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Zaltz DA, Prowse R, Yi Y, O'Dea J, Harding SV. Beverage consumption among adults in Newfoundland and Labrador, Canada prior to the implementation of a sugar-sweetened beverage tax. BMC Public Health 2025; 25:1226. [PMID: 40165161 PMCID: PMC11959793 DOI: 10.1186/s12889-025-22432-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Accepted: 03/21/2025] [Indexed: 04/02/2025] Open
Abstract
BACKGROUND Lawmakers in Newfoundland and Labrador (NL) recently passed Canada's first sugar-sweetened beverage (SSB) tax. SSB tax evaluations rely on detailed understandings of beverage consumption patterns prior to policy implementation, but there is no recent literature about such patterns among NL residents during the pre-tax period. METHODS We recruited a convenience sample of NL adults ages 19 and older and measured participant characteristics via online surveys and beverage intake via previously-validated, semi-quantitative beverage frequency questionnaires. We generated inverse probability weights of sample selection using the Canadian Census as a representative reference sample. We described the weighted prevalence and intake among consumers of taxable SSBs (e.g., regular pop), non-taxable SSBs (e.g., sweetened milk), diet (non-nutritive sweetened) beverages and unsweetened beverages (including 100% juice). We explored weighted bivariate associations between consumption of beverages and sociodemographic characteristics identified as potential correlates of SSB intake. RESULTS The sample (n = 1233) was 65% female, 57% between ages 30-59 years, and nearly all (94%) white. More than half (57.3%) consumed taxable SSBs weekly, and 23.2% consumed non-taxable SSBs weekly. The most-consumed (highest volume) taxable SSB was regular pop (weighted mean (SD) 2.3 (3.5) L/week); the most-consumed non-taxable SSB was sweetened, flavoured milk (mean (SD) 1.2 2.0) L/week). We found independent differences in consumption patterns (prevalence, mean intake among consumers) across each beverage category. People who were younger, had fewer years of education, reported income below the poverty threshold, or reported experiencing food insecurity had a higher prevalence and mean intake among consumers of taxable SSBs. People with fewer years of education or those who reported experiencing food insecurity had a lower prevalence and mean intake among consumers of unsweetened beverages. CONCLUSIONS Our findings align with prior studies of socioeconomic position and SSB consumption in Canada, which collectively demonstrate that, on average, those with less education and income consume more SSBs and fewer unsweetened beverages. This research provides necessary understanding of social patterning of beverage consumption in NL prior to tax implementation. Post-tax evaluations of this policy should investigate potential impacts of the tax on diet and health equity, as well as potential beverage substitutions towards other beverage categories.
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Affiliation(s)
- Daniel A Zaltz
- Department of Nutritional Sciences, University of Toronto Temerty Faculty of Medicine, Toronto, ON, Canada
| | - Rachel Prowse
- Division of Population Health and Applied Health Sciences, Faculty of Medicine, Memorial University, St. John's, NL, Canada.
| | - Yanqing Yi
- Division of Population Health and Applied Health Sciences, Faculty of Medicine, Memorial University, St. John's, NL, Canada
| | - Jessica O'Dea
- Division of Population Health and Applied Health Sciences, Faculty of Medicine, Memorial University, St. John's, NL, Canada
| | - Scott V Harding
- Department of Biochemistry, Faculty of Science, Memorial University, St. John's, NL, Canada.
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Hamamji S, Zaltz D, L'Abbé M. Cardiometabolic health, socioeconomic status, and 2019 Canada's Food Guide Food Choices Assessment Score: findings from the Canadian Health Measures Survey. Appl Physiol Nutr Metab 2025; 50:1-12. [PMID: 40096711 DOI: 10.1139/apnm-2024-0357] [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: 03/19/2025]
Abstract
Suboptimal diets are linked to higher cardiometabolic risks and influenced by socioeconomic status. In 2019, Health Canada released an updated Canda's Food Guide (CFG) supported with Canada's Dietary Guidelines (CDG) to help Canadians achieve healthy diet. This study aims to investigate the association between food choices assessed by a Food Choices Assessment Score (FCAS) according to 2019 CFG/CDG, and socioeconomic status and cardiometabolic risk factors among Canadian adults. Dietary choices of Canadian adults (n = 6352) from the food frequency questionnaire data of the Canadian Health Measures Survey cycles 5 and 6 (2016-2019) were used. Canadian adults with post-secondary education and high household income were associated with higher FCAS (+6.2; 95%CI 4.2, 8.2) and (+2.1; 95%CI 0.3, 3.8), respectively. Compared with the lowest quintile of the FCAS, Canadians in the highest quintile of the FCAS had lower odds of elevated BMI (0.63; 95%CI 0.44, 0.91), elevated WC (0.51; 95%CI 0.27, 0.97) in females but not in males, elevated systolic (0.69; 95%CI 0.48, 0.97), diastolic blood pressure (0.69; 95%CI 0.50, 0.96), TC (0.59; 95%CI 0.39, 0.89), non-HDL-C (0.51; 95%CI 0.31, 0.86), LDL-C (0.60; 95%CI 0.38, 0.95), Apo-B (0.62; 95%CI 0.39, 0.96), HbA1C (0.53; 95%CI 0.31, 0.93), FBG (0.62; 95%CI 0.4, 0.94), HOMA-IR (0.60; 95%CI 0.39, 0.91), and hs-CRP (0.59; 95%CI 0.36, 0.96). HDL-C and TG were not associated with FCAS. These analyses suggest strong associations between dietary choices, aligned with 2019 CFG/CDG as measured by the FCAS, and socioeconomic status and better cardiometabolic health among Canadian adults.
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Affiliation(s)
- Samer Hamamji
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 3H2, Canada
| | - Daniel Zaltz
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 3H2, Canada
| | - Mary L'Abbé
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 3H2, Canada
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Jacobs AC, Jessri M. Canadian Dietary Intakes Assessed by Nutrient Profiling Models and Association with Mortality and Cardiovascular Disease. CAN J DIET PRACT RES 2024; 85:410-417. [PMID: 39317681 DOI: 10.3148/cjdpr-2024-017] [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: 09/26/2024]
Abstract
Purpose: Nutrient profiling (NP) ranks foods according to nutritional composition and underpins policies (e.g., front-of-package (FOP) labelling). This study aimed to evaluate Canadian adults' dietary intakes using proposed Canadian FOP "high-in" labelling thresholds and international NP models (i.e., Ofcom, FSANZ, and Nutri-Score) and examine the association between intakes using international NP models and all-cause mortality and cardiovascular disease (CVD).Methods: Intakes from the Canadian Community Health Survey-Nutrition (CCHS-Nutrition) 2004 and 2015 were given NP scores and assessed against FOP thresholds. CCHS-Nutrition 2004 was linked with death records (Canadian Vital Statistics Database, n = 6767) and CVD incidence and mortality (hospital Discharge Abstract Database, n = 6420) until December 2017.Results: Foods that would require FOP labels, should there be such regulation in Canada, contributed 38% of calories. Association between NP scores and mortality was significant for Ofcom, FSANZ, and Nutri-Score (hazard ratio (HR) in highest quintile (lowest quality): 1.73, 95%CI [1.20-2.49], 1.59[1.15-2.21], and 1.75[1.18-2.59], respectively), and for CVD incidence, among males (HR in highest quintile: 2.11[1.15-3.89], 1.74[1.07-2.84], and 2.29[1.24-4.24], respectively).Conclusions: Canadians had moderately healthy intakes. NP systems could discriminate between low and high dietary quality such that adults with the lowest diet quality were more likely to experience all-cause mortality and CVD events (for males).
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Affiliation(s)
- Adelia C Jacobs
- Food, Nutrition and Health Program, Faculty of Land and Food Systems, The University of British Columbia, Vancouver, BC
| | - Mahsa Jessri
- Food, Nutrition and Health Program, Faculty of Land and Food Systems, The University of British Columbia, Vancouver, BC
- Centre for Health Services and Policy Research (CHSPR), School of Population and Public Health, Faculty of Medicine, The University of British Columbia, Vancouver, BC
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Pozveh SH, Aktary ML, Polsky JY, Moubarac JC, Vanderlee L, Olstad DL. Socioeconomic Inequalities in Intakes of Ultraprocessed and Minimally Processed Foods in Nationally Representative Samples of Adults in Canada: An Analysis of Trends between 2004 and 2015. J Nutr 2024; 154:3088-3104. [PMID: 39053608 PMCID: PMC11522980 DOI: 10.1016/j.tjnut.2024.07.029] [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: 06/07/2024] [Revised: 07/09/2024] [Accepted: 07/18/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Individuals with a lower socioeconomic position (SEP) often have higher intakes of ultraprocessed food (UPF) and lower intakes of minimally processed food (MPF); however, studies have not examined trends in absolute and relative gaps and gradients in UPF and MPF intake using multiple indicators of SEP. OBJECTIVES We examined within-year absolute and relative gaps and gradients in UPF and MPF intake and trends between 2004 and 2015 according to 6 indicators of SEP among nationally representative samples of adults in Canada. METHODS Adults (≥18 y) in the Canadian Community Health Survey-Nutrition 2004 (n = 20,880) or 2015 (n = 13,970) reported SEP (individual and household education, household income adequacy, household food insecurity, neighborhood material and social deprivation) and completed a 24-h dietary recall. Multivariable linear regression assessed within-year absolute and relative gaps and gradients in the proportion of energy from UPF and MPF and trends between 2004 and 2015. RESULTS The largest and most consistent within-year inequities in UPF and MPF intake were for individual and household educational attainment. Overall and among males, higher SEP groups had more favorable intakes over time based on trends in absolute and relative gaps and gradients in UPF and MPF intake by household food insecurity [for example, the absolute gap in UPF intake declined from -1.2% (95% confidence interval: -5.3%, 2.9%) to -7.9% of energy (95% confidence interval: -11.2%, -4.5%) in the overall population]. Overall and among males, lower SEP groups had more favorable intakes over time based on trends in absolute and relative gaps in UPF and MPF intake by neighborhood material deprivation. CONCLUSIONS Socioeconomic inequalities in UPF and MPF intake were most pronounced for individual and household education. Between 2004 and 2015, several inequalities in UPF and MPF intake emerged according to household food insecurity (favoring higher SEP groups) and neighborhood material deprivation (favoring lower SEP groups).
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Affiliation(s)
- Seyed Hosseini Pozveh
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Michelle L Aktary
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Jane Y Polsky
- Health Analysis Division, Statistics Canada, Ottawa, Ontario, Canada
| | - Jean-Claude Moubarac
- Département de nutrition, Faculté de médecine, Université de Montréal, Pavillon Liliane de Stewart, Montréal, Québec, Canada
| | - Lana Vanderlee
- Centre Nutrition, Santé et Société (NUTRISS), École de Nutrition, Université Laval, Québec, Québec, Canada
| | - Dana Lee Olstad
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
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Polsky JY, Jovovic S, Nardocci M, Moubarac JC. Socio-demographic correlates of ultra-processed food consumption in Canada. Public Health Nutr 2024; 27:e180. [PMID: 39324345 PMCID: PMC11504217 DOI: 10.1017/s1368980024001630] [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: 03/18/2024] [Revised: 07/09/2024] [Accepted: 08/17/2024] [Indexed: 09/27/2024]
Abstract
OBJECTIVE To characterise consumption of ultra-processed foods and drinks (UPF) across a range of socio-demographic characteristics of Canadians. DESIGN Cross-sectional study. The national-level 2015 Canadian Community Health Survey-Nutrition provided data on all foods and drinks consumed on the previous day via a 24-hour dietary recall. All food items were classified according to the type of industrial processing using the NOVA system. Multivariable linear regression models examined associations between a range of socio-demographic characteristics and the mean energy contribution (% of total daily energy intake) from total UPF and UPF subgroups. SETTING The ten Canadian provinces. PARTICIPANTS Canadians aged 2 or older (n 20 103). RESULTS UPF contributed, on average, nearly half (44·9 %) of total daily energy intake of Canadians. Children aged 6-12 and adolescents aged 13-18 consumed over half of total daily energy from UPF (adjusted means of 51·9 % and 50·7 %, respectively). Recent and long-term immigrants consumed a significantly lower share of energy from UPF (adjusted means of 42·2 % and 45·1 %, respectively) compared with non-immigrants (54·4 %), as did the food secure (42·8 %) v. those in moderately (48·1 %) or severely food-insecure households (50·8 %). More modest differences were observed for intake of total UPF and UPF subgroups by sex, education, income adequacy and region of residence. CONCLUSION Levels of UPF consumption in 2015 in Canada were pervasive in all socio-demographic groups and highest among children and adolescents, non-immigrants and those living in food-insecure households. These findings can inform public health interventions to reduce UPF consumption and promote healthier diets in various socio-demographic groups.
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Affiliation(s)
- Jane Y Polsky
- Health Analysis Division, Statistics Canada, Ottawa, ON, Canada
| | - Sara Jovovic
- TRANSNUT (WHO Collaborating Centre on Nutrition Changes and Development), Département de Nutrition, Faculté de Médecine, Université de Montréal, Montréal, QCH3C 3J7, Canada
| | - Milena Nardocci
- TRANSNUT (WHO Collaborating Centre on Nutrition Changes and Development), Département de Nutrition, Faculté de Médecine, Université de Montréal, Montréal, QCH3C 3J7, Canada
| | - Jean-Claude Moubarac
- TRANSNUT (WHO Collaborating Centre on Nutrition Changes and Development), Département de Nutrition, Faculté de Médecine, Université de Montréal, Montréal, QCH3C 3J7, Canada
- Centre de Recherche en Santé Publique, Université de Montréal et CIUSS du Centre-Sud-de-l’île-de-Montréal, Montréal, QC, Canada
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Pons-Muzzo L, de Cid R, Obón-Santacana M, Straif K, Papantoniou K, Santonja I, Kogevinas M, Palomar-Cros A, Lassale C. Sex-specific chrono-nutritional patterns and association with body weight in a general population in Spain (GCAT study). Int J Behav Nutr Phys Act 2024; 21:102. [PMID: 39267095 PMCID: PMC11396659 DOI: 10.1186/s12966-024-01639-x] [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: 02/12/2024] [Accepted: 08/01/2024] [Indexed: 09/14/2024] Open
Abstract
BACKGROUND Altered meal timing patterns can disrupt the circadian system and affect metabolism. Our aim was to describe sex-specific chrono-nutritional patterns, assess their association with body mass index (BMI) and investigate the role of sleep in this relationship. METHODS We used the 2018 questionnaire data from the population-based Genomes for Life (GCAT) (n = 7074) cohort of adults aged 40-65 in Catalonia, Spain, for cross-sectional analysis and its follow-up questionnaire data in 2023 (n = 3128) for longitudinal analysis. We conducted multivariate linear regressions to explore the association between mutually adjusted meal-timing variables (time of first meal, number of eating occasions, nighttime fasting duration) and BMI, accounting for sleep duration and quality, and additional relevant confounders including adherence to a Mediterranean diet. Finally, cluster analysis was performed to identify chrono-nutritional patterns, separately for men and women, and sociodemographic and lifestyle characteristics were compared across clusters and analyzed for associations with BMI. RESULTS In the cross-sectional analysis, a later time of first meal (β 1 h increase = 0.32, 95% CI 0.18, 0.47) and more eating occasions (only in women, β 1 more eating occasion = 0.25, 95% CI 0.00, 0.51) were associated with a higher BMI, while longer nighttime fasting duration with a lower BMI (β 1 h increase=-0.27, 95% CI -0.41, -0.13). These associations were particularly evident in premenopausal women. Longitudinal analyses corroborated the associations with time of first meal and nighttime fasting duration, particularly in men. Finally, we obtained 3 sex-specific clusters, that mostly differed in number of eating occasions and time of first meal. Clusters defined by a late first meal displayed lower education and higher unemployment in men, as well as higher BMI for both sexes. A clear "breakfast skipping" pattern was identified only in the smallest cluster in men. CONCLUSIONS In a population-based cohort of adults in Catalonia, we found that a later time of first meal was associated with higher BMI, while longer nighttime fasting duration associated with a lower BMI, both in cross-sectional and longitudinal analyses.
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Affiliation(s)
- Luciana Pons-Muzzo
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Rafael de Cid
- Genomes for Life -GCAT lab Group, Program of Predictive and Personalized Medicine of Cancer (PMPPC), Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain
| | - Mireia Obón-Santacana
- Genomes for Life -GCAT lab Group, Program of Predictive and Personalized Medicine of Cancer (PMPPC), Institute for Health Science Research Germans Trias i Pujol (IGTP), Badalona, Spain
- Oncology Data Analytics Program (ODAP), Unit of Biomarkers and Suceptibility (UBS), Catalan Institute of Oncology (ICO), L'Hospitalet del Llobregat, Barcelona, Spain
- ONCOBELL Program, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Kurt Straif
- ISGlobal, Barcelona, Spain
- Boston College, Boston, MA, USA
| | - Kyriaki Papantoniou
- ISGlobal, Barcelona, Spain
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Isabel Santonja
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Manolis Kogevinas
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Anna Palomar-Cros
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Camille Lassale
- ISGlobal, Barcelona, Spain.
- Universitat Pompeu Fabra (UPF), Barcelona, Spain.
- Consortium for Biomedical Research - Physiopathology of Obesity and Nutrition (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
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Olstad DL, Nejatinamini S, Blanchet R, Moubarac JC, Polsky J, Vanderlee L, Livingstone KM, Hosseini Pozveh S. Protecting traditional cultural food practices: Trends in diet quality and intake of ultra-processed foods by Indigenous status and race/ethnicity among a nationally representative sample of adults in Canada. SSM Popul Health 2023; 24:101496. [PMID: 37701069 PMCID: PMC10493595 DOI: 10.1016/j.ssmph.2023.101496] [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: 06/20/2023] [Revised: 07/29/2023] [Accepted: 08/20/2023] [Indexed: 09/14/2023] Open
Abstract
Background The traditional cultural food practices of Indigenous people and adults from racial/ethnic minority groups may be eroded in the current food system where nutrient-poor and ultra-processed foods (UPF) are the most affordable and normative options, and where experiences of racism may promote unhealthy dietary patterns. We quantified absolute and relative gaps in diet quality and UPF intake of a nationally representative sample of adults in Canada by Indigenous status and race/ethnicity, and trends between 2004 and 2015. Methods Adults (≥18 years) in the Canadian Community Health Survey-Nutrition self-reported Indigenous status and race/ethnicity and completed a 24-h dietary recall in 2004 (n = 20,880) or 2015 (n = 13,970) to calculate Healthy Eating Index-2015 (HEI-2015) scores from 0 to 100 and proportion of energy from UPF. Absolute and relative dietary gaps were quantified for Indigenous people and six racial/ethnic minority groups relative to White adults and trends between 2004 and 2015. Results Adults from all six racial/ethnic minority groups had higher mean HEI-2015 scores (58.7-61.9) than White (56.3) and Indigenous adults (51.9), and lower mean UPF intake (31.0%-41.0%) than White (45.9%) and Indigenous adults (51.9%) in 2015. As a result, absolute gaps in diet quality were positive and gaps in UPF intake were negative among racial/ethnic minority groups-indicating more favourable intakes-while the reverse was found among Indigenous adults. Relative dietary gaps were small. Absolute and relative dietary gaps remained largely stable. Conclusions Adults from six racial/ethnic minority groups had higher diet quality and lower UPF intake, whereas Indigenous adults had poorer diet quality and higher UPF intake compared to White adults between 2004 and 2015. Absolute and relative dietary gaps remained largely stable. Findings suggest racial/ethnic minority groups may have retained some healthful aspects of their traditional cultural food practices while highlighting persistent dietary inequities that affect Canada's Indigenous people.
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Affiliation(s)
- Dana Lee Olstad
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Sara Nejatinamini
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
| | - Rosanne Blanchet
- Département de Médecine Sociale et Préventive, École de Santé Publique, Université de Montréal, 7101 Avenue du Parc, 3e étage, Montréal, Québec, H3N 1X9, Canada
| | - Jean-Claude Moubarac
- Département de Nutrition, Faculté de Médecine, Université de Montréal, Pavillon Liliane de Stewart, Montréal, Québec, H3T 1A8, Canada
| | - Jane Polsky
- Health Analysis Division, Statistics Canada, 150 Tunney's Pasture Driveway, Ottawa, Ontario, K1A 0T6, Canada
| | - Lana Vanderlee
- École de Nutrition, Université Laval, Québec, Québec, G1V 0A6, Canada
| | - Katherine M. Livingstone
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, 1 Gheringhap St, Geelong, Victoria, 3220, Australia
| | - Seyed Hosseini Pozveh
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Drive NW, Calgary, AB, T2N 4Z6, Canada
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Carnauba RA, Sarti FM, Hassimotto NMA, Lajolo FM. Bioactive compounds intake in the Brazilian population: Trends and determinants of socioeconomic inequalities between 2008 and 2018. PLoS One 2023; 18:e0292006. [PMID: 37797046 PMCID: PMC10553810 DOI: 10.1371/journal.pone.0292006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 09/11/2023] [Indexed: 10/07/2023] Open
Abstract
OBJECTIVE The present study aims at evaluating trends and determinants of socioeconomic inequalities in consumption of bioactive compounds in representative sample of the Brazilian population the period from 2008-2009 to 2017-2018. METHODS Data from two cross-sectional population-based surveys were analyzed in the study, using descriptive analysis and estimation of inequalities in consumption. Trends in polyphenol and carotenoid intake were estimated using food consumption data from National Dietary Survey (NDS) 2008-2009 (n = 34,003) and 2017-2018 (n = 46,164). Evolution and determinants of inequalities in bioactive compounds intake were identified using analysis of inequality based on concentration index. RESULTS Consumption of total polyphenols, phenolic acids, flavonoids and carotenoid classes (except for zeaxanthin) was significantly associated with per capita income after adjustment for potential confounders, being higher income associated with higher intake of bioactive compounds. Disaggregation of inequalities showed that education was the main factor associated with consumption of flavonoids, other polyphenols and β-cryptoxanthin in 2008-2009; whilst income was the main barrier to intake of polyphenols and carotenoids in 2017-2018. CONCLUSION Income level and educational attainment have been important determinants to inequalities in bioactive compounds intake in the Brazilian population throughout the period of analysis, being higher intake of bioactive compounds-rich foods and beverages associated with higher income.
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Affiliation(s)
- Renata A Carnauba
- Department of Food Science and Experimental Nutrition, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
- Food Research Center, CEPID-FAPESP (Research Innovation and Dissemination Centers, São Paulo Research Foundation), São Paulo, Brazil
| | - Flavia M Sarti
- Center for Research in Complex Systems Modeling, School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, Brazil
| | - Neuza M A Hassimotto
- Department of Food Science and Experimental Nutrition, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
- Food Research Center, CEPID-FAPESP (Research Innovation and Dissemination Centers, São Paulo Research Foundation), São Paulo, Brazil
| | - Franco M Lajolo
- Department of Food Science and Experimental Nutrition, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
- Food Research Center, CEPID-FAPESP (Research Innovation and Dissemination Centers, São Paulo Research Foundation), São Paulo, Brazil
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Impact of a farmers' market healthy food subsidy on the diet quality of adults with low incomes in British Columbia, Canada: a pragmatic randomized controlled trial. Am J Clin Nutr 2023; 117:766-776. [PMID: 36804420 DOI: 10.1016/j.ajcnut.2023.01.017] [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: 08/22/2022] [Revised: 01/20/2023] [Accepted: 01/24/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Adults with low incomes have lower diet quality than their higher income counterparts. In Canada, the British Columbia Farmers' Market Nutrition Coupon Program (FMNCP) provides coupons to low-income households to purchase healthy foods in farmers' markets. OBJECTIVE The objective of this study was to examine the impact of the FMNCP on the diet quality of adults with low incomes. METHOD In a pragmatic randomized controlled trial conducted in 2019, adults with low incomes (≥18 y) were randomly assigned either to an FMNCP intervention (n = 143) or a no-intervention control group (n = 142). The FMNCP group received 16 coupon sheets valued at $21 per sheet over 10-15 wk to purchase healthy foods from farmers' markets. Participants completed a questionnaire and 2 24-h dietary recalls at baseline (0 wk), immediately post-intervention (10-15 wk), and 16-wk post-intervention (26-31 wk). Diet quality was calculated using the Healthy Eating Index-2015 (HEI-2015). Linear mixed-effects regression assessed differences in HEI-2015 total (primary outcome) and component scores (secondary outcomes) between the FMNCP and control groups at post-intervention and 16-wk post-intervention. Subgroup analyses examined program impacts by sex and age group (18-59 y, ≥60 y). RESULTS There were no significant differences in HEI-2015 total scores between the FMNCP and control groups at post-intervention (-0.07; 95% CI: -4.07, 3.93) or 16-wk post-intervention (1.22; 95% CI: -3.00, 5.44) overall or between subgroups. There were no significant between-group differences in HEI-2015 component scores at post-intervention, although there were significant differences in component scores for dairy and fatty acids at 16-wk post-intervention. CONCLUSION The FMNCP did not significantly improve diet quality among adults with low incomes over the study period. Further research is needed to explore whether higher subsidy amounts or a longer intervention period is needed to meaningfully improve diet quality among adults with low incomes. This trial was registered at [clinicaltrials.gov] as [NCT03952338].
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Hosseini SH, Farag M, Hosseini SZ, Vatanparast H. Behavioral factors are perhaps more important than income in determining diet quality in Canada. SSM Popul Health 2022; 17:101001. [PMID: 35005185 PMCID: PMC8715369 DOI: 10.1016/j.ssmph.2021.101001] [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: 04/18/2021] [Revised: 11/25/2021] [Accepted: 12/11/2021] [Indexed: 12/01/2022] Open
Abstract
This study examines the importance of income in determining the diet quality of Canadian adults measured based on Nutrient Rich Food Index version 9.3. We used the latest available data on Canadians' consumption of foods and nutrients from the Canadian Community Health Survey-Nutrition 2015. The Canada' Food Guide classification was used for categorizing food groups based on types of food and their healthiness. Unsupervised and supervised machine learning models were employed in order to examine the links between income and the choice of foods. We first employed cluster analysis to identify the dietary patterns among individuals included in the sample and then we examined whether the intakes of various food groups across the identified clusters vary by income levels. Further, we evaluated the association between diet quality and income using Lasso Regression to determine the most important predictors of diet quality among adults in Canada. The results of both cluster analysis and regularized regression model suggested that behavioral factors and cultural backgrounds are more important determinants of diet quality among adults in Canada.
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Affiliation(s)
- Seyed H. Hosseini
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 4Z2, Canada
| | - Marwa Farag
- School of Public Health, University of Saskatchewan, Saskatoon, SK S7N 4Z2, Canada
| | - Seyedeh Zeinab Hosseini
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 4Z2, Canada
| | - Hassan Vatanparast
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 4Z2, Canada
- School of Public Health, University of Saskatchewan, Saskatoon, SK S7N 4Z2, Canada
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Olstad DL, Nejatinamini S, Victorino C, Kirkpatrick SI, Minaker LM, McLaren L. Trends in Socioeconomic Inequities in Diet Quality between 2004 and 2015 among a Nationally Representative Sample of Children in Canada. J Nutr 2021; 151:3781-3794. [PMID: 34515311 PMCID: PMC8643615 DOI: 10.1093/jn/nxab297] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 07/23/2021] [Accepted: 08/12/2021] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Dietary inequities in childhood may shape dietary and health inequities across the life course. Quantifying the magnitude and direction of trends in absolute and relative gaps and gradients in diet quality according to multiple indicators of socioeconomic position (SEP) can inform strategies to narrow these inequities. OBJECTIVES We examined trends in absolute and relative gaps and gradients in diet quality between 2004 and 2015 according to 3 indicators of SEP among a nationally representative sample of children in Canada. METHODS Data from children (aged 2-17 y; n = 18,670) who participated in the cross-sectional Canadian Community Health Survey-Nutrition in 2004 or 2015 were analyzed. SEP was based on total household income, household educational attainment, and neighborhood deprivation. Dietary intake data from 1 interviewer-administered 24-h dietary recall were used to derive a Healthy Eating Index-2015 (HEI-2015) score for each participant as a measure of diet quality. Inequities in diet quality were quantified using 4 indices: absolute and relative gaps (between highest and lowest SEP) and absolute (Slope Index of Inequality) and relative gradients (Relative Index of Inequality). Overall and age-stratified multivariable linear regression and generalized linear models examined trends in HEI-2015 scores between 2004 and 2015. RESULTS Although mean HEI-2015 total scores improved from 52.3 to 57.3 (maximum 100 points; P < 0.001), absolute and relative gaps and gradients in diet quality remained mostly stable for all 3 SEP indicators. However, among children aged 6-11 y, absolute and relative gradients in diet quality according to household educational attainment and neighborhood deprivation widened. CONCLUSIONS The diet quality of children in Canada was poor and inequitably patterned in 2004 and 2015. Although mean diet quality improved between 2004 and 2015, absolute and relative gaps and gradients in diet quality persisted, with some evidence of widening absolute and relative gradients among 6- to 11-y-olds.
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Affiliation(s)
- Dana Lee Olstad
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Sara Nejatinamini
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Charlie Victorino
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Sharon I Kirkpatrick
- School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
| | - Leia M Minaker
- School of Planning, University of Waterloo, Waterloo, Ontario, Canada
| | - Lindsay McLaren
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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