1
|
Patte KA, Duncan MJ, Amores A, Belita E, Kocsis R, Riazi NA, Laxer R, Leatherdale ST. Inequities in dietary intake and eating behaviours among adolescents in Canada. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2024; 115:507-520. [PMID: 38381304 PMCID: PMC11133286 DOI: 10.17269/s41997-024-00854-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 01/17/2024] [Indexed: 02/22/2024]
Abstract
OBJECTIVE To provide contemporary evidence of how dietary intake and eating behaviours vary by social positions among adolescents. METHODS We used survey data collected during the 2020-2021 school year from 52,138 students attending 133 secondary schools in Alberta, British Columbia, Ontario, and Quebec, Canada. Multiple regression models tested whether self-reported indicators of dietary intake and eating behaviours differed by gender, race/ethnicity, and socioeconomic status (SES). RESULTS Females were more likely than males to skip breakfast, restrict eating, and consume fruit, vegetables, and fast food on more days. Gender-diverse/"prefer not to say" students were more likely to restrict eating than males and the least likely to consume breakfast and drink water daily, and fruits and vegetables regularly. Black and Latin American students were more likely to restrict eating and consume purchased snacks and fast food, and less likely to drink water daily than white and Asian adolescents. Daily breakfast consumption was most likely among Latin American students. Black students were the least likely to report eating breakfast daily and fruits and vegetables regularly. Lower SES was associated with lower odds of eating breakfast and drinking water daily and regular fruit and vegetable consumption, and higher odds of restrictive eating and purchased snack consumption. Fast food consumption had a u-shaped association with SES. CONCLUSION Results emphasize gender, racial/ethnic, and socioeconomic inequities in the diets and eating behaviours of adolescents. There is a critical need to address the structural factors contributing to inequities and prevent the consequences of dietary disparities.
Collapse
Affiliation(s)
- Karen A Patte
- Department of Health Sciences, Brock University, St. Catharines, ON, Canada.
| | - Markus J Duncan
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Angelica Amores
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Emily Belita
- School of Nursing, McMaster University, Hamilton, ON, Canada
| | - Rita Kocsis
- Department of Health Sciences, Brock University, St. Catharines, ON, Canada
| | - Negin A Riazi
- Student Health & Wellbeing, University of British Columbia, Vancouver, BC, Canada
| | | | - Scott T Leatherdale
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| |
Collapse
|
2
|
Al-Harthy F, Kamath N, Hill L, Popov J, Bossert A, Brill H, Pai N. Evaluation of Hepatitis in Pediatric Patients With Presumed Nonalcoholic Fatty Liver Disease. JPGN REPORTS 2022; 3:e181. [PMID: 37168906 PMCID: PMC10158344 DOI: 10.1097/pg9.0000000000000181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 11/03/2021] [Indexed: 05/13/2023]
Abstract
In 2017, the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition published clinical practice guidelines for the assessment and diagnosis of nonalcoholic fatty liver disease (NAFLD). We determined how frequently these investigations suggest an alternate etiology for chronic hepatitis in 8- to 17-year-old patients with body mass index >85%, elevated alanine aminotransferase and radiographic steatosis, and rates of adherence to 2017 guidelines. Methods We conducted a retrospective chart review of patients presenting to McMaster Children's Hospital from 2017-2020 for evaluation of suspected NAFLD. Bloodwork was reviewed. Results Ninety-five patients met inclusion criteria. Abnormal bloodwork that required further testing was found in 28.4%; a different chronic liver disease was ultimately diagnosed in 11.6%. Only 9.5% received comprehensive, additional bloodwork for other causes of liver disease. Conclusion A high proportion of patients evaluated for suspected NAFLD had bloodwork possibly suggesting an alternate diagnosis. Comprehensive testing was infrequently performed. These results reinforce the importance of maintaining a differential diagnosis among children presumed to have NAFLD.
Collapse
Affiliation(s)
- Fat’hiya Al-Harthy
- From the Department of Pediatrics, Division of Gastroenterology and Nutrition, McMaster University, Hamilton, Canada
| | - Neha Kamath
- Faculty of Science, University of Western Ontario, London, Canada
| | - Lee Hill
- Department of Pediatrics, Division of Gastroenterology and Nutrition, McMaster University, Hamilton, Canada
- Department of Exercise Science and Sports Medicine, University of Cape Town, Cape Town, ZA
| | - Jelena Popov
- Department of Pediatrics, Division of Gastroenterology and Nutrition, McMaster University, Hamilton, Canada
- College of Medicine and Health, University College Cork, Cork, Republic of Ireland
| | - Allison Bossert
- Pediatric Gastroenterology and Nutrition, Hamilton Health Sciences Corporation (McMaster Children’s Hospital), Hamilton, Canada
| | - Herbert Brill
- Department of Pediatrics, Division of Gastroenterology and Nutrition, McMaster University, Hamilton, Canada
| | - Nikhil Pai
- Department of Pediatrics, Division of Gastroenterology and Nutrition, McMaster University, Hamilton, Canada
- Department of Medicine, Farncombe Family Digestive Diseases Research Institute, McMaster University, Hamilton, Canada
| |
Collapse
|
3
|
Rossiter MD, Mann L, Kelly E, Kirk SFL. Food and Nutrient Intakes of Nova Scotian Children in Home and Childcare Environments. CAN J DIET PRACT RES 2021; 82:176-182. [PMID: 34286630 DOI: 10.3148/cjdpr-2021-011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Purpose: To describe the energy (E), sodium, saturated fat, sugar, and fibre intakes of a sample of children attending regulated childcare (RCC) in Nova Scotia.Methods: Nutrient analyses from 79 food records were compiled and grouped by intakes in and outside of RCC, age, sex, location of the RCC (urban or rural), and nutrient intake data. Descriptive statistics and independent t tests were conducted.Results: Mean E and macronutrients were within recommended ranges and, for days attending RCC, 45%E was consumed in RCC. Saturated fat intake was 12%E on average. Mean sodium intake exceeded or approached the tolerable upper limit for 3-year olds (1726 mg/day) and 4-5-year olds (1770 mg/day), respectively. Total sugar was 27%E intake and significantly more sugar was consumed outside RCC and by boys compared to girls. Mean daily dietary fibre intake was below recommended levels (15 g/day).Conclusions: On average dietary intakes of children exceeded recommendations for sodium, saturated fat, and sugar with higher intakes outside RCC. The foods provided by RCC have a positive influence on children's intakes, but given the pervasiveness of sugar and sodium in the food environment and the challenges of feeding children, support is needed for both RCC and families to encourage healthy eating behaviours for positive growth and development.
Collapse
Affiliation(s)
- Melissa D Rossiter
- Applied Human Sciences, University of Prince Edward Island, Charlottetown, PE.,Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS
| | - Linda Mann
- Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS
| | - Erin Kelly
- New Brunswick Department of Population Health, Horizon Health Network, Fredericton, NB
| | - Sara F L Kirk
- School of Health and Human Performance and Healthy Populations Institute, Dalhousie University, Halifax, NS
| |
Collapse
|
4
|
Lane C, Naylor PJ, Tomlin D, Kirk S, Hanning R, Masse L, Olstad DL, Prowse R, Caswell S, Jarvis S, Milford T, Raine K. Healthy vending contracts: Do localized policy approaches improve the nutrition environment in publicly funded recreation and sport facilities? Prev Med Rep 2019; 16:100967. [PMID: 31497499 PMCID: PMC6718942 DOI: 10.1016/j.pmedr.2019.100967] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 07/09/2019] [Accepted: 08/07/2019] [Indexed: 01/12/2023] Open
Abstract
This study explored the influence of healthy vending contracts (HVC) on the nutritional quality of vending machine products in 46 Canadian publicly funded recreation and sport facilities. A quasi-experimental comparison design was used to examine the difference in nutritional quality of snack and beverage vending machine products at baseline (December 2015–May 2016) and 18-month follow-up. Staff Surveys assessed facility contract type (HVC or conventional) and vending machine audits identified product nutritional quality. Products were categorized by provincial guidelines as Do Not Sell (DNS), Sell Sometimes (SS) or Sell Most (SM). ANOVA compared categories cross-sectionally (HVC vs conventional) and repeated measures ANOVA compared them longitudinally (HVC-HVC, vs conventional-conventional and conventional-HVC). Approximately one quarter of contracts (24% beverage and 28% snack) had health stipulations at baseline or follow-up. Cross-sectionally, facilities with HVC at any time period had significantly lower percentage DNS (beverage: 56% vs 73%, p = 0.001; snack: 55% vs 85%, p < 0.001), higher SS (beverage: 24% vs 14%, p = 0.003; snack: 35% vs 12%, p < 0.001) and higher SM Products (beverage: 21% vs 13%, p = 0.030; snack: 10% vs 3%, p < 0.003). Longitudinally, facilities with consistent HVC or that changed to HVC showed greater decreases in DNS products over time (p < 0.050). Although less healthy products were still highly prevalent, facilities with HVC or that changed to HVC had fewer unhealthy products available in their vending machines over time compared to those without HVCs. Healthy vending contracts appear to be an effective change strategy. Healthy vending contracts are associated with healthier vending product profiles. Healthy vending contracts improved the ‘healthiness’ of the products sold in vending machines. Healthy vending contracts appear to improve the food environment of recreational and sport facilities. Unhealthy foods remain prevalent in recreational and sport facilities even when healthy vending contracts are in place.
Collapse
Affiliation(s)
- Cassandra Lane
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, 1 University Drive, Callaghan, NSW 2308, Australia.,Institute of Applied Physical Activity and Health Research, School of Exercise Science, Physical and Health Education, University of Victoria, PO Box 3015, STN CSC, Victoria V8W 3P1, BC, Canada
| | - Patti-Jean Naylor
- Institute of Applied Physical Activity and Health Research, School of Exercise Science, Physical and Health Education, University of Victoria, PO Box 3015, STN CSC, Victoria V8W 3P1, BC, Canada
| | - Dona Tomlin
- Institute of Applied Physical Activity and Health Research, School of Exercise Science, Physical and Health Education, University of Victoria, PO Box 3015, STN CSC, Victoria V8W 3P1, BC, Canada
| | - Sara Kirk
- Healthy Populations Institute, Dalhousie University, PO Box 15000, Halifax B3H 4R2, NS, Canada
| | - Rhona Hanning
- School of Public Health & Health Systems, Faculty of Applied Health Sciences, University of Waterloo, 200 University Ave. W., LNH 3117, Waterloo N2L 3G1, ON, Canada
| | - Louise Masse
- BC Children's Hospital Research Institute, School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver V6T 1Z3, BC, Canada
| | - Dana Lee Olstad
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary T2N 4Z6, AB, Canada
| | - Rachel Prowse
- Centre for Health and Nutrition, School of Public Health, University of Alberta, 4-077 Edmonton Clinic Health Academy, 11405 - 87 Ave., Edmonton T6G 1C9, AB, Canada
| | - Susan Caswell
- School of Public Health & Health Systems, Faculty of Applied Health Sciences, University of Waterloo, 200 University Ave. W., LNH 3117, Waterloo N2L 3G1, ON, Canada
| | - Sherry Jarvis
- Healthy Populations Institute, Dalhousie University, PO Box 15000, Halifax B3H 4R2, NS, Canada
| | - Todd Milford
- Institute of Applied Physical Activity and Health Research, School of Exercise Science, Physical and Health Education, University of Victoria, PO Box 3015, STN CSC, Victoria V8W 3P1, BC, Canada
| | - Kim Raine
- Centre for Health and Nutrition, School of Public Health, University of Alberta, 4-077 Edmonton Clinic Health Academy, 11405 - 87 Ave., Edmonton T6G 1C9, AB, Canada
| |
Collapse
|