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Adopting and implementing nutrition guidelines in recreational facilities: public and private sector roles. A multiple case study.

https://arctichealth.org/en/permalink/ahliterature124044
Source
BMC Public Health. 2012;12:376
Publication Type
Article
Date
2012
Author
Dana Lee Olstad
Kim D Raine
Linda J McCargar
Author Affiliation
Alberta Institute for Human Nutrition, 4-126 Li Ka Shing Centre, 8606 112 St, University of Alberta, Edmonton, AB T6G 2E1, Canada.
Source
BMC Public Health. 2012;12:376
Date
2012
Language
English
Publication Type
Article
Keywords
Canada
Child
Food - standards
Guideline Adherence - statistics & numerical data
Guidelines as Topic
Humans
Nutrition Policy
Obesity - prevention & control
Private Sector - organization & administration
Public Facilities
Qualitative Research
Recreation
Abstract
Recreational facilities are an important community resource for health promotion because they provide access to affordable physical activities. However, despite their health mandate, many have unhealthy food environments that may paradoxically increase the risk of childhood obesity. The Alberta Nutrition Guidelines for Children and Youth (ANGCY) are government-initiated, voluntary guidelines intended to facilitate children's access to healthy food and beverage choices in schools, childcare and recreational facilities, however few recreational facilities are using them.
We used mixed methods within an exploratory multiple case study to examine factors that influenced adoption and implementation of the ANGCY and the nature of the food environment within three cases: an adopter, a semi-adopter and a non-adopter of the ANGCY. Diffusion of Innovations theory provided the theoretical platform for the study. Qualitative data were generated through interviews, observations, and document reviews, and were analysed using directed content analysis. Set theoretic logic was used to identify factors that differentiated adopters from the non-adopter. Quantitative sales data were also collected, and the quality of the food environment was scored using four complementary tools.
The keys to adoption and implementation of nutrition guidelines in recreational facilities related to the managers' nutrition-related knowledge, beliefs and perceptions, as these shaped his decisions and actions. The manager, however, could not accomplish adoption and implementation alone. Intersectoral linkages with schools and formal, health promoting partnerships with industry were also important for adoption and implementation to occur. The food environment in facilities that had adopted the ANGCY did not appear to be superior to the food environment in facilities that had not adopted the ANGCY.
ANGCY uptake may continue to falter under the current voluntary approach, as the environmental supports for voluntary action are poor. Where ANGCY uptake does occur, changes to the food environment may be relatively minor. Stronger government measures may be needed to require recreational facilities to improve their food environments and to limit availability of unhealthy foods.
Notes
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PubMed ID
22632384 View in PubMed
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Alberta Nutrition Guidelines for Children and Youth: awareness and use in schools.

https://arctichealth.org/en/permalink/ahliterature131582
Source
Can J Diet Pract Res. 2011;72(3):137-40
Publication Type
Article
Date
2011
Author
Shauna M Downs
Anna Farmer
Maira Quintanilha
Tanya R Berry
Diana R Mager
Noreen D Willows
Linda J McCargar
Author Affiliation
Department of Agricultural, Food and Nutritional Science, Faculty of Agricultural, Life and Environmental Sciences, University of Alberta, Edmonton.
Source
Can J Diet Pract Res. 2011;72(3):137-40
Date
2011
Language
English
Publication Type
Article
Keywords
Adolescent
Alberta
Child
Cross-Sectional Studies
Diet - standards
Food Services
Guideline Adherence - statistics & numerical data
Guidelines as Topic
Health promotion
Humans
Interviews as Topic
Nutritional Status
Questionnaires
Schools
Social Environment
Abstract
In June 2008, the Alberta government released the Alberta Nutrition Guidelines for Children and Youth. We evaluated the awareness of and intent to use the guidelines in Alberta schools, and sought to determine whether organizational characteristics were a factor in adoption of the guidelines.
Randomly selected schools from across Alberta completed a 19-question telephone survey, which included open- and closed-ended questions about the schools' characteristics, the priority given to healthy eating, awareness of the guidelines, and the schools' intent to use the guidelines. Of the 554 schools contacted, 357 (64%) completed the survey.
Overall, 76.1% of schools were aware of the guidelines and 65% were in the process of adopting them. Fifty percent of schools identified healthy eating as a high priority and 65.9% reported making changes to improve the nutritional quality of foods offered in the past year. Schools that were larger, public, and urban, and had a school champion and healthy eating as a high priority were more likely to be adopting the guidelines.
Most schools were aware of the nutrition guidelines and many had begun the adoption process. Identifying a school champion may be an important first step for schools in terms of adopting health promotion initiatives.
PubMed ID
21896251 View in PubMed
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The Alberta Pregnancy Outcomes and Nutrition (APrON) cohort study: rationale and methods.

https://arctichealth.org/en/permalink/ahliterature122539
Source
Matern Child Nutr. 2014 Jan;10(1):44-60
Publication Type
Article
Date
Jan-2014
Author
Bonnie J Kaplan
Gerald F Giesbrecht
Brenda M Y Leung
Catherine J Field
Deborah Dewey
Rhonda C Bell
Donna P Manca
Maeve O'Beirne
David W Johnston
Victor J Pop
Nalini Singhal
Lisa Gagnon
Francois P Bernier
Misha Eliasziw
Linda J McCargar
Libbe Kooistra
Anna Farmer
Marja Cantell
Laki Goonewardene
Linda M Casey
Nicole Letourneau
Jonathan W Martin
Author Affiliation
Department of Paediatrics, University of Calgary, Calgary, Alberta, Canada Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada Department of Family Medicine, University of Alberta, Edmonton, Alberta, Canada Department of Family Medicine, University of Calgary, Calgary, Alberta, Canada Department of Primary Health Care, University of Tilburg, Tilburg, The Netherlands Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada Department of Medical Genetics, University of Calgary, Calgary, Alberta, Canada Department of Public Health and Community Medicine, Tufts University, Boston, Massachusetts, USA Department of Teaching & Research Support, University of Groningen, The Netherlands Clinical & Developmental Neuropsychology, University of Groningen, The Netherlands Department of Paediatrics, University of Alberta, Edmonton, Alberta, Canada Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada Department of Lab Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada.
Source
Matern Child Nutr. 2014 Jan;10(1):44-60
Date
Jan-2014
Language
English
Publication Type
Article
Keywords
Alberta
Anthropometry
Child Development
Child Nutritional Physiological Phenomena
Child, Preschool
Cohort Studies
Energy intake
Female
Follow-Up Studies
Humans
Infant
Linear Models
Longitudinal Studies
Maternal Nutritional Physiological Phenomena
Multivariate Analysis
Neurons - metabolism
Nutritional Status
Pilot Projects
Pregnancy
Pregnancy outcome
Prospective Studies
Questionnaires
Socioeconomic Factors
Abstract
The Alberta Pregnancy Outcomes and Nutrition (APrON) study is an ongoing prospective cohort study that recruits pregnant women early in pregnancy and, as of 2012, is following up their infants to 3 years of age. It has currently enrolled approximately 5000 Canadians (2000 pregnant women, their offspring and many of their partners). The primary aims of the APrON study were to determine the relationships between maternal nutrient intake and status, before, during and after gestation, and (1) maternal mood; (2) birth and obstetric outcomes; and (3) infant neurodevelopment. We have collected comprehensive maternal nutrition, anthropometric, biological and mental health data at multiple points in the pregnancy and the post-partum period, as well as obstetrical, birth, health and neurodevelopmental outcomes of these pregnancies. The study continues to follow the infants through to 36 months of age. The current report describes the study design and methods, and findings of some pilot work. The APrON study is a significant resource with opportunities for collaboration.
PubMed ID
22805165 View in PubMed
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Assessment of iron status in adolescents: dietary, biochemical and lifestyle determinants.

https://arctichealth.org/en/permalink/ahliterature174256
Source
J Adolesc Health. 2005 Jul;37(1):75
Publication Type
Article
Date
Jul-2005
Author
Heather Deegan
Heidi M Bates
Linda J McCargar
Author Affiliation
Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, Canada.
Source
J Adolesc Health. 2005 Jul;37(1):75
Date
Jul-2005
Language
English
Publication Type
Article
Keywords
Adolescent
Alberta - epidemiology
Anemia, Iron-Deficiency - epidemiology
Cross-Sectional Studies
Diet Surveys
Female
Health Behavior
Humans
Iron, Dietary - administration & dosage
Life Style
Male
Nutritional Status
Prevalence
Questionnaires
Abstract
This study assessed the impact of dietary intake and lifestyle factors on iron status in adolescents.
Iron status, dietary intakes and relevant lifestyle behaviors of 396 healthy adolescents were assessed using food frequency questionnaires, a lifestyle survey, anthropometric measures, and blood analysis for serum ferritin, percent transferrin saturation, and serum hemoglobin levels.
Six percent of the females in the sample were found to be iron deficient. The prevalence of iron deficiency anemia in the total female population was 3.4%. No males met the criteria for iron deficiency or iron deficiency anemia. Dietary iron intake exceeded the Estimated Average Requirement for all groups. However, iron intake was observed to be significantly higher in individuals with a healthy iron status, as compared with those who were considered iron deficient.
The results counter the assertion that iron deficiency in developed countries is the result of low iron intakes. This study did not explore factors such as the type and bioavailability of dietary iron sources consumed by the participants. However, the authors speculate that these variables may have a greater impact on iron status than total dietary iron intakes or lifestyle determinants.
PubMed ID
15963912 View in PubMed
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Associations between the perceived presence of vending machines and food and beverage logos in schools and adolescents' diet and weight status.

https://arctichealth.org/en/permalink/ahliterature135770
Source
Public Health Nutr. 2011 Aug;14(8):1350-6
Publication Type
Article
Date
Aug-2011
Author
Leia M Minaker
Kate E Storey
Kim D Raine
John C Spence
Laura E Forbes
Ronald C Plotnikoff
Linda J McCargar
Author Affiliation
Department of Public Health Sciences, University of Alberta, Edmonton, AB, Canada.
Source
Public Health Nutr. 2011 Aug;14(8):1350-6
Date
Aug-2011
Language
English
Publication Type
Article
Keywords
Adolescent
Adolescent Behavior - psychology
Advertising as Topic - methods
Alberta - epidemiology
Body Weight
Child
Cross-Sectional Studies
Diet
Feeding Behavior - psychology
Female
Food Dispensers, Automatic
Humans
Internet
Logistic Models
Male
Overweight - epidemiology
Schools
Abstract
The increasing prevalence of obesity among youth has elicited calls for schools to become more active in promoting healthy weight. The present study examined associations between various aspects of school food environments (specifically the availability of snack- and beverage-vending machines and the presence of snack and beverage logos) and students' weight status, as well as potential influences of indices of diet and food behaviours.
A cross-sectional, self-administered web-based survey. A series of multinomial logistic regressions with generalized estimating equations (GEE) were constructed to examine associations between school environment variables (i.e. the reported presence of beverage- and snack-vending machines and logos) and self-reported weight- and diet-related behaviours.
Secondary schools in Alberta, Canada.
A total of 4936 students from grades 7 to 10.
The presence of beverage-vending machines in schools was associated with the weight status of students. The presence of snack-vending machines and logos was associated with students' frequency of consuming vended goods. The presence of snack-vending machines and logos was associated with the frequency of salty snack consumption.
The reported presence of snack- and beverage-vending machines and logos in schools is related to some indices of weight status, diet and meal behaviours but not to others. The present study supported the general hypothesis that the presence of vending machines in schools may affect students' weight through increased consumption of vended goods, but notes that the frequency of 'junk' food consumption does not seem to be related to the presence of vending machines, perhaps reflecting the ubiquity of these foods in the daily lives of students.
PubMed ID
21450139 View in PubMed
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Cancer cachexia in the age of obesity: skeletal muscle depletion is a powerful prognostic factor, independent of body mass index.

https://arctichealth.org/en/permalink/ahliterature115218
Source
J Clin Oncol. 2013 Apr 20;31(12):1539-47
Publication Type
Article
Date
Apr-20-2013
Author
Lisa Martin
Laura Birdsell
Neil Macdonald
Tony Reiman
M Thomas Clandinin
Linda J McCargar
Rachel Murphy
Sunita Ghosh
Michael B Sawyer
Vickie E Baracos
Author Affiliation
University of Alberta, Edmonton, Alberta, Canada. vickie.baracos@ualberta.ca
Source
J Clin Oncol. 2013 Apr 20;31(12):1539-47
Date
Apr-20-2013
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Body Composition
Body mass index
Cachexia - diagnosis - etiology - mortality
Canada - epidemiology
Cancer Care Facilities
Female
Follow-Up Studies
Gastrointestinal Neoplasms - complications - mortality - therapy
Humans
Lung Neoplasms - complications - mortality - therapy
Male
Middle Aged
Muscle, Skeletal - pathology
Neoplasm Staging
Obesity - epidemiology
Prognosis
Risk factors
Survival Rate
Abstract
Emerging evidence suggests muscle depletion predicts survival of patients with cancer.
At a cancer center in Alberta, Canada, consecutive patients with cancer (lung or GI; N = 1,473) were assessed at presentation for weight loss history, lumbar skeletal muscle index, and mean muscle attenuation (Hounsfield units) by computed tomography (CT). Univariate and multivariate analyses were conducted. Concordance (c) statistics were used to test predictive accuracy of survival models.
Body mass index (BMI) distribution was 17% obese, 35% overweight, 36% normal weight, and 12% underweight. Patients in all BMI categories varied widely in weight loss, muscle index, and muscle attenuation. Thresholds defining associations between these three variables and survival were determined using optimal stratification. High weight loss, low muscle index, and low muscle attenuation were independently prognostic of survival. A survival model containing conventional covariates (cancer diagnosis, stage, age, performance status) gave a c statistic of 0.73 (95% CI, 0.67 to 0.79), whereas a model ignoring conventional variables and including only BMI, weight loss, muscle index, and muscle attenuation gave a c statistic of 0.92 (95% CI, 0.88 to 0.95; P
Notes
Comment In: Nat Rev Clin Oncol. 2013 May;10(5):25023568419
PubMed ID
23530101 View in PubMed
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Changes in dietary and physical activity risk factors for type 2 diabetes in Alberta youth between 2005 and 2008.

https://arctichealth.org/en/permalink/ahliterature105066
Source
Can J Public Health. 2013 Nov-Dec;104(7):e490-5
Publication Type
Article
Author
Laura E Forbes
Shawn N Fraser
Shauna M Downs
Kate E Storey
Ronald C Plotnikoff
Kim D Raine
John C Spence
Rhona M Hanning
Linda J McCargar
Author Affiliation
University of Guelph. forbesl@uoguelph.ca.
Source
Can J Public Health. 2013 Nov-Dec;104(7):e490-5
Language
English
Publication Type
Article
Keywords
Adolescent
Alberta
Cross-Sectional Studies
Diabetes Mellitus, Type 2 - prevention & control
Diet - psychology
Female
Health promotion
Health Surveys
Humans
Life Style
Male
Motor Activity
Program Evaluation
Risk factors
Abstract
Unhealthy dietary and physical inactivity patterns inspired many initiatives promoting healthy youth and healthy schools in Alberta between 2005 and 2008. The purpose of this study was to examine differences in the prevalence of lifestyle risk factors for type 2 diabetes (T2D) between two province-wide samples of Alberta adolescents (2005 and 2008).
The dietary and physical activity (PA) patterns of Alberta youth were assessed in two cross-sectional studies of grade 7-10 students, one in 2005 (n=4936) and one in 2008 (n=5091), using a validated web-survey. For each diabetes risk factor, participants were classified as either at risk or not at risk, depending on their survey results relative to cut-off values. Chi-square tests and logistic regression models were used to determine differences in risk factor prevalence between 2005 and 2008.
Compared to 2005, mean BMI, energy intake, fat intake, glycemic index (GI) and glycemic load (GL) were lower in 2008 (p
PubMed ID
24495827 View in PubMed
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Childhood obesity in Canada: a review of prevalence estimates and risk factors for cardiovascular diseases and type 2 diabetes.

https://arctichealth.org/en/permalink/ahliterature186047
Source
Can J Appl Physiol. 2003 Feb;28(1):117-40
Publication Type
Article
Date
Feb-2003
Author
Geoff D C Ball
Linda J McCargar
Author Affiliation
Department of Health Promotion and Disease Prevention Research in the Faculty of Medicine, University of Southern California, Los Angeles, CA, USA.
Source
Can J Appl Physiol. 2003 Feb;28(1):117-40
Date
Feb-2003
Language
English
Publication Type
Article
Keywords
Age Factors
Body mass index
Canada - epidemiology
Cardiovascular Diseases - epidemiology - etiology
Child
Diabetes Mellitus, Type 2 - epidemiology - etiology
Humans
Obesity - complications - epidemiology
Prevalence
Risk factors
Abstract
Childhood obesity in Canada has become increasingly prevalent over the past 2 decades. Despite inconsistencies regarding different anthropometric indicators, cut-offs, and reference populations, both regional and national investigations have revealed high numbers of overweight and obese children and adolescents. A number of risk factors and health consequences have been associated with increased levels of body fatness in youth. Specifically, risk factors for cardiovascular diseases (CVD) and type 2 diabetes are known to develop early in life and tend to emerge in clusters among overweight youngsters. Unhealthy lifestyle behaviours (i.e., physical inactivity), a genetic disposition, and a centralized body fat distribution, all contribute to increased risk. In order to prevent future generations of children from experiencing increased morbidity and mortality as overweight and obese adults, coordinated efforts at all levels (family, school, community, and government) must be established with a long-term commitment to promote healthy nutrition and physical activity behaviours in our youth.
PubMed ID
12671200 View in PubMed
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Determinants of diet quality among Canadian adolescents.

https://arctichealth.org/en/permalink/ahliterature150393
Source
Can J Diet Pract Res. 2009;70(2):58-65
Publication Type
Article
Date
2009
Author
Kate E Storey
Rhona M Hanning
Irene A Lambraki
Pete Driezen
Shawn N Fraser
Linda J McCargar
Author Affiliation
Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, Canada.
Source
Can J Diet Pract Res. 2009;70(2):58-65
Date
2009
Language
English
Publication Type
Article
Keywords
Adolescent
Adolescent Nutritional Physiological Phenomena - physiology
Alberta
Cross-Sectional Studies
Diet - standards
Dietary Carbohydrates - administration & dosage
Dietary Fats - administration & dosage
Dietary Proteins - administration & dosage
Feeding Behavior
Female
Food Habits
Humans
Male
Micronutrients - administration & dosage
Nutrition Policy
Nutritional Requirements
Nutritive Value
Ontario
Abstract
Dietary intakes and nutrition behaviours were examined among different diet quality groups of Canadian adolescents.
This cross-sectional study included 2850 Alberta and Ontario adolescents aged 14 to 17, who completed a self-administered web-based survey that examined nutrient intakes and meal behaviours (meal frequency and meal consumption away from home).
Mean macronutrient intakes were within Acceptable Macronutrient Distribution Ranges; however, micronutrient intakes and median food group intakes were below recommendations based on Canada's Food Guide to Healthy Eating (CFGHE). Overall diet quality indicated that 43%, 47%, and 10% of students had poor, average, and superior diet quality, respectively. Adolescents with lower diet quality had significantly different intakes of macronutrients and CFGHE-defined "other foods." In terms of diet quality determinants, those with poor diet quality had higher frequencies of suboptimal meal behaviours. Students with poor diet quality consumed breakfast and lunch less frequently than did those with average and superior diet quality.
Canadian adolescents have low intakes of CFGHE-recommended foods and high intakes of "other foods." Those with poor diet quality had suboptimal macro-nutrient intakes and increased meal skipping and meal consumption away from home. Adherence to CFGHE may promote optimal dietary intakes and improve nutritional behaviours.
PubMed ID
19515268 View in PubMed
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Dietary patterns associated with glycemic index and glycemic load among Alberta adolescents.

https://arctichealth.org/en/permalink/ahliterature148454
Source
Appl Physiol Nutr Metab. 2009 Aug;34(4):648-58
Publication Type
Article
Date
Aug-2009
Author
Laura E Forbes
Kate E Storey
Shawn N Fraser
John C Spence
Ronald C Plotnikoff
Kim D Raine
Rhona M Hanning
Linda J McCargar
Author Affiliation
Department of Agricultural, Food and Nutritional Science, University of Alberta, University of Alberta, Edmonton, AB T6G 2P5, Canada.
Source
Appl Physiol Nutr Metab. 2009 Aug;34(4):648-58
Date
Aug-2009
Language
English
Publication Type
Article
Keywords
Adolescent
Adolescent Behavior
Alberta
Blood Glucose - metabolism
Body Weight
Child
Cross-Sectional Studies
Diet Records
Female
Food Habits
Food Preferences
Glycemic Index
Humans
Internet
Male
Mental Recall
Nutrition Surveys
Abstract
The purpose of this study was to assess the dietary glycemic index (GI) and glycemic load (GL) of adolescents, based on a Web-based 24-h recall, and to investigate dietary predictors of GI and GL. In addition, the relationship between GI and GL and weight status was examined. A Web-based 24-h recall was completed by 4936 adolescents, aged 9-17 years; macronutrient and food group intakes were assessed using the ESHA Food Processor, the Canadian Nutrient File, and Canada's Food Guide. Dietary GI and GL were calculated based on published GI values for foods. Students provided self-reported height and mass. Multiple regression models assessed the ability of food group choices and food behaviours to predict GI and GL. Mean GI was 55 for girls and 56 for boys. Mean GL was 128 for girls and 168 for boys. Food group choices explained 26% of the variation in GI (p
PubMed ID
19767800 View in PubMed
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23 records – page 1 of 3.