grain products (6/11; 54.5%), meat, poultry, and eggs (4/8, 50.0%), diet quality indices and/or overall dietary assessments (7/13, 53.8%), and the frequency of snacking (9/12; 75.0%), whereas generally finding a decrease in ultraprocessed foods (32/53; 60.4%), compared with before the COVID-19 pandemic. Mixed findings or primarily no changes were found for fish and aquatic products, legumes, beans, seeds and nuts, milk and milk products, breakfast consumption, and nutrient intake. CONCLUSIONS Mostly favorable dietary changes appear to have occurred among youth during COVID-19, although there were several mixed findings and unclear takeaways among the foods and habits under study. The heterogeneity of defining food groups was a noted limitation in the current review.
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Affiliation(s)
- Nicolas Woods
- School of Health Studies, the University of Western Ontario, London, Ontario, Canada; Human Environments Analysis Laboratory, the University of Western Ontario, London, Ontario, Canada; Health and Rehabilitation Sciences, Faculty of Health Sciences, the University of Western Ontario, London, Ontario, Canada.
| | - Jamie A Seabrook
- Human Environments Analysis Laboratory, the University of Western Ontario, London, Ontario, Canada; Department of Epidemiology & Biostatistics, the University of Western Ontario, London, Ontario, Canada; School of Food and Nutritional Sciences, Brescia University College, London, Ontario, Canada; Children's Health Research Institute, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada; Department of Paediatrics, the University of Western Ontario, London, Ontario, Canada.
| | - Holly Schaafsma
- School of Health Studies, the University of Western Ontario, London, Ontario, Canada; Human Environments Analysis Laboratory, the University of Western Ontario, London, Ontario, Canada; Health and Rehabilitation Sciences, Faculty of Health Sciences, the University of Western Ontario, London, Ontario, Canada.
| | - Shauna Burke
- School of Health Studies, the University of Western Ontario, London, Ontario, Canada; Children's Health Research Institute, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada.
| | - Trish Tucker
- Children's Health Research Institute, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada; School of Occupational Therapy, the University of Western Ontario, London, Ontario, Canada.
| | - Jason Gilliland
- School of Health Studies, the University of Western Ontario, London, Ontario, Canada; Human Environments Analysis Laboratory, the University of Western Ontario, London, Ontario, Canada; Department of Epidemiology & Biostatistics, the University of Western Ontario, London, Ontario, Canada; Children's Health Research Institute, London, Ontario, Canada; Lawson Health Research Institute, London, Ontario, Canada; Department of Paediatrics, the University of Western Ontario, London, Ontario, Canada; Department of Geography and Environment, the University of Western Ontario, London, Ontario, Canada; Health and Rehabilitation Sciences, Faculty of Health Sciences, the University of Western Ontario, London, Ontario, Canada.
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Slater J, Katz A, Pilli B, Hinds A, Urquia ML, Sanguins J, Green C, Cidro J, Chateau D, Nickel N. Geographic Comparison of Dietary Intake and Quality in Manitoba Adolescents. CAN J DIET PRACT RES 2024:1-9. [PMID: 38456655 DOI: 10.3148/cjdpr-2024-004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
Purpose: The Food and Nutrition for Manitoba Youth (FANS) study examined dietary intakes, food behaviours, food security status, health indicators, and body mass index of a cohort of grade 9 students. This paper describes regional differences and similarities in dietary intake (food and nutrients) and quality of youth participants in the FANS study.Methods: Grade 9 students completed a web-based survey on dietary intakes (24-hour recall), food behaviours, self-reported health indicators, and sociodemographic variables. Nutrient intakes were compared with national guidelines and diet quality was assessed using a modified Healthy Eating Index.Results: A total of 1587 students participated from northern, rural, and urban regions in Manitoba. Northern and rural students had higher intakes of sugar, sodium, and saturated fat compared with urban. Northern students consumed fewer grain products compared to urban, and more servings of "other" foods compared with rural and urban. While most participants were classified into the "needs improvement" or "poor" Healthy Eating Index categories, significantly more northern participants were in the "poor" category.Conclusions: Most adolescents in the study are at nutritional risk; however, there are additional vulnerabilities for those in rural and northern communities. Dietitians can use results to advocate for and plan interventions to improve adolescent nutrition.
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Affiliation(s)
- Joyce Slater
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, MB
| | - Alan Katz
- Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB
- Department of Family Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB
| | - Bhanu Pilli
- Department of Food and Human Nutritional Sciences, University of Manitoba, Winnipeg, MB
| | - Aynslie Hinds
- Department of Psychology, University of Winnipeg, Winnipeg, MB
| | - Marcelo L Urquia
- Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB
| | | | - Chris Green
- Winnipeg Regional Health Authority, Winnipeg, MB
| | - Jaime Cidro
- Department of Anthropology, University of Winnipeg, Winnipeg, MB
| | - Dan Chateau
- Research School of Population Health, Australian National University, Canberra ACT
| | - Nathan Nickel
- Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, MB
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Gaudin V, Stranges S, Wilk P, Sarma S. School nutrition policy and diet quality of children and youth: a quasi-experimental study from Canada. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2023; 114:613-628. [PMID: 36976487 PMCID: PMC10351299 DOI: 10.17269/s41997-023-00743-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 01/10/2023] [Indexed: 03/29/2023]
Abstract
OBJECTIVE We investigated the impact of mandatory school nutrition policy on diet quality of Canadian school children using a quasi-experimental study design. METHODS Using 24-h dietary recall data from the 2004 Canadian Community Health Survey (CCHS) Cycle 2.2 and 2015 CCHS - Nutrition, we constructed the Diet Quality Index (DQI). We used multivariable difference-in-differences regressions to quantify the DQI scores associated with school nutrition policy. We conducted stratified analyses by sex, school grade, household income, and food security status to gain additional insights into the impact of nutrition policy. RESULTS We found that mandatory school nutrition policy was associated with an increased DQI score by 3.44 points (95% CI: 1.1, 5.8) during school-hours in intervention provinces relative to control provinces. DQI score was higher among males (3.8 points, 95% CI: 0.6, 7.1) than among females (2.9 points, 95% CI: -0.5, 6.3), and the score among students in elementary schools was higher (5.1 points, 95% CI: 2.3, 8.0) than that among high school students (0.4 points, 95% CI: -3.6, 4.5). We also found that DQI scores were higher for middle-high income and food secure households. CONCLUSION Provincial mandatory school nutrition policy was associated with better diet quality among children and youth in Canada. Our findings suggest that other jurisdictions may consider implementing mandatory school nutrition policy.
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Affiliation(s)
- Victoria Gaudin
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western Centre for Public Health and Family Medicine, University of Western Ontario, Room 313, 11465 Richmond Street, London, ON, N6G 2M1, Canada
| | - Saverio Stranges
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western Centre for Public Health and Family Medicine, University of Western Ontario, Room 313, 11465 Richmond Street, London, ON, N6G 2M1, Canada
- Department of Family Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
- Department of Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Piotr Wilk
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western Centre for Public Health and Family Medicine, University of Western Ontario, Room 313, 11465 Richmond Street, London, ON, N6G 2M1, Canada
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Department of Epidemiology, Maastricht University, Maastricht, the Netherlands
| | - Sisira Sarma
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western Centre for Public Health and Family Medicine, University of Western Ontario, Room 313, 11465 Richmond Street, London, ON, N6G 2M1, Canada.
- Institute for Clinical Evaluative Sciences (ICES), Toronto, ON, Canada.
- Lawson Health Research Institute, London, ON, Canada.
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Guedes DP, Zuppa MA, Yamaji BHS. Health-promoting domains and lifestyle of a sample of Brazilian adolescents. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:83. [PMID: 37288419 PMCID: PMC10243423 DOI: 10.4103/jehp.jehp_1024_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 10/10/2022] [Indexed: 06/09/2023]
Abstract
BACKGROUND Reports indicate that the health habits of adults are strongly linked to the behaviors incorporated in adolescence. Therefore, it is essential to monitor the lifestyle of adolescents to promote their present and future health. This study aimed to identify differences in health-promoting domains according to demographic data and lifestyle behaviors, including physical activity, sedentary behavior, sleep duration, and food intake, in a sample of Brazilian adolescents. MATERIALS AND METHODS Cross-sectional school-based study, with the participation of 306 adolescents aged 14 to 18 years. A questionnaire was applied with structured questions to collect demographic data and lifestyle behaviors. To examine the health-promoting domains the Adolescent Health Promotion Scale (AHPS) was used. Data were analyzed using multivariate analysis. RESULTS Scores attributed to each of the health-promoting domains showed substantial variations according to sex, age, year of study, parents' schooling, and family economic class. After adjustment for covariables, the adolescent who presented significantly higher scores equivalent to the overall index of health promotion reported being more physically active (F = 4.848; P = 0.009), sleeping 6-8 hours/night (F = 2.328; P = 0.046), consuming fruit/vegetable more frequently (F = 3.168; P = 0.024), while sedentary behavior and intake of sweetened products/soft drinks have not shown any significant effect. CONCLUSION The findings confirmed the consistent positive influence of health-promoting domains assessed by AHPS on healthy lifestyle behaviors, suggesting in the intervention programs aimed at adopting healthy lifestyle approaches it is important enough to contemplate actions aimed at all the areas of health promotion with characteristics aimed at nutrition behavior, social support, health responsibility, life appreciation, exercise behavior, and stress management.
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Woods N, Seabrook JA, Haines J, Stranges S, Minaker L, O’Connor C, Doherty S, Gilliland J. Breakfast Consumption and Diet Quality of Teens in Southwestern Ontario. Curr Dev Nutr 2023; 7:100003. [PMID: 37180078 PMCID: PMC10111595 DOI: 10.1016/j.cdnut.2022.100003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 09/27/2022] [Accepted: 10/06/2022] [Indexed: 12/24/2022] Open
Abstract
Background Breakfast skipping has previously been associated with worse diet quality among adolescents; the latter increases the risk of chronic disease. However, many studies do not consider diet quality as a function of calories, which is problematic as skippers tend to consume less energy than consumers. Additionally, due to the lack of one accepted definition of both breakfast skipping and diet quality, it is unclear how differences found may change when using varying definitions. Objectives We aimed to compare the Healthy Eating Index-2015 (HEI-2015) scores and nutrient intakes of teen breakfast skippers and consumers in Southwestern Ontario, Canada. Methods Cross-sectional, baseline data were used from SmartAPPetite, an ongoing nutrition intervention study. Singular 24-h dietary recalls and sociodemographic data from 512 adolescents aged 13-19 y were used to compare HEI-2015 scores and nutrient intakes via multivariable linear regression. Results Previous day breakfast skippers had significantly lower HEI-2015 scores (-4.4; 95% CI: -8.4, -0.4) and significantly lower intakes of calories, saturated fat, and vitamin C, as well as significantly higher intake of sodium and total fat. Conclusions Previous day breakfast consumers had significantly higher diet quality scores and better nutrient intakes than breakfast skippers, although, on average, both had poor diet quality. Consequently, it is unlikely that simply advising teens to consume breakfast will result in meaningful change in diet quality, and more effort should be placed on promoting nutritious breakfasts.
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Affiliation(s)
- Nicolas Woods
- Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada
- Department of Epidemiology & Biostatistics, The University of Western Ontario, London, Ontario, Canada
- Human Environments Analysis Laboratory, The University of Western Ontario, London, Ontario, Canada
| | - Jamie A. Seabrook
- Department of Epidemiology & Biostatistics, The University of Western Ontario, London, Ontario, Canada
- Human Environments Analysis Laboratory, The University of Western Ontario, London, Ontario, Canada
- School of Food and Nutritional Sciences, Brescia University College, London, Ontario, Canada
- Children’s Health Research Institute, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
- Department of Paediatrics, The University of Western Ontario, London, Ontario, Canada
| | - Jess Haines
- Human Environments Analysis Laboratory, The University of Western Ontario, London, Ontario, Canada
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
| | - Saverio Stranges
- Department of Epidemiology & Biostatistics, The University of Western Ontario, London, Ontario, Canada
- Human Environments Analysis Laboratory, The University of Western Ontario, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
- Department of Family Medicine, The University of Western Ontario, London, Ontario, Canada
- Department of Medicine, The University of Western Ontario, London, Ontario, Canada
- Department of Population Health, Luxembourg Institute of Health, Strassen, Luxembourg
- Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Leia Minaker
- Human Environments Analysis Laboratory, The University of Western Ontario, London, Ontario, Canada
- School of Planning, University of Waterloo, Waterloo, Ontario, Canada
| | - Colleen O’Connor
- Human Environments Analysis Laboratory, The University of Western Ontario, London, Ontario, Canada
- School of Food and Nutritional Sciences, Brescia University College, London, Ontario, Canada
| | - Sean Doherty
- Human Environments Analysis Laboratory, The University of Western Ontario, London, Ontario, Canada
- Department of Geography and Environmental Studies, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Jason Gilliland
- Faculty of Health Sciences, The University of Western Ontario, London, Ontario, Canada
- Department of Epidemiology & Biostatistics, The University of Western Ontario, London, Ontario, Canada
- Human Environments Analysis Laboratory, The University of Western Ontario, London, Ontario, Canada
- Children’s Health Research Institute, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
- Department of Paediatrics, The University of Western Ontario, London, Ontario, Canada
- Department of Geography and Environment, The University of Western Ontario, London, Ontario, Canada
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Suleman S, Sweeney-Magee M, Pinkney S, Charbonneau K, Banh K, Hale I, Amed S. Evaluation of two social norms nudge interventions to promote healthier food choices in a Canadian grocery store. BMC Public Health 2022; 22:1946. [PMID: 36266681 PMCID: PMC9583495 DOI: 10.1186/s12889-022-14370-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 10/11/2022] [Indexed: 11/10/2022] Open
Abstract
The objective of this study was to determine the impact of two nudge interventions on customers’ produce purchases at a rural Canadian grocery store. A pre- and post-intervention observational study design was used. Sales data were gathered before and after the staggered implementation of two nudge-based interventions to encourage produce purchases: grocery cart dividers to encourage shoppers to fill one-third of their cart with produce and grocery cart plaques with information about how many fruits and vegetables were typically purchased in the store. The proportion of total sales accounted for by produce was compared between baseline and implementation of the first intervention (Phase 1), between implementation of the first intervention and the addition of the second intervention (Phase 2), and between baseline and post-implementation of both interventions together. There was a 5% relative increase (0.5% absolute increase) in produce spending between baseline and post-implementation of both interventions (10.3% to 10.8%, p < 0.001, 95% CI 0.2%, 0.7%). Intervention phase-specific produce spending showed no significant change in the percentage of produce spending from baseline to Phase 1 of the intervention, and an 8% relative increase (0.8% absolute increase) in the percentage of produce spending from Phase 1 to Phase 2 of the intervention (10.3% to 11.1%, p < 0.001, 95% CI 0.5, 1.1%). Simple, low-cost nudge interventions were effective at increasing the proportion of total grocery spend on produce. This study also demonstrated that partnerships with local businesses can promote healthier food choices in rural communities in Canada.
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Affiliation(s)
- Selina Suleman
- British Columbia Children's Hospital Research Institute, 4480 Oak Street, Vancouver, BC, V6H 3V4, Canada
| | - Molly Sweeney-Magee
- British Columbia Children's Hospital Research Institute, 4480 Oak Street, Vancouver, BC, V6H 3V4, Canada
| | - Susan Pinkney
- British Columbia Children's Hospital Research Institute, 4480 Oak Street, Vancouver, BC, V6H 3V4, Canada
| | - Kimberly Charbonneau
- British Columbia Children's Hospital Research Institute, 4480 Oak Street, Vancouver, BC, V6H 3V4, Canada
| | - Kelly Banh
- British Columbia Children's Hospital Research Institute, 4480 Oak Street, Vancouver, BC, V6H 3V4, Canada
| | - Ilona Hale
- Department of Family Practice, 3rd Floor David Strangway Building, 5950 University Boulevard, Vancouver, BC, V6T 1Z3, Canada
| | - Shazhan Amed
- British Columbia Children's Hospital Research Institute, 4480 Oak Street, Vancouver, BC, V6H 3V4, Canada. .,Department of Pediatrics, University of British Columbia, 4480 Oak Street, Vancouver, BC, K4-213, Canada.
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McEachern LW, Ismail MR, Seabrook JA, Gilliland JA. Fruit and Vegetable Intake Is Associated with Food Knowledge among Children Aged 9–14 Years in Southwestern Ontario, Canada. CHILDREN 2022; 9:children9101456. [PMID: 36291393 PMCID: PMC9600281 DOI: 10.3390/children9101456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/15/2022] [Accepted: 09/19/2022] [Indexed: 11/22/2022]
Abstract
Interventions to improve dietary quality and intake of fruits and vegetables (FV) among Canadian children have had modest success, and it has been suggested that food knowledge could be key to improvement. Programs have been criticized for insufficiently connecting food knowledge with food skills and decision making about dietary intake. The objective of this study was to investigate factors associated with FV consumption by elementary school children, aged 9–14 years, in Ontario, Canada, including food knowledge, socioeconomic status, sociodemographic characteristics, and the food environment. In 2017–2019, a cross-sectional survey was administered to 2443 students at 60 elementary schools across Southwestern Ontario (SWO), Canada. A parent survey was used to validate self-reported sociodemographic variables. The mean intake of FV reported by these participants was 2.6 (SD 1.1) and 2.4 (SD 1.2) servings/day, respectively. A FV intake below WHO guidelines was reported by 40.7% of respondents. Knowledge score, child age, and parent employment status significantly predicted higher reported intake of FV. This study shows that FV intake among this population group is low, and increased intake is associated with higher food knowledge. To encourage healthy eating, school-based food and nutrition programs that incorporate multiple components and emphasize food literacy are needed.
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Affiliation(s)
- Louise W. McEachern
- Human Environments Analysis Laboratory, Western University, London, ON N6A 3K7, Canada
- Department of Geography and Environment, Western University, London, ON N6A 5C2, Canada
| | - Mariam R. Ismail
- Human Environments Analysis Laboratory, Western University, London, ON N6A 3K7, Canada
- School of Health and Rehabilitation Sciences, Western University, London, ON N6A 3K7, Canada
| | - Jamie A. Seabrook
- Human Environments Analysis Laboratory, Western University, London, ON N6A 3K7, Canada
- School of Food and Nutritional Sciences, Brescia University College, London, ON N6G 1H2, Canada
- Department of Paediatrics, School of Health Studies, Western University, London, ON N6A 3K7, Canada
- Department of Epidemiology and Biostatistics, Western University, London, ON N6A 5C1, Canada
- Children’s Health Research Institute, Lawson Health Research Institute, London, ON N6C 2V5, Canada
| | - Jason A. Gilliland
- Human Environments Analysis Laboratory, Western University, London, ON N6A 3K7, Canada
- Department of Geography and Environment, Western University, London, ON N6A 5C2, Canada
- Department of Paediatrics, School of Health Studies, Western University, London, ON N6A 3K7, Canada
- Department of Epidemiology and Biostatistics, Western University, London, ON N6A 5C1, Canada
- Children’s Health Research Institute, Lawson Health Research Institute, London, ON N6C 2V5, Canada
- Schulich School of Medicine and Dentistry, Western University, London, ON N6A 5C1, Canada
- Correspondence:
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Reagan R, Woodruff SJ, Seabrook JA, Gilliland J. A randomized control trial of a Canadian-based school food program on the home food environment. Health Promot Int 2022; 37:6648070. [PMID: 35862774 DOI: 10.1093/heapro/daac087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Research provides evidence of take-home effects in school-based nutrition interventions, citing children as important influencers of family nutrition, acting as agents of change in the household and potentially influencing family food consumption. Therefore, the purpose of this randomized control trial was to examine whether implementation of a centrally procured school food program would produce changes in children's home food environment, including fruit and/or vegetable availability and parental modelling of fruit and/or vegetable consumption. A secondary objective was to investigate whether children's fruit and/or vegetable intake predicted their parent's fruit and/or vegetable intake. A total of 60 schools participated in the evaluation, including 2443 students (and their parents) in grades 5-8. Findings indicated that the intervention did not produce take-home effects on children's home availability of fruit (p = 0.52) and vegetables (p = 0.67) or parental modelling of fruit (p = 0.26) and vegetable consumption (p = 0.78), which may be related to the fact that only food provisions were given. However, children's fruit and vegetable consumption predicted parents' fruit and vegetable consumption (p < 0.001), thereby indicating that children may possess the capacity to influence home nutrition. Future school-based nutrition interventions are recommended to be multi-component (e.g. experiential learning, parent involvement) and that encourage nutrition leadership opportunities for children in the home context.
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Affiliation(s)
- Rebecca Reagan
- Department of Kinesiology, University of Windsor, 401 Sunset Ave, Windsor, ON, N9B 3P4, Canada
| | - Sarah J Woodruff
- Department of Kinesiology, University of Windsor, 401 Sunset Ave, Windsor, ON, N9B 3P4, Canada
| | - Jamie A Seabrook
- School of Food and Nutritional Sciences, Brescia University College at Western University, 1285 Western Rd, London, ON, N6G 1H2, Canada.,Department of Paediatrics, Western University, 1151 Richmond St, London, ON, N6A 3K7, Canada.,Department of Epidemiology & Biostatistics, Western University, 1151 Richmond St, London, ON, N6A 3K7, Canada
| | - Jason Gilliland
- Department of Paediatrics, Western University, 1151 Richmond St, London, ON, N6A 3K7, Canada.,Department of Epidemiology & Biostatistics, Western University, 1151 Richmond St, London, ON, N6A 3K7, Canada.,Department of Geography, Western University, 1151 Richmond St, London, ON, N6A 3K7, Canada.,School of Health Studies, Western University, 1151 Richmond St, London, ON, N6A 3K7, Canada
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Ismail MR, Gilliland JA, Matthews JI, Battram DS. Process evaluation of the Centrally Procured School Food Program (CPSFP) in Ontario, Canada: school-level perspectives. HEALTH EDUCATION RESEARCH 2022; 36:554-567. [PMID: 34191009 DOI: 10.1093/her/cyab023] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 04/19/2021] [Accepted: 05/20/2021] [Indexed: 06/13/2023]
Abstract
This study explored the implementation of the Centrally Procured School Food Program (CPSFP)-a free, universal, volunteer-led snack program for elementary school children. To assess participants' perceptions and experiences with the CPSFP, interviews were conducted in school-level participants (n = 33) using a semi-structured interview guide. Fifteen on-site visits also were conducted at each school to observe implementation practices. Quantitative data were obtained through a general information form where participants provided school characteristics and weekly logbooks where they described program operations and food quality. Most participants expressed positive perceptions of the CPSFP, identifying it as a valuable program for their students. Successful program implementation was associated with an appreciation for the CPSFP and the participation of the school community. Challenges to program implementation included concerns with the volume and types of food provided, issues with classroom food delivery and distribution and communication challenges. Suggestions for improvement included building capacities and enhancing student engagement in the program. Participants provided an in-depth assessment of the implementation of the CPSFP. The lessons learned and suggestions provided may help not only enhance the reach, feasibility and fidelity of the CPSFP, but inform the best practices for similar programs.
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Colley P, Seabrook JA, Woodruff SJ, Gilliland J. Examining Elementary School Children's Knowledge about Food and Nutrition in Southwestern Ontario, Canada. CAN J DIET PRACT RES 2022; 83:59-67. [PMID: 35014546 DOI: 10.3148/cjdpr-2021-037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Purpose: Knowledge is fundamental to helping children make nutritional choices that support lifelong healthy behaviours. This study (i) investigates elementary school children's knowledge about food and nutrition and (ii) identifies sociodemographic factors influencing children's reported knowledge.Methods: In 2017-2019, a survey was administered to 2443 students (grades 5-8) at 60 schools across southwestern Ontario, Canada, and a parent survey was used to validate self-reported sociodemographics. Multiple regression was used to analyse children's knowledge scores and related sociodemographic factors. A total knowledge score was calculated by summing correct responses derived from 46 individual questions in the student survey.Results: Mean total knowledge score was 29.2 out of a possible 46 points (63.5% correct). Students demonstrated some knowledge and awareness of strategies to encourage fruit and vegetable consumption, healthy food selection, nutrition, and food preparation skills, although knowledge of food guide recommendations and locally sourced produce were limited. Female sex, family income, and rurality were associated with higher knowledge scores.Conclusions: Results provide insight regarding strengths and gaps in elementary-school children's food and nutrition knowledge. Poor performance of students on specific food guide-related questions suggests that the general guidance of the 2019 Canada's Food Guide might be better understood by children and adolescents.
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Affiliation(s)
- Paige Colley
- Health and Rehabilitation Sciences, Western University, London, ON
| | - Jamie A Seabrook
- School of Food and Nutritional Sciences, Brescia University College at Western University, London, ON
| | | | - Jason Gilliland
- Department of Geography and Environment, Western University, London, ON
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Ismail MR, Seabrook JA, Gilliland JA. Outcome evaluation of fruits and vegetables distribution interventions in schools: a systematic review and meta-analysis. Public Health Nutr 2021; 24:4693-4705. [PMID: 33866997 PMCID: PMC10195380 DOI: 10.1017/s1368980021001683] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 03/10/2021] [Accepted: 04/13/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Fruits and vegetables (FV) distribution interventions have been implemented as a public health strategy to increase children's intake of FV at school settings. The purpose of this review was to examine whether snack-based FV distribution interventions can improve school-aged children's consumption of FV. DESIGN Systematic review and meta-analysis of articles published in English, in a peer-reviewed journals, were identified by searching six databases up to August 2020. Standardised mean differences (SMD) and 95 % CI were calculated using a random effects model. Heterogeneity was quantified using I2 statistics. SETTING Population-based studies of interventions where the main focus was the effectiveness of distributed FV as snacks to schoolchildren in North America, Europe and Pacific were included. RESULTS Forty-seven studies, reporting on fifteen different interventions, were identified; ten studies were included in the meta-analysis. All interventions were effective in increasing children's consumption of FV, with only one intervention demonstrating a null effect. Pooled results under all classifications showed effectiveness in improving children's consumption of FV, particularly for multi-component interventions at post-intervention (SMD 0·20, 95 % CI 0·13, 0·27) and free distribution interventions at follow-up (SMD 0·19, 95 % CI 0·12, 0·27). CONCLUSIONS Findings suggest that FV distribution interventions provide a promising avenue by which children's consumption can be improved. Nonetheless, our results are based on a limited number of studies, and further studies should be performed to confirm these results. More consistent measurement protocols in terms of rigorous study methodologies, intervention duration and follow-up evaluation are needed to improve comparability across studies.
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Affiliation(s)
- Mariam R Ismail
- School of Health and Rehabilitation Sciences, Western University, London, ON, Canada
| | - Jamie A Seabrook
- School of Food and Nutritional Sciences, Brescia University College; Department of Pediatrics, Department of Epidemiology & Biostatistics, Western University; Children’s Health Research Institute, Lawson Health Research Institute, London, ON, Canada
| | - Jason A Gilliland
- Department of Geography & Environment, School of Health Studies, Department of Pediatrics, Department of Epidemiology & Biostatistics, Western University; Children’s Health Research Institute, Lawson Health Research Institute, 1151 Richmond Street, London, ONN6A 3K7, Canada
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Kholina K, Grant A, Waddington M, Egbe M, Grant S, Terashima M, Williams PL. In-store food environment for adults and children in Nova Scotia, Canada. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2021; 112:430-439. [PMID: 33237485 PMCID: PMC8076380 DOI: 10.17269/s41997-020-00431-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 10/06/2020] [Indexed: 01/17/2023]
Abstract
OBJECTIVES This paper examines the retail food environment in grocery and convenience stores across Nova Scotia with specific attention to prominence and promotion of foods and beverages, as well as in-store promotion of foods and beverages to children. METHODS A descriptive cross-sectional analysis of data on the availability, price, prominence, and promotion of foods and beverages classified as "healthier" and "less healthy" was undertaken as a part of a Nova Scotia Consumer Food Environment (NS-CFE) project. Data were collected in a random stratified sample of 47 grocery stores and 59 convenience stores by trained research assistants working in pairs using adapted Nutrition Environment Measures Survey Toronto grocery store (NEMS-S) and NEMS Corner Store (NEMS-CS) tools. RESULTS "Less healthy" snack foods and sugar-sweetened beverages were more prominently displayed than "healthier" options with an exception of cereal, at both grocery and convenience stores (all p < 0.001). Coke™ and fruit juice were more expensive than water in both grocery and convenience stores (both p ≤ 0.05). Significantly more child-specific strategies were used to promote "less healthy" compared with "healthier" options in both grocery and convenience stores (both p < 0.001). CONCLUSION Results of this study demonstrate that "less healthy" options are significantly more prominently displayed and more heavily marketed to all Nova Scotians, including children, in the retail food environment compared with items classified as "healthier". These findings indicate that there is a need for comprehensive structural changes to the retail food environment in Nova Scotia, to support population health.
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Affiliation(s)
- Ksenia Kholina
- Food Action Research Centre (FoodARC) and Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Amy Grant
- Maritime SPOR Support Unit and Nova Scotia Health Authority, Halifax, Canada
| | | | - Manfred Egbe
- Food Action Research Centre (FoodARC) and Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Shannan Grant
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, Canada
- Department of Pediatrics, IWK Health Centre and Department of Pediatrics, Dalhousie University, Halifax, Canada
| | - Mikiko Terashima
- School of Planning, Department of Community Health and Epidemiology, Dalhousie University, Halifax, Canada
| | - Patricia L Williams
- Food Action Research Centre (FoodARC) and Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, Nova Scotia, Canada.
- Healthy Populations Institute, Dalhousie University, Halifax, Canada.
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Nutrition across the curriculum: a scoping review exploring the integration of nutrition education within primary schools. Nutr Res Rev 2021; 35:181-196. [PMID: 33926596 DOI: 10.1017/s0954422421000111] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Primary schools contribute to promoting healthy eating behaviour and preventing overweight and obesity by providing nutrition education. Research highlights the importance of improving teachers' programme implementation to enhance intervention effectiveness. An integrative approach has been suggested to reduce time barriers that teachers currently experience in teaching nutrition. This scoping review explores use and effectiveness of integrative teaching in primary-school-based nutrition education programmes. Six databases were searched for primary-school-based interventions on nutrition education. Papers reporting on integration of nutrition topics within core curriculum were included. Abstracts and full texts of potentially relevant articles were screened to determine eligibility. Next, data were extracted and tabulated. Findings were collated and summarised to describe intervention characteristics, subject integration and effectiveness of the included programmes. Data describing integration of nutrition into the primary school curriculum were extracted from 39 eligible papers. Nutrition education programmes often involve lessons about food groups and are frequently embedded within the mathematics, science or literacy syllabus. Although articles report on the integration of nutrition, the use of this approach was not commonly described in detail. Only seven papers discussed student outcomes related to the integration of nutrition education within core subjects. The ability to draw strong conclusions about school-based nutrition intervention effectiveness is limited by the current lack of programme description and methodological issues. Hence, more research is warranted to inform evidence on effectiveness of integrative nutrition education for both teacher and student outcomes. Future studies that include greater detail regarding the integrative approach are needed.
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Colley P, Miller L, Seabrook JA, Woodruff SJ, Gilliland J. Children's perceptions of a Centrally Procured School Food Program in southwestern Ontario, Canada. HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION IN CANADA-RESEARCH POLICY AND PRACTICE 2021; 41:131-137. [PMID: 33851812 DOI: 10.24095/hpcdp.41.4.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION This qualitative study investigates children's perceptions of the influences of a Centrally Procured School Food Program on their dietary behaviours and their recommendations on how to improve the program. METHODS The observations of 208 students aged 9 to 14 years (Grades 5-8) at 21 elementary schools were collected through focus groups in 2017/18. The larger intervention consisted of a 10-week program offering daily snacks (i.e. fruit, vegetables, whole grains, dairy, meat alternatives) for elementary school children in southwestern Ontario, Canada. RESULTS The participants' overall impressions of the program were positive. They noted reduced hunger, increased energy and improved nutrition. Many children felt that the program changed their dietary patterns at home as well as at school, particularly in terms of eating more fruit and vegetables. The snack program also enabled children to try healthy foods. CONCLUSION Most participants considered the program to be beneficial in promoting healthy eating. Participants recommended adding educational activities, expanding the variety of foods and increasing child involvement in selecting and preparing foods.
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Affiliation(s)
| | | | - Jamie A Seabrook
- Western University, London, Ontario, Canada.,Brescia University College, London, Ontario, Canada
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Ismail MR, Seabrook JA, Gilliland JA. Process evaluation of fruit and vegetables distribution interventions in school-based settings: A systematic review. Prev Med Rep 2020; 21:101281. [PMID: 33364152 PMCID: PMC7753971 DOI: 10.1016/j.pmedr.2020.101281] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 11/19/2020] [Accepted: 12/01/2020] [Indexed: 12/18/2022] Open
Abstract
Assesses how school fruit & vegetable distribution interventions are implemented. Child fruit & vegetable intake is influenced by how intervention is implemented. Recommendations for implementing fruit & vegetable interventions in schools. Studies should also consider sustainability, cost-effectiveness and implementation.
Despite the importance of process evaluation in program evaluations, research has focused primarily on the effectiveness of fruit and vegetables (FVs) distribution interventions on children’s consumption, with little attention given to how these interventions achieve their outcomes. Five bibliographic databases (Embase, PubMed, ProQuest, Scopus, and Web of Science Core Collection) were searched in June 2019 for studies of interventions where the main focus was the implementation of distributed FVs to school-aged children as a snack. The Critical Appraisal Skills Programme (CASP) tool was used to appraise the risk of bias within included studies. Data were extracted based on study characteristics and findings. Results identified 24 studies reporting on 11 interventions and 1 policy. The findings of this systematic review indicate that the majority of the studies included limited references to implementation research. Recurring limitations include an absence of an evaluation theoretical framework and the data collection methods used. Also, several factors were identified as informing the success of snack-based FVs distribution programs, including participation of the school community, school characteristics, background knowledge, and parental engagement. Lack of timely FVs delivery, limited funding, inadequate awareness about the program, insufficient teachers’ time, and food waste were identified as challenges to successful programming. Findings indicate that distributing FVs to school-aged children as a snack can increase their consumption, but only with proper implementation. Further evaluative research is required to better inform future implementation of snack-based FV distribution interventions in school settings.
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Affiliation(s)
- Mariam R Ismail
- School of Health and Rehabilitation Sciences, Western University, London, Ontario, Canada
| | - Jamie A Seabrook
- School of Food and Nutritional Sciences, Brescia University College, Department of Paediatrics, Department of Epidemiology and Biostatistics, Human Environments Analysis Laboratory, Western University, Children's Health Research Institute, Lawson Health Research Institute, London, Ontario, Canada
| | - Jason A Gilliland
- Department of Geography, School of Health Studies, Department of Paediatrics, Department of Epidemiology & Biostatistics, Human Environments Analysis Laboratory, Western University, Children's Health Research Institute, Lawson Health Research Institute, London, Ontario, Canada
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Fruit and Vegetable Lesson Plan Pilot Intervention for Grade 5 Students from Southwestern Ontario. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228422. [PMID: 33203027 PMCID: PMC7697685 DOI: 10.3390/ijerph17228422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 10/28/2020] [Accepted: 11/12/2020] [Indexed: 12/15/2022]
Abstract
The purpose was to create and assess the impact of food literacy curriculum alongside a centrally procured school snack program among grade five students in Southwestern Ontario, Canada. Grade five students (N = 287) from five intervention and three controls schools participated in an 8-week food delivery program. In addition to the food delivery program, intervention schools received a resource kit and access to 42 multidisciplinary food literacy lesson plans using the produce delivered as part of the food delivery program. Participants completed matched pre- and post-test online surveys to assess fruit and vegetable intake, knowledge, preferences, and attitudes. Descriptive analyses and changes in scores between the intervention and control schools were assessed using one-way ANOVAs, paired samples t-tests, and McNemar’s tests. In total, there were 220 participants that completed both the pre- and post-test surveys. There was a significant improvement in fruit and vegetable intake (p = 0.038), yet no differences in knowledge of the recommended number of food group servings, knowledge of food groups, or fruit and vegetable preferences or attitudes were observed. Integrating nutrition lesson plans within core curricula classes (e.g., math, science, and literacy) can lead to modest increases in fruit and vegetable intake.
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Pourrostami K, Heshmat R, Hemati Z, Heidari-Beni M, Qorbani M, Motlagh ME, Raeisi A, Shafiee G, Ziaodini H, Beshtar S, Taheri M, Mahdavi-Gorabi A, Aminaei T, Kelishadi R. Association of fruit and vegetable intake with meal skipping in children and adolescents: the CASPIAN-V study. Eat Weight Disord 2020; 25:903-910. [PMID: 31098987 DOI: 10.1007/s40519-019-00704-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Accepted: 04/27/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND There are few studies on the association of main meal consumption with fruit and vegetable intake. This study aims to assess the relation between skipping main meals and fruit and vegetable intake in children and adolescents. METHODS This multi-centric cross-sectional study was conducted in 30 provinces of Iran. This study was conducted in the framework of the fifth survey of a national surveillance program entitled Childhood and Adolescence Surveillance and Prevention of Adult Non-communicable Disease study (CASPIAN- V). 14,440 school students aged 7-18 years were assessed. Logistic regression analyses were used to evaluate the association between frequency of fruit and vegetable intake with skipping main meals. RESULTS Overall, 14,274 students completed the study (99% participation rate). Their mean (SD) age was 12.3 (3.2) (53% were aged 6-12), 50.6% of them were boys, and 71.3% lived in urban area. In multivariate logistic regression model, statistically significant associations were found between skipping main meals and low fruits and vegetables intake. Skipping breakfast was associated with vegetables intake [OR = 1.19(95% CI 1.02-1.38)] and fruits intake [OR = 5.33(95% CI 4.46-6.37)]. Skipping lunch was associated with vegetables intake [OR = 1.61(95% CI 1.29-1.96)] and fruit intake [OR = 9.11(95% CI 6.55-12.67)]. Skipping dinner was associated with vegetables intake [OR = 1.52 (95% CI 1.15-2.01)] and fruits intake [OR = 2.21(95% CI 1.64-2.97)]. CONCLUSIONS In this study, low frequency of fruit and vegetable intake was associated with skipping main meals. The results highlight the importance of promoting regular meal consumption with increase in the intake of fruit and vegetables among children and adolescents. LEVEL OF EVIDENCE Level V.
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Affiliation(s)
- Kumars Pourrostami
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zeinab Hemati
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Motahar Heidari-Beni
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mostafa Qorbani
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. .,Department of Community Medicine, Alborz University of Medical Sciences, Karaj, Iran.
| | | | - Alireza Raeisi
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Gita Shafiee
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hasan Ziaodini
- Bureau of Health and Fitness, Ministry of Education and Training, Tehran, Iran
| | - Shagayegh Beshtar
- Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
| | - Majzoubeh Taheri
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Armita Mahdavi-Gorabi
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Tahereh Aminaei
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Roya Kelishadi
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
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Food Co-Operatives: A Potential Community-Based Strategy to Improve Fruit and Vegetable Intake in Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17114154. [PMID: 32532100 PMCID: PMC7312496 DOI: 10.3390/ijerph17114154] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/05/2020] [Accepted: 06/09/2020] [Indexed: 12/22/2022]
Abstract
Only 5% of Australian children and adults eat enough fruit and vegetables. Two common barriers are high cost and limited access. Food co-operatives (‘co-ops’) may have the potential to reduce these barriers. We conducted a scoping analysis of food co-ops in the Sydney region to describe their characteristics and objectives. We also conducted a survey of members and non-members of co-ops to assess their fruit and vegetable intake using validated questions. Fifteen food co-ops were identified in the Sydney region and the most common objective was to provide cheap affordable produce. Most co-ops (61%) were in areas of high socio-economic status (SES). Members of food co-ops had a higher vegetable intake than non-members [mean difference (MD) = 0.54 serves/daily; 95% confidence interval (CI) of 0.15 to 0.93] and were also more likely to meet the recommendations for fruit and vegetable intake [odds ratio (OR) = 4.77 (95% CI = 1.15, 19.86)]. Implications of this study are that if food co-ops can be implemented on a wider scale, they hold potential for improving fruit and vegetable intakes.
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Vegetable intake in Australian children and adolescents: the importance of consumption frequency, eating occasion and its association with dietary and sociodemographic factors. Public Health Nutr 2019; 23:474-487. [PMID: 31551110 DOI: 10.1017/s136898001900209x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE We aimed to profile vegetable consumption and its association with dietary and sociodemographic factors. DESIGN Secondary analysis of a nationally representative nutrition survey. 'Vegetables' refers to non-discretionary 'vegetables and legumes/beans' as defined by the Australian Dietary Guidelines (ADG). Prevalence of vegetable consumption, frequency of intake, proportion meeting ADG recommendations, most popular food groups, intake at each reported eating occasion, and the profile of high and low vegetable consumers (based on the median servings) were determined. SETTING Australian 2011-2012 National Nutrition and Physical Activity Survey. PARTICIPANTS Children and adolescents aged 2 to 18 years (n 2812). RESULTS Vegetables were consumed by 83·0% (95% CI 81·6, 84·4%) of participants, but the median vegetable servings was less than a third of the ADG recommendations. 'Leaf and stalk vegetables' and 'potatoes' were the most popular vegetable-dense food groups at lunch and dinner, respectively. Sixty-four percent had vegetables once a day, and predominantly at dinner. Vegetable frequency was positively associated with daily vegetable servings and variety. Participants who consumed vegetables twice a day generally had vegetables at both lunch and dinner and had nearly double the servings (2·6, sd 1·9) of those who consumed them once (1·5, sd 1·5). High vegetable consumers were older, had higher total energy, but lower discretionary energy intake and were less likely to be at risk of metabolic complications. CONCLUSION Increasing the frequency of vegetable consumption may assist with increasing daily vegetable servings. A focus on consuming vegetables at lunch may assist with increasing both total servings and variety.
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Gatien SAR, Mann LL, Kirk SFL, Hernandez KJ, Rossiter M. Vegetable/Fruit Intakes of Young Children at Home and in Childcare Centres. CAN J DIET PRACT RES 2019; 81:15-20. [PMID: 31512496 DOI: 10.3148/cjdpr-2019-021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Purpose: The vegetable/fruit intakes of a sample of children attending regulated childcare in Nova Scotia was assessed and compared by age groups (3 and 4-5 year olds) and by home and childcare environments. Methods: Seventy-nine children had 3-4-day food records and 58 had records from both environments. The data were coded by the 2007 Canada's Food Guide (CFG) recommendations and the 2014 Classification of Foods in the Canadian Nutrient File according to CFG (CNF/CFG) Tiers. Descriptive statistics and tests of significance were determined. Results: Overall, 56% of children met the CFG vegetable/fruit recommendations but the percentage of older children meeting recommendations was half that of the younger age group; a significant difference. Fruit and juice comprised 65% of vegetable/fruit intakes with more consumed at home. Vegetable/fruit items were mostly from the higher quality CNF/CFG Tiers but more of the lower quality items were consumed at home. Conclusions: The 4-5 year olds may not be increasing their vegetable/fruit intakes as the CFG recommends. While just over half of children met CFG vegetable/fruit recommendations, the vegetable/fruit items were mostly high quality; fruit and juice predominated. Identification of strategies to support increased vegetable/fruit intakes of children in both home and childcare environments is warranted.
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Affiliation(s)
- Sarah A R Gatien
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS
| | - Linda L Mann
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS
| | - Sara F L Kirk
- School of Health and Human Performance, Dalhousie University, Halifax, NS
| | | | - Melissa Rossiter
- Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, PE
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Bélanger M, Dugas C, Perron J, Ruchat SM, Weisnagel SJ, Marc I, Tchernof A, Robitaille J. Association between lifestyle habits and adiposity values among children exposed and unexposed to gestational diabetes mellitus in utero. Diabetes Metab Syndr 2019; 13:2947-2952. [PMID: 31425961 DOI: 10.1016/j.dsx.2019.07.053] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 07/29/2019] [Indexed: 12/25/2022]
Abstract
AIMS The objectives of this study were to assess the profile of lifestyle habits among children exposed (GDM+) or unexposed (GDM-) to GDM and to assess whether a healthy lifestyle profile is associated with lower adiposity values among these children. METHODS A total of 105 GDM+ and 38 GDM- children aged 2-14 years were included. Vegetables and fruit intakes were collected using two 24-h dietary recalls. Physical activity and sedentary time were measured with accelerometers. Screen and sleep time were assessed using questionnaires. Weight, height and waist circumference were measured. Body composition was assessed by absorptiometry. RESULTS GDM+ children had lower moderate-to-vigorous physical activity practice (p = 0.043) and fruit intake (p = 0.020) than GDM- children. Among children with an unhealthy lifestyle (meeting 0-2 lifestyle recommendations), GDM+ children had greater percentage of fat mass (p = 0.021) and android fat mass (p = 0.020) than GDM- children. Moreover, among GDM+ children, children with a healthy lifestyle (meeting 3-4 lifestyle recommendations) tended to have lower percentage of fat mass (p = 0.053) and android fat mass (p = 0.071) than those with an unhealthy lifestyle. CONCLUSION Improving lifestyle habits among GDM+ children could represent a promising approach to prevent deteriorated adiposity values.
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Affiliation(s)
- Mélissa Bélanger
- School of Nutrition, Laval University, Québec, Québec, Canada; Institute of Nutrition and Functional Foods (INAF), Laval University, Québec, Québec, Canada
| | - Camille Dugas
- School of Nutrition, Laval University, Québec, Québec, Canada; Institute of Nutrition and Functional Foods (INAF), Laval University, Québec, Québec, Canada
| | - Julie Perron
- Institute of Nutrition and Functional Foods (INAF), Laval University, Québec, Québec, Canada
| | - Stephanie-May Ruchat
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
| | - S John Weisnagel
- Endocrinology and Nephrology Axis, CHU de Quebec Research Center, Québec, Québec, Canada; Diabetes Research Unit, Laval University Medical Research Center, Québec, Québec, Canada
| | - Isabelle Marc
- Department of Pediatrics, Laval University, CHU de Quebec Research Center, Québec, Québec, Canada
| | - André Tchernof
- School of Nutrition, Laval University, Québec, Québec, Canada; Quebec Heart and Lung Institute, Laval University, Québec, Québec, Canada
| | - Julie Robitaille
- School of Nutrition, Laval University, Québec, Québec, Canada; Institute of Nutrition and Functional Foods (INAF), Laval University, Québec, Québec, Canada; Endocrinology and Nephrology Axis, CHU de Quebec Research Center, Québec, Québec, Canada.
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Colley P, Myer B, Seabrook J, Gilliland J. The Impact of Canadian School Food Programs on Children’s Nutrition and Health: A Systematic Review. CAN J DIET PRACT RES 2019; 80:79-86. [DOI: 10.3148/cjdpr-2018-037] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
The quality of children’s diets has declined over the past few decades, giving rise to a variety of health-related consequences. In response to this trend, school food programs have become an increasingly effective method to support nutrition and lifelong healthy eating habits. This systematic review synthesizes current academic literature pertaining to school nutrition programs in Canada to identify existing interventions and their impacts on children’s nutritional knowledge, dietary behaviour, and food intake. The review was conducted through a search of the following databases: ERIC, Education Source, CINAHL, PubMed, SagePub, SCOPUS, EMBASE, and CBCA. Information extracted from the articles included the program objectives, intervention design and components, research evaluation, and primary outcomes. A total of 11 articles evaluating Canadian school nutrition programs were identified. The programs incorporated a variety of intervention components including policy, education, family and community involvement, and/or food provision. These multi-component interventions were positively associated with children’s development of nutrition knowledge, dietary behaviour changes, and intake of healthy foods; however, barriers associated with intervention duration, intensity, and availability of resources may have influenced the extent to which these programs impacted children’s diets and overall health.
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Affiliation(s)
- Paige Colley
- Health and Rehabilitation Sciences, Western University, London, ON
| | - Bronia Myer
- Medical Sciences and Psychology, Western University, London, ON
| | - Jamie Seabrook
- School of Food and Nutritional Sciences, Brescia University College at Western University, London, ON
- Department of Paediatrics and Epidemiology & Biostatistics, Western University, London, ON
| | - Jason Gilliland
- Department of Geography, Health Studies, Paediatrics, and Epidemiology & Biostatistics, Western University, London, ON
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Woodruff SJ. Fruit and Vegetable Intake and Preferences Associated with the Northern Fruit and Vegetable Program (2014–2016). CAN J DIET PRACT RES 2019; 80:72-78. [DOI: 10.3148/cjdpr-2018-042] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Purpose: To examine overall usual fruit and vegetable (FV) intake and preferences among grade 5–8 students participating in the Northern Fruit and Vegetable Program (NFVP) over 3 years (2014–2016). Methods: In each year, a survey was administered 4 months into the NFVP in Northern Ontario, Canada. Results: A total of 4744 students participated (2014 = 1551; 2015 = 1617; 2016 = 1576). Overall usual FV intake did not change over the 3 years, yet preferences generally increased. FVs offered by the NFVP were rated higher on preference than those not offered (fruit P < 0.001; vegetables P < 0.005). In each year, participants were more likely to consume a higher overall usual fruit intake if they had higher preference for fruit as offered by the NFVP (all P < 0.05) as opposed to not offered by the NFVP (all P > 0.05). For vegetables, participants were more likely to consume higher overall usual vegetables if they had a higher preference for vegetables as offered (all P < 0.05) and not offered by the NFVP (all P < 0.05). Conclusions: This study documented that higher preferences for fruit (as offered) and vegetables (as offered and not offered) were associated with higher overall usual FV intakes within each of the 3 years.
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Affiliation(s)
- Sarah J. Woodruff
- Department of Kinesiology, University of Windsor, 401 Sunset Avenue, Windsor, ON
- Department of Kinesiology, University of Windsor, 401 Sunset Avenue, Windsor, ON
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McIsaac JLD, Ata N, Kirk SFL. Describing Food Availability in Schools Using Different Healthy Eating Guidelines: Moving Forward with Simpler Nutrition Recommendations. CAN J DIET PRACT RES 2018; 80:22-29. [PMID: 30280920 DOI: 10.3148/cjdpr-2018-030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
PURPOSE Internationally, there is debate on whether a nutrient or a food-based approach to policy is more effective. This study describes the food/beverage availability in schools in Nova Scotia through a comparison of a traditional nutrient classification ("Maximum/Moderate/Minimum"), currently used in the provincial school policy and a simplified food-based system ("Core/Extra"). METHODS School food environment audits were conducted in schools (n = 25) to record the food and beverages available. Registered dietitians categorized information using both the nutrient-based and simplified food-based classification systems. Number and percent in each category were described for items. RESULTS Food and beverage items consisted of breakfast, lunch, snacks, beverages, and vending of which 81% were permissible by the policy, whereas only 54% were categorized as Core. Many snacks and vending items classified as Extra fell within either Moderate (45% and 35%, respectively) or Minimum (29% and 33%, respectively) categories. CONCLUSIONS Dietitians have a role to support interpretation of classification systems for school nutrition policies. The nutrient-based classification used in the policy permitted some items not essential to a healthy diet as defined by the Extra food-based classification. However, the food-based Core/Extra categorization had less detail to classify nutrients.
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Affiliation(s)
- Jessie-Lee D McIsaac
- a Healthy Populations Institute, Dalhousie University, Halifax, NS.,b Faculty of Education, Mount Saint Vincent University, Halifax, NS
| | - Nicole Ata
- a Healthy Populations Institute, Dalhousie University, Halifax, NS
| | - Sara F L Kirk
- a Healthy Populations Institute, Dalhousie University, Halifax, NS
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25
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Mihrshahi S, Myton R, Partridge SR, Esdaile E, Hardy LL, Gale J. Sustained low consumption of fruit and vegetables in Australian children: Findings from the Australian National Health Surveys. Health Promot J Austr 2018; 30:83-87. [PMID: 30175423 DOI: 10.1002/hpja.201] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 08/29/2018] [Indexed: 01/15/2023] Open
Abstract
ISSUE ADDRESSED Intakes of fruit and vegetables in children are inadequate. Our purpose was to examine national data on the proportion of Australian children meeting the fruit and vegetable recommendations in 2011-2012 and 2014-2015, assessing changes over time and differences by age, sex and socio-economic status (SES). METHODS Secondary analysis of 2011-2012 and 2014-2015 Australian National Health Surveys of Australian children aged 2-18 years. Percentages of children meeting fruit and vegetable recommendations by survey year, age group, sex and SES tertile were calculated using population weights supplied by the Australian Bureau of Statistics (ABS). Chi-squared tests and logistic regression were used to test for the relative influence of each factor. RESULTS In 2011-2012, 64.6%, 5.1% and 4.6% of children met the recommended intake for fruit, vegetable and fruit-vegetable combined, respectively. In 2014-2015, 68.2%, 5.3% and 5.1% of all children met the recommended intake for fruit, vegetable and fruit-vegetable combined, respectively. There was a large reduction in proportions of children meeting both the fruit and vegetable recommendations between 3 and 4 years of age, which coincides with when most Australian children start pre-school. There were consistent differences by sex for both fruit and vegetables, but we found little evidence that SES is a significant factor predicting the difference in meeting the vegetable recommendations. CONCLUSION The proportion of Australian children meeting fruit and vegetable recommendations are sub-optimal across all SES groups which suggests that a national approach across demographic strata is warranted. SO WHAT?: Future health promotion interventions should have a refocus on vegetables instead of "fruit and vegetables," particularly in the key transition period when children start pre-school.
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Affiliation(s)
- Seema Mihrshahi
- Prevention Research Collaboration, Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, NSW, Australia.,NHMRC Centre of Research Excellence in the Early Prevention of Obesity in Childhood, School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Rimma Myton
- Prevention Research Collaboration, Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Stephanie R Partridge
- Prevention Research Collaboration, Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Emma Esdaile
- Prevention Research Collaboration, Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, NSW, Australia.,NHMRC Centre of Research Excellence in the Early Prevention of Obesity in Childhood, School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Louise L Hardy
- Prevention Research Collaboration, Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Joanne Gale
- Prevention Research Collaboration, Faculty of Medicine and Health, School of Public Health, The University of Sydney, Sydney, NSW, Australia
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McIsaac JLD, Kontak JCH, Kirk SFL. Moving from Policy to Practice: A Report of School Nutrition Policy Adherence in Nova Scotia. CAN J DIET PRACT RES 2018; 79:196-199. [PMID: 30014717 DOI: 10.3148/cjdpr-2018-017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
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.
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Affiliation(s)
- Jessie-Lee D McIsaac
- a Healthy Populations Institute, School of Health and Human Performance, Dalhousie University, Halifax, NS.,b Faculty of Education and Department of Child and Youth Study, Mount Saint Vincent University, Halifax, NS
| | - Julia C H Kontak
- a Healthy Populations Institute, School of Health and Human Performance, Dalhousie University, Halifax, NS
| | - Sara F L Kirk
- a Healthy Populations Institute, School of Health and Human Performance, Dalhousie University, Halifax, NS
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