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Chen Q(J, Gillis M, Bernstein JT, Jacobs A, Morrison CL, Jessri M. Modelling Food Substitution Using the Ofcom Nutrient Profiling Model on Population Intakes from the Canadian Community Health Survey-Nutrition 2015. Nutrients 2024; 16:1874. [PMID: 38931231 PMCID: PMC11206488 DOI: 10.3390/nu16121874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 06/12/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024] Open
Abstract
This study aimed to model how substituting foods consumed by Canadians for alternatives with more favourable nutrient profiling (NP) scores would impact dietary intakes. The Ofcom NP system, developed to help the UK Office of Communication differentiate foods that can be advertised to children, was applied to foods consumed by Canadians aged 2 years and older in the 2015 Canadian Community Health Survey (CCHS) (n = 19,447). Foods were substituted for similar options from the Euromonitor branded food composition database (Scenario 1) or from the primarily aggregated food profiles in the CCHS survey food composition database (Scenario 2) with either the most favourable (optimistic; 1A and 2A) or a more favourable Ofcom score (realistic; 1B and 2B). Mean intakes of Ofcom scores, calories, saturated fat, sugars, and sodium from these scenarios were compared to baseline. Only 2.9% of foods consumed had a similar Euromonitor option with a lower Ofcom score. Scenarios 1A, 1B, and 2A had lower Ofcom scores, calorie, sodium, saturated fat, and sugar intakes compared to baseline. Scenario 2B had lower levels of all outcome measures, except for an increase in calories compared to baseline. Selection of foods with more favourable NP scores has the potential to decrease the Canadian intake of nutrients of concern.
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Affiliation(s)
- Qiuyu (Julia) Chen
- Food, Nutrition and Health Program, Faculty of Land and Food Systems, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Misa Gillis
- Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Jodi T. Bernstein
- Food, Nutrition and Health Program, Faculty of Land and Food Systems, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Adelia Jacobs
- Food, Nutrition and Health Program, Faculty of Land and Food Systems, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Conor L. Morrison
- Department of Statistics, Faculty of Science, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| | - Mahsa Jessri
- Food, Nutrition and Health Program, Faculty of Land and Food Systems, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada
- Centre for Health Services and Policy Research (CHSPR) and Health Services and Policy (HSP), Faculty of Medicine, The University of British Columbia, Vancouver, BC V6T 1Z3, Canada
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Mauch CE, Brindal E, Hendrie GA. Australians' willingness to change their discretionary food intake: findings from the CSIRO junk food analyser. Front Public Health 2024; 12:1385173. [PMID: 38813402 PMCID: PMC11133598 DOI: 10.3389/fpubh.2024.1385173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 04/08/2024] [Indexed: 05/31/2024] Open
Abstract
Introduction Overconsumption of energy dense, nutrient poor foods and beverages is a major problem globally. This study describes what and how Australian adults consume and are willing to change their intake in terms of discretionary food and beverage categories. Methods Cross-sectional data were collected via the CSIRO Junk Food Analyser. This online tool contains short questions on discretionary food and beverage consumption, and items relating to stage of and willingness and strategies to reduce discretionary food and beverage intake. Analyses focussed on describing discretionary intake, adherence to guidelines and the prediction of willingness to change discretionary food intake amongst those exceeding guidelines. Results In 2021, 41,109 Australian adults completed the CSIRO Junk Food Analyser. Participants were mostly female (73.1%) and aged 31-70 years (78.9%). Most participants exceeded dietary guidelines for discretionary food and beverage intake (67.4%, 27,694/41,109) with 40% reporting actively trying to reduce intake. Most people exceeding guidelines did so in categories of alcohol (39.3%) and cakes and biscuits (21.0%). Yet, willingness to change intake was lowest for alcohol (median, IQR of 3, 2:4 out of 5). Almost half of the participants were willing to try 'having a few days off per week' (46.0%), while only 13.4% were willing to try to 'eliminate' their highest ranked category. Discussion Australian adults are willing to reduce their discretionary food and beverage intake, but simply targeting the foods and beverages consumed most may not be the best place to start. Messages encouraging days off frequently consumed discretionary foods and beverages may be well received.
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Affiliation(s)
| | | | - Gilly A. Hendrie
- Human Health Program, Health and Biosecurity, CSIRO, Adelaide, SA, Australia
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Mauch CE, Golley RK, Hendrie GA. Variety Predicts Discretionary Food and Beverage Intake of Australian Adults: A Cross-Sectional Analysis of an Online Food Intake Survey. J Acad Nutr Diet 2024; 124:509-520. [PMID: 37499867 DOI: 10.1016/j.jand.2023.07.019] [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: 06/17/2022] [Revised: 06/15/2023] [Accepted: 07/20/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Variety has been used as a strategy for increasing intakes of healthy foods, but has not been well explored with respect to discretionary food/beverages. The diverse sensory properties of these foods suggests that variety could play an important role in total intake. OBJECTIVE This study explored variety as a predictor of intake of discretionary food/beverages, and described the variety of these items consumed by Australian adults. DESIGN Secondary analyses of cross-sectional data from a validated, online survey that assesses participants' dietary intake using frequency and portion-based questions. Discretionary food/beverages are grouped into 11 categories. PARTICIPANTS/SETTING Participants included 235,203 Australian adults, aged 18 years or older, who provided data from May 2015 to November 2020. OUTCOME MEASURES Variety was the number of categories of discretionary food/beverages consumed. Servings were estimated from usual intake questions, and percent contribution summarized by category. Consumption prevalence was the proportion of the sample/subgroup consuming each category. Consumption was calculated as the mean of the sample and per capita in servings. STATISTICAL ANALYSES PERFORMED Descriptive statistics were used to present variety and percent contribution to total intake across the sample and subgroups, and multiple regression was used to examine whether or not variety predicted intake of discretionary food/beverages. RESULTS Participants consumed a median of 8 categories of discretionary food/beverages, with every additional category associated wit h an increase in intake of half a serving of discretionary food/beverages per day (B = 0.48; P < 0.001). Alcohol, cakes and cookies, takeaway, and confectionary collectively contributed around two-thirds of total daily intake of discretionary food/beverages, with alcohol contributing the largest proportion (28.3% of total daily intake). CONCLUSIONS Variety is related to total intake of discretionary food/beverages. Intervention approaches targeting a reduction in variety, as an alternative to a focus on portion size or frequency of intake, would be a novel way of addressing overconsumption of discretionary food/beverages in future research.
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Affiliation(s)
- Chelsea E Mauch
- Commonwealth Scientific and Industrial Research Organisation, Adelaide, South Australia, Australia
| | - Rebecca K Golley
- College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia
| | - Gilly A Hendrie
- Commonwealth Scientific and Industrial Research Organisation, Adelaide, South Australia, Australia.
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Biancaniello EC, Tiessen S, Hartman B, Battram DS. Dietary polyphenol intake in the Canadian population: Findings from the 2015 Canadian Community Health Survey-Nutrition. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2024; 115:315-331. [PMID: 38180640 PMCID: PMC11027756 DOI: 10.17269/s41997-023-00845-7] [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: 08/02/2023] [Accepted: 11/28/2023] [Indexed: 01/06/2024]
Abstract
OBJECTIVES This study aimed to estimate usual polyphenol intake among Canadians using the nationally representative 2015 Canadian Community Health Survey-Nutrition and to explore the main dietary contributors to polyphenol intake and the sociodemographic and lifestyle factors that may impact polyphenol intake. METHODS Dietary information was collected from 19,409 respondents using 24-h dietary recalls. The polyphenol content of foods was estimated using the Phenol-Explorer Database (version 3.6). Daily intake values for total polyphenols (adjusted to energy intake), main classes, and subclasses were calculated for each respondent and dietary recall. Usual intake was estimated by age/sex groups and by sociodemographic and lifestyle characteristics independently for adults and children using the National Cancer Institute method. Given-day arithmetic mean polyphenol intakes and mean proportions of main classes contributing to sum total polyphenol intakes were explored. Population proportions were used to determine dietary contributors. RESULTS Usual total polyphenol intake was 1119.3 mg/1000 kcal/day (95% CI: 1090.5, 1148.1) for adults ≥ 19 years and 473.0 mg/1000 kcal/day (95% CI: 454.9, 491.0) for children 2‒18 years. Generally, total polyphenol intakes differed by age, sex, ethnicity, and household education status and were higher among coffee and tea consumers. Most polyphenols came from flavonoids (40.0%) and phenolic acids (49.8%), with children consuming more flavonoids and other polyphenols and adults more phenolic acids. The top food contributors to polyphenol intake were coffee (26.8%), tea (8.9%), fruit juice (4.2%), banana (4.1%), and apple (3.8%). CONCLUSION Usual intake of total polyphenols among Canadians differed primarily by age. Non-alcoholic beverages were top contributors to total polyphenol intake.
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Affiliation(s)
- Emma C Biancaniello
- School of Food and Nutritional Sciences, Brescia University College, London, ON, Canada.
| | - Sarah Tiessen
- School of Food and Nutritional Sciences, Brescia University College, London, ON, Canada
| | - Brenda Hartman
- School of Food and Nutritional Sciences, Brescia University College, London, ON, Canada
| | - Danielle S Battram
- School of Food and Nutritional Sciences, Brescia University College, London, ON, Canada
- Schulich Interfaculty Program in Public Health, Western University, London, ON, Canada
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Jessri M, Jacobs A, Ng AP, Bennett C, Quinlan A, Nutt C, Brown J, Hennessy D, Manuel DG. Development and Evaluation of the Dietary Pattern Calculator (DiPaC) for Personalized Assessment and Feedback. CAN J DIET PRACT RES 2024; 85:25-31. [PMID: 37824093 DOI: 10.3148/cjdpr-2023-013] [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] [Indexed: 10/13/2023]
Abstract
This study aimed to develop and validate a diet assessment screener - the Dietary Pattern Calculator (DiPaC). A scoping review identified currently available short diet quality assessment tools. Twenty-one articles covering 19 unique tools were included. The current tools mainly focused on individual nutrients or food groups or were developed for a specific population, and few ascertained overall dietary patterns. The 24-hour dietary recalls from the nationally representative Canadian Community Health Survey (CCHS)-Nutrition 2015 (n = 13,958) were used to derive and validate a personalized dietary pattern informed by the scoping review using weighted partial least squares. The dominant dietary pattern in CCHS-Nutrition 2015 was characterized by high consumption of fast foods, carbonated drinks, and salty snacks and low consumption of whole fruits, orange vegetables, other vegetables and juices, whole grains, dark green vegetables, legumes, and soy. The dietary pattern assessment was used to create and evaluate DiPaC following an agile and user-centred research and development approach. DiPaC, which demonstrated high validity and intermediate reliability (internal consistency = 0.47-0.51), is publicly available at https://www.projectbiglife.ca/. DiPaC can be used by the public, clinicians, and researchers for quick and robust assessment of diet quality, providing immediate feedback with the advantage of being easy to implement.
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Affiliation(s)
- Mahsa Jessri
- Food, Nutrition and Health Program, Faculty of Land and Food Systems, The University of British Columbia
- Centre for Health Services and Policy Research (CHSPR), Faculty of Medicine, The University of British Columbia
| | - Adelia Jacobs
- Food, Nutrition and Health Program, Faculty of Land and Food Systems, The University of British Columbia
| | - Alena Praneet Ng
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON
| | - Carol Bennett
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON
| | - Alison Quinlan
- Food, Nutrition and Health Program, Faculty of Land and Food Systems, The University of British Columbia
| | - Charlotte Nutt
- Ottawa Hospital Bariatric Centre of Excellence, Ottawa, ON
| | - Jennifer Brown
- Ottawa Hospital Bariatric Centre of Excellence, Ottawa, ON
- Executive Member of the Dietitians of Canada Diabetes Obesity and Cardiovascular Disease Network
| | - Deirdre Hennessy
- Health Analysis Division, Statistics Canada, Government of Canada, Ottawa, ON
| | - Douglas G Manuel
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON
- Health Analysis Division, Statistics Canada, Government of Canada, Ottawa, ON
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON
- Institute for Clinical Evaluative Sciences, Ottawa, ON
- C.T. Lamont Primary Health Care Research Centre Program, Bruyère Research Institute, Ottawa, ON
- Department of Family Medicine, University of Ottawa, Ottawa, ON
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Kebebe E, Ibrahim N, White R, Wittenberg K, Aukema H, McAllister T, Riediger N, Legesse G, McGeough E, Ominski K. Nutritional impact of excluding red meat from the Canadian diet. Meat Sci 2023; 201:109161. [PMID: 37031667 DOI: 10.1016/j.meatsci.2023.109161] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 03/06/2023] [Accepted: 03/09/2023] [Indexed: 03/14/2023]
Abstract
The objective of the study was to examine differences in nutrient intake between consumers and non-consumers of red meat and to assess nutritional adequacy of consumers relative to Recommended Daily Allowance (RDA) in Canada. Matching estimators were used to identify differences in nutrient intake between the two groups. Statistically significant differences were observed in nutrient intake between red meat consumers and non-consumers, including lower daily intake of protein, riboflavin, niacin, vitamin D, and zinc and a higher daily intake of dietary fiber, folate, and magnesium among Canadians who did not consume red meat. Further, red meat consumers and non-consumers had nutrient intakes below RDA for dietary energy, fiber, and calcium. While individuals who did not consume red meat were at increased risk of calcium, vitamin D, energy, and potassium inadequacy, those who consumed red meat were at increased risk of dietary fiber, vitamin A, and magnesium inadequacy.
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Jessri M, Hennessey D, Bader Eddeen A, Bennett C, Sanmartin C, Manuel D. Mortality and Life Expectancy Lost in Canada Attributable to Dietary Patterns: Evidence From Canadian National Nutrition Survey Linked to Routinely Collected Health Administrative Databases. Am J Epidemiol 2023; 192:377-396. [PMID: 36288797 DOI: 10.1093/aje/kwac189] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 07/18/2022] [Accepted: 10/18/2022] [Indexed: 11/14/2022] Open
Abstract
Using 5 diet quality indexes, we estimated the mortality and life expectancy lost, at the national level, attributable to poor dietary patterns, which had previously been largely unknown. We used the Canadian Community Health Survey 2004, linked to vital statistics (n = 16,212 adults; representing n = 22,898,880). After a median follow-up of 7.5 years, 1,722 deaths were recorded. Population attributable fractions were calculated to estimate the mortality burden of poor dietary patterns (Dietary Guidelines for Americans Adherence Index 2015, Dietary Approaches to Stop Hypertension, Healthy Eating Index, Alternative Healthy Eating Index, and Mediterranean Style Dietary Pattern Score). Better diet quality was associated with a 32%-51% and 21%-43% reduction in all-cause mortality among adults aged 45-80 years and ≥20 years, respectively. Projected life expectancy at 45 years was longer for Canadians adhering to a healthy dietary pattern (average of 5.2-8.0 years (men) and 1.6-4.1 (women)). At the population level, 26.5%-38.9% (men) and 8.9%-22.9% (women) of deaths were attributable to poor dietary patterns. Survival benefit was greater for individuals with higher scores on all diet indexes, even with relatively small intake differences. The large attributable burden was likely from assessing overall dietary patterns instead of a limited range of foods and nutrients.
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Dietary Intake and the Neighbourhood Environment in the BC Generations Project. Nutrients 2022; 14:nu14224882. [PMID: 36432566 PMCID: PMC9695357 DOI: 10.3390/nu14224882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/06/2022] [Accepted: 11/16/2022] [Indexed: 11/19/2022] Open
Abstract
Poor diet is a major risk factor for many chronic diseases including cancer. Understanding broader contextual factors that influence dietary intake is important for making tangible progress towards improving diet at the population level. This study investigated neighbourhood social and built environment factors and fruit and vegetable intake among ~28,000 adults aged 35−69 years within the BC Generations Project. Daily fruit and vegetable intake was categorized according to guidelines (≥5 servings/day vs. <5 servings/day). Geospatial characteristics included walkability, greenness, marginalization, and material and social deprivation, reflecting access to goods and amenities and social relationships. Generalized, linear mixed-effect models adjusted for sociodemographic factors and lifestyle variables were used to estimate the odds ratios (ORs). Participants living in neighbourhoods with greater material deprivation (e.g., OR = 0.77; 95% CI: 0.70−0.86 for very high material deprivation) and very high social deprivation (OR = 0.90; 95% CI: 0.82−0.99) were less likely to meet recommendations for fruit and vegetable consumption relative to those living in areas with very low material deprivation and very low social deprivation, respectively. Relative to participants living in areas with very low greenness, participants living in neighbourhoods with high (OR = 1.10, 95% CI 1.01−1.20) to very high (OR = 1.11, 95% CI 1.01−1.21) greenness were more likely to meet recommendations for fruits and vegetables. These findings highlight the complexity of dietary intake which may be shaped by multiple neighbourhood characteristics.
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Warken MM, Sanden T, Shanks N, Engler-Stringer R, Vatanparast H. A need for multi-sector and multi-pronged solutions to address the many barriers inhibiting change from unhealthy food environments in publicly funded recreation facilities: a mixed-method study. Appl Physiol Nutr Metab 2022; 47:847-859. [PMID: 35544945 DOI: 10.1139/apnm-2021-0770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Public recreation facilities are preferred gathering places for families to participate in physical, social, intellectual, and creative pursuits, and the importance of food environments in these facilities is gaining recognition. Evidence from other Canadian jurisdictions describes such food environments as unsupportive of health, which contradicts national recreation priorities to have healthy choices as the easy choices. This study aimed to characterize food environments in a convenient sample of Saskatchewan public recreation facilities. A convergent/parallel mixed methods study design used quantitative methods to determine the healthfulness of concession stands and vending machines and qualitative methods to examine barriers and facilitators to healthy eating at facilitates. Results found that 5% of concession main dishes were defined as healthy and packaged foods/beverages in concession stands and vending machines were defined as Offer Most Often 6% and 8% of the time, respectively, according to Saskatchewan Nutrition Standards. Reported barriers to healthy eating were more than twice as prevalent as facilitators. To align with population health recommendations in Saskatchewan, food environments in public recreation facilities require immediate attention. Results and recommendations can be used to build collective action to address the problem and as a benchmark to measure change. Novelty Bullets • Only 5% of concession main dishes were defined as healthy. • Only 6% of packaged foods and beverages in concessions, and 8% in vending, were defined as Offer Most Often. • Reported barriers to healthy eating were more than twice as prevalent as facilitators, resulting in a current state that is difficult to change.
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Affiliation(s)
- Melanie May Warken
- University of Saskatchewan, 7235, College of Pharmacy and Nutrition, Saskatoon, Saskatchewan, Canada;
| | - Tracy Sanden
- Saskatchewan Health Authority, 7234, Saskatoon, Canada;
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Prowse R, Doan N, Philipneri A, Thielman J, Hack S, Harrington DW, Jessri M. Creating "Plates" to Evaluate Canadians' Dietary Intake in Relation to the 2019 Canada's Food Guide. CAN J DIET PRACT RES 2022; 83:152-159. [PMID: 35503904 DOI: 10.3148/cjdpr-2022-010] [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: 11/10/2022]
Abstract
Purpose: Explore Canadians' dietary intake in relation to the 2019 Canada's Food Guide (CFG) Plate using novel volume-based food analyses, by age and meal occasion.Methods: Foods reported in 24-hour recalls by 20,456 Canadians in the 2015 Canadian Community Health Survey - Nutrition were classified as: Vegetables and Fruits, Whole Grain Foods, Protein Foods, Non-Whole Grain Foods or Other Foods (high in fat, sugar, sodium). Food volumes were used to calculate percent contributions of each grouping to total intake, stratified by age (1-6; 7-12; 13-17; 18-64; 65+years) and meal (breakfast, lunch, supper, snack), applying sample survey weights and bootstrapping.Results: By volume, the Canadian population diet included: 29% Vegetables and Fruits, 22% Protein Foods, 7% Whole Grains, 24% Non-Whole Grain Foods, and 18% Other Foods. Intakes of Protein Foods (1-6 years) and Other Foods (7-12; 13-17 years) were higher in children than adults by volume, relative to total intake. Whole Grains intake was highest at breakfast. Other Foods intake was highest at snack.Conclusions: The volume-based population diet of Canadians reported on a single day includes a substantial proportion of non-recommended foods. There are opportunities to design interventions that target specific foods, ages, and meals to align intake with recommendations.
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Affiliation(s)
- Rachel Prowse
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL
| | - Natalie Doan
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, ON
| | - Anne Philipneri
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, ON
| | - Justin Thielman
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, ON
| | - Salma Hack
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, ON
| | - Dan W Harrington
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, ON
| | - Mahsa Jessri
- Food, Nutrition and Health, Faculty of Land and Food Systems, University of British Columbia, Vancouver, BC
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Smith BT, Hack S, Jessri M, Arcand J, McLaren L, L’Abbé MR, Anderson LN, Hobin E, Hammond D, Manson H, Rosella LC, Manuel DG. The Equity and Effectiveness of Achieving Canada's Voluntary Sodium Reduction Guidance Targets: A Modelling Study Using the 2015 Canadian Community Health Survey-Nutrition. Nutrients 2021; 13:nu13030779. [PMID: 33673550 PMCID: PMC7997239 DOI: 10.3390/nu13030779] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/02/2021] [Accepted: 02/05/2021] [Indexed: 12/02/2022] Open
Abstract
Background: High sodium intake is a leading modifiable risk factor for cardiovascular diseases. This study estimated full compliance to Canada’s voluntary sodium reduction guidance (SRG) targets on social inequities and population sodium intake. Methods: We conducted a modeling study using n = 19,645, 24 h dietary recalls (Canadians ≥ 2 years) from the 2015 Canadian Community Health Survey—Nutrition (2015 CCHS-N). Multivariable linear regressions were used to estimate mean sodium intake in measured (in the 2015 CCHS-N) and modelled (achieving SRG targets) scenarios across education, income and food security. The percentage of Canadians with sodium intakes above chronic disease risk reduction (CDRR) thresholds was estimated using the US National Cancer Institute (NCI) method. Results: In children aged 2–8, achieving SRG targets reduced mean sodium intake differences between food secure and insecure households from 271 mg/day (95%CI: 75,468) to 83 mg/day (95%CI: −45,212); a finding consistent across education and income. Mean sodium intake inequities between low and high education households were eliminated for females aged 9–18 (96 mg/day, 95%CI: −149,341) and adults aged 19 and older (males: 148 mg/day, 95%CI: −30,327; female: −45 mg/day, 95%CI: −141,51). Despite these declines (after achieving the SRG targets) the majority of Canadians’ are above the CDRR thresholds. Conclusion: Achieving SRG targets would eliminate social inequities in sodium intake and reduce population sodium intake overall; however, additional interventions are required to reach recommended sodium levels.
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Affiliation(s)
- Brendan T. Smith
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, ON M5G 1V2, Canada; (S.H.); (E.H.); (H.M.)
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada;
- Correspondence:
| | - Salma Hack
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, ON M5G 1V2, Canada; (S.H.); (E.H.); (H.M.)
| | - Mahsa Jessri
- Food, Nutrition and Health Program, University of British Columbia, Vancouver, BC V6T 1Z4, Canada;
| | - JoAnne Arcand
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON L1H 7K4, Canada;
| | - Lindsay McLaren
- Department of Community Health Sciences, University of Calgary, Calgary, AB T2N 4Z6, Canada;
| | - Mary R. L’Abbé
- Department of Nutritional Sciences, University of Toronto, Toronto, ON M5S 1A8, Canada;
| | - Laura N. Anderson
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada;
- Child Health Evaluative Sciences, Sickkids Research Institute, Toronto, ON M5G 0A4, Canada
| | - Erin Hobin
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, ON M5G 1V2, Canada; (S.H.); (E.H.); (H.M.)
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada;
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON N2L 3G1, Canada;
| | - David Hammond
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON N2L 3G1, Canada;
| | - Heather Manson
- Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, ON M5G 1V2, Canada; (S.H.); (E.H.); (H.M.)
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada;
- School of Public Health and Health Systems, University of Waterloo, Waterloo, ON N2L 3G1, Canada;
| | - Laura C. Rosella
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada;
- ICES, Toronto, ON K1Y 4E9, Canada;
| | - Douglas G. Manuel
- ICES, Toronto, ON K1Y 4E9, Canada;
- Ottawa Hospital Research Institute, Clinical Epidemiology, Ottawa, ON K1H 8L6, Canada
- Health Analysis Division, Statistics Canada, Ottawa, ON K1A 0T6, Canada
- Department of Family Medicine, and School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON K1H 8L6, Canada
- Bruyère Research Institute, Ottawa, ON K1R 6M1, Canada
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Mulligan C, Franco-Arellano B, Ahmed M, Vergeer L, Dickinson K, L'Abbé MR. Comparing how Canadian packaged food products align with the 2007 and 2019 versions of Canada's Food Guide. Appl Physiol Nutr Metab 2021; 46:934-944. [PMID: 33596121 DOI: 10.1139/apnm-2020-0620] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
In 2019, Canada's Food Guide (CFG) was updated from the 2007 version. This study developed a food-based nutrient profile model (NPM) to evaluate the alignment of packaged food and beverage products with CFG 2019 and compared it with CFG 2007. Packaged products from the University of Toronto's Food Label Information Program 2017 database were evaluated in terms of their alignment with CFG 2007 (using the Health Canada Surveillance Tool (HCST)) and CFG 2019 (using our newly developed CFG 2019 NPM). Agreement in alignment (e.g., products "in line" according to CFG 2019 NPM and in Tiers 1 or 2 according to the HCST) was calculated and differences in alignment and reasons for differences were quantified and described. Overall agreement in product alignment between CFG 2007 and 2019 was 81.9%, with fewer products aligned with CFG 2019: 16.4% vs. 31.8%, (χ2 = 189.12, p < 0.001). Differences in alignment varied across food categories (0.0-73.8%), explained by differences in CFG 2019, reflected in the CFG 2019 NPM (e.g., emphasis on avoiding processed foods, encouraging whole grains and low-fat dairy). This study presents a first step in assessing packaged foods' alignment with CFG 2019; future work is needed to evaluate broader dietary adherence to the updated recommendations. Novelty: A food-based nutrient profile model was developed based on the 2019 CFG and tested on packaged foods by comparing it with the nutrient-based HCST, based on CFG 2007. Most (82%) packaged products were "not in line" with either CFG version.
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Affiliation(s)
- Christine Mulligan
- Department of Nutritional Sciences, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
| | - Beatriz Franco-Arellano
- Department of Nutritional Sciences, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
| | - Mavra Ahmed
- Department of Nutritional Sciences, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
| | - Laura Vergeer
- Department of Nutritional Sciences, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
| | - Kacie Dickinson
- Department of Nutritional Sciences, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada.,Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, GPO Box 2100, Adelaide, Australia
| | - Mary R L'Abbé
- Department of Nutritional Sciences, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
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Hendrie GA, Lyle G, Mauch CE, Haddad J, Golley RK. Understanding the Variation within a Dietary Guideline Index Score to Identify the Priority Food Group Targets for Improving Diet Quality across Population Subgroups. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E378. [PMID: 33418998 PMCID: PMC7825319 DOI: 10.3390/ijerph18020378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 12/24/2020] [Accepted: 12/25/2020] [Indexed: 11/18/2022]
Abstract
Globally, population dietary intakes fall below the guideline recommendations and large-scale interventions have had modest success in improving diet quality. To inform the development of more targeted approaches, this study analysed the variations in self-reported data from an online survey of Australian adults collected between 2015 and 2020, to identify common combinations of low scoring components within a dietary guideline index. A low score was defined as meeting less than half the guideline recommendations (a score <50 out of 100). Among 230,575 adults, a single component analysis showed that 79.5% had a low score for discretionary choices, 72.2% for healthy fats and 70.8% for dairy. The combinations approach showed 83.0% of individuals had two to five low scoring components, with men, younger adults aged 18-30 years and individuals with obesity (BMI ≥ 30) more likely to have five or more. The most common dietary pattern combination included low scores for discretionary choices, dairy and healthy fats. There was a considerable but systematic variation in the low scoring components within the dietary patterns, suggesting that interventions with the flexibility to address particular combinations of key food groups across subgroups could be an effective and resource efficient way to improve diet quality in the population.
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Affiliation(s)
- Gilly A. Hendrie
- Nutrition and Health Program, Health & Biosecurity, CSIRO, Adelaide, SA 5000, Australia; (G.A.H.); (J.H.)
| | - Greg Lyle
- School of Public Health, Curtin University, Bentley Campus, Perth, WA 6102, Australia;
| | - Chelsea E. Mauch
- Nutrition and Health Program, Health & Biosecurity, CSIRO, Adelaide, SA 5000, Australia; (G.A.H.); (J.H.)
| | - Joyce Haddad
- Nutrition and Health Program, Health & Biosecurity, CSIRO, Adelaide, SA 5000, Australia; (G.A.H.); (J.H.)
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA 5042, Australia;
| | - Rebecca K. Golley
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA 5042, Australia;
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