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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.
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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
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Consumption of Milk and alternatives decreased among Canadians from 2004 to 2015: evidence from the Canadian community health surveys. BMC Nutr 2021; 7:63. [PMID: 34719398 PMCID: PMC8559356 DOI: 10.1186/s40795-021-00465-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 08/26/2021] [Indexed: 11/10/2022] Open
Abstract
Background Milk and milk products make important contributions to the diet of Canadians. The aim of this study was to examine trends in Milk & Alternatives consumption among Canadians (≥2 years) from 2004 to 2015. Methods We used nutrition data from 2 nationally representative cross-sectional surveys conducted in 2004 and 2015 [Canadian Community Health Survey (CCHS) 2004 Cycle 2.2 and CCHS-Nutrition 2015] to compare Milk & Alternatives consumption between 2004 and 2015. Data from 24-h dietary recalls were collected using the Automated Multiple-Pass Method (AMPM). Result From 2004 to 2015, the proportion of Canadians consuming Milk & Alternatives food group significantly decreased from 89.5 to 87.7% and the number of servings consumed per day dropped from 1.9 to 1.7. Despite their low energy contribution (12.3% of energy), Milk & Alternatives contributed 45.8% of calcium, 39.9% of vitamin D, and 36.0% of vitamin B12 to the diet of the Canadian population in 2015. Milk & Alternatives were among the top sources of vitamin A, phosphorus and riboflavin. Milk & Alternatives food group was a major contributor to saturated fat intake in both 2004 (31.2%) and 2015 (28.6%). In 2015, dietary intakes of calcium and vitamin D among Milk & Alternatives consumers were 137.8, and 59.4% higher, respectively, than those of non-consumers. Conclusion Daily intake of Milk & Alternatives has decreased in the Canadian population over time, which may adversely affect the nutritional profile of the diet.
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Murphy MM, Barraj LM, Brisbois TD, Duncan AM. Frequency of fruit juice consumption and association with nutrient intakes among Canadians. Nutr Health 2020; 26:277-283. [PMID: 32787502 PMCID: PMC7536509 DOI: 10.1177/0260106020944299] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background: In Canada, studies on consumption of 100% fruit juice and nutrient intakes
are limited. Aim: This study aimed to evaluate nutrient intakes and adequacy of intake by
frequency of fruit juice consumption. Methods: Individuals ≥1 year (n = 34,351) participating in the
Canadian Community Health Survey, 2004 with a 24-hour dietary recall and
reported usual frequency of fruit juice consumption (assumed to be 100%
juice) were categorized by frequency of consumption as <0.5, ≥0.5 to
<1.5, or ≥1.5 times/day. Results: More frequent consumption of fruit juice (≥0.5 times/day) was associated with
higher intakes of total fruits and vegetables, whole fruits, energy, total
sugars, vitamin C and potassium. More frequent consumption of fruit juice
was associated with improved intake adequacy of vitamin C for adults. Conclusions: Fruit juice consumption contributes to increased intakes of vitamin C and
potassium as well as energy and total sugars, thus presenting a trade-off
for consumers to balance.
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Affiliation(s)
- Mary M Murphy
- 360554Exponent, Inc., Center for Chemical Regulation & Food Safety, Washington DC, USA
| | - Leila M Barraj
- 360554Exponent, Inc., Center for Chemical Regulation & Food Safety, Washington DC, USA
| | | | - Alison M Duncan
- Department of Human Health and Nutritional Sciences, 3653University of Guelph, Ontario, Canada
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Irwin BR, Speechley M, Wilk P, Clark AF, Gilliland JA. Promoting healthy beverage consumption habits among elementary school children: results of the Healthy Kids Community Challenge 'Water Does Wonders' interventions in London, Ontario. Canadian Journal of Public Health 2019; 111:257-268. [PMID: 31721081 DOI: 10.17269/s41997-019-00262-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 09/20/2019] [Indexed: 01/29/2023]
Abstract
INTERVENTION This study examines the impact of London's Healthy Kids Community Challenge (HKCC) 'Water Does Wonders' interventions, which combined water infrastructure and education programs. RESEARCH QUESTION How effective were the HKCC interventions at increasing water and decreasing sugar-sweetened beverage (SSB) consumption among grade 4-8 children in London, Ontario? METHODS Non-randomized controlled trial. Children's knowledge and beverage intake were measured before and after the interventions were implemented during the 2016-2017 school year. Children at intervention schools (n = 521) received education programs (Growing Chefs or UTRCA [Upper Thames River Conservation Authority]) and water bottle filling stations. Children at control schools (n = 410) received filling stations only. Multivariable linear mixed-model ANCOVAs were used to compare water and SSB consumption and knowledge across intervention groups, accounting for school-level clustering. RESULTS Children who received an education intervention and filling station compared with only a filling station consumed more water (β = 2.18 (95% CI - 1.87, 6.22) for Growing Chefs and β = 2.90 (95% CI - 0.23, 6.03) for UTRCA) and fewer SSBs (β = - 1.17 (95% CI - 3.83, 1.49) for Growing Chefs and β = - 2.56 (95% CI - 5.12, 0.001) for UTRCA) post-intervention, and had higher nutrition knowledge (β = 1.57 (95% CI - 1.68, 4.83) for Growing Chefs and β = 2.02 (95% CI - 0.35, 4.39) for UTRCA). These findings were not statistically significant. CONCLUSIONS An intervention intended to promote healthy beverage consumption yielded effects in the expected direction; however, they were small and not statistically significant. This is likely because the educational interventions were not fully aligned with the goals of the 'Water Does Wonders' program, preventing them from evoking meaningful changes in dietary behaviours.
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Affiliation(s)
- Bridget R Irwin
- Human Environments Analysis Laboratory, Western University, 1151 Richmond St, London, Ontario, N6A 3K7, Canada.,Department of Epidemiology and Biostatistics, Western University, 1151 Richmond St, London, Ontario, N6A 3K7, Canada
| | - Mark Speechley
- Department of Epidemiology and Biostatistics, Western University, 1151 Richmond St, London, Ontario, N6A 3K7, Canada.,Schulich Interfaculty Program in Public Health, Western University, 1151 Richmond St, London, Ontario, N6A 3K7, Canada
| | - Piotr Wilk
- Human Environments Analysis Laboratory, Western University, 1151 Richmond St, London, Ontario, N6A 3K7, Canada.,Department of Epidemiology and Biostatistics, Western University, 1151 Richmond St, London, Ontario, N6A 3K7, Canada.,Department of Paediatrics, Western University, 1151 Richmond St, London, Ontario, N6A 3K7, Canada.,Children's Health Research Institute, 800 Commissioners Rd. E, London, Ontario, N6C 2V5, Canada
| | - Andrew F Clark
- Human Environments Analysis Laboratory, Western University, 1151 Richmond St, London, Ontario, N6A 3K7, Canada.,Department of Geography, Western University, 1151 Richmond St, London, Ontario, N6A 3K7, Canada.,Children's Health Research Institute, 800 Commissioners Rd. E, London, Ontario, N6C 2V5, Canada
| | - Jason A Gilliland
- Human Environments Analysis Laboratory, Western University, 1151 Richmond St, London, Ontario, N6A 3K7, Canada. .,Department of Epidemiology and Biostatistics, Western University, 1151 Richmond St, London, Ontario, N6A 3K7, Canada. .,Department of Paediatrics, Western University, 1151 Richmond St, London, Ontario, N6A 3K7, Canada. .,Department of Geography, Western University, 1151 Richmond St, London, Ontario, N6A 3K7, Canada. .,School of Health Studies, Western University, 1151 Richmond St, London, Ontario, N6A 3K7, Canada. .,Children's Health Research Institute, 800 Commissioners Rd. E, London, Ontario, N6C 2V5, Canada. .,Lawson Health Research Institute, 750 Base Line Rd. E, London, Ontario, N6C 2R5, Canada.
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Ziesmann A, Kiflen R, Rubeis VD, Smith BT, Maguire On Behalf Of The TARGet Kids Collaboration JL, Birken CS, Anderson LN. The Association between Early Childhood and Later Childhood Sugar-Containing Beverage Intake: A Prospective Cohort Study. Nutrients 2019; 11:E2338. [PMID: 31581586 PMCID: PMC6835692 DOI: 10.3390/nu11102338] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 09/22/2019] [Accepted: 09/27/2019] [Indexed: 12/12/2022] Open
Abstract
Sugar-containing beverages (SCBs) are a major source of sugar intake in children. Early life intake of SCBs may be a strong predictor of SCB intake later in life. The primary objective of this study was to evaluate if SCB intake (defined as 100% fruit juice, soda, and sweetened drinks) in early childhood (≤2.5 years of age) was associated with SCB intake in later childhood (5-9 years of age). A prospective cohort study was conducted using data from the TARGet Kids! primary care practice network (n = 999). Typical daily SCB intake was measured by parent-completed questionnaires. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using logistic regression. A total of 43% of children consumed ≥0.5 cups/day of SCBs at ≤2.5 years and this increased to 64% by 5-9 years. Daily SCB intake, compared to no daily intake, at ≤2.5 years was significantly associated with SCB intake at 5-9 years (adjusted OR: 4.03; 95% CI: 2.92-5.55) and this association was much stronger for soda/sweetened drinks (adjusted OR: 12.83; 95% CI: 4.98, 33.0) than 100% fruit juice (OR: 3.61; 95% CI: 2.63-4.95). Other early life risk factors for SCB intake at 5-9 years were presence of older siblings, low household income, and shorter breastfeeding duration. Daily intake of SCBs in early childhood was strongly associated with greater SCB intake in later childhood. Early life may be an important period to target for population prevention strategies.
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Affiliation(s)
- Andrea Ziesmann
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada.
| | - Ruhi Kiflen
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada.
| | - Vanessa De Rubeis
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada.
| | - Brendan T Smith
- Department of Health Promotion, Chronic Disease and Injury Prevention, Public Health Ontario, Toronto, ON M5G 1V2, Canada.
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada.
| | - Jonathon L Maguire On Behalf Of The TARGet Kids Collaboration
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada.
- Applied Health Research Centre of the Li Ka Shing Knowledge Institute of St. Michael's Hospital, University of Toronto, Toronto, ON M5G 1B1, Canada.
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario M5S 1A8, Canada.
- Department of Pediatrics, St. Michael's Hospital, Toronto, ON M5C 2T2, Canada.
| | - Catherine S Birken
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada.
- Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario M5S 1A8, Canada.
- Division of Child Health Evaluative Sciences (CHES), Sick Kids Research Institute, Toronto, ON M5G 0A4, Canada.
| | - Laura N Anderson
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON L8S 4L8, Canada.
- Division of Child Health Evaluative Sciences (CHES), Sick Kids Research Institute, Toronto, ON M5G 0A4, Canada.
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