Current dietary recommendations for cardiovascular disease prevention suggest dietary patterns that promote achieving healthy weight, emphasize vegetables, legumes, fruit, whole grains, fish and nuts, substituting mono-unsaturated fats for saturated fats and restricting dietary sodium to less than 2300 mg/day. However, trends in nutrient intake and food consumption patterns suggest that the need for improvement in the dietary patterns of Canadians is clear. Influencing eating behaviour requires more than addressing nutrition knowledge and perceptions of healthy eating - it requires tackling the context within which individuals make choices. A comprehensive approach to improving nutrition includes traditional downstream strategies such as counselling to improve knowledge and skills; midstream strategies such as using the media to change social norms; and upstream strategies such as creating supportive environments through public policy including regulatory measures. While the evidence base for more upstream strategies continues to grow, key examples of comprehensive approaches to population change provide a call to action.
Cites: Asia Pac J Clin Nutr. 2002;11 Suppl 9:S755-812656679
Measuring the outcomes of nutrition interventions in health promotion settings can be a challenge. Nutrition screening tools are often used to measure dietary patterns and nutrition intervention outcomes, but these tools may lack quantitative scoring methods. Using the SmartDiet questionnaire from Oslo, Norway, as a model, the SmartDiet Canadian Version questionnaire was developed to assess fiber and fat intake. The purpose of this study was to assess the reliability and validity of this new questionnaire. In 2007, 54 volunteer subjects (63% men, mean age 68.3+/-9.7 years) were recruited from the Cardiac Rehabilitation Program at Vancouver General Hospital, Vancouver, BC, Canada. Test-retest reliability was assessed by having subjects complete the questionnaire at recruitment and 1 month later. Intraclass correlation coefficients of reliability (ICC) for both fiber and fat intake were calculated. For fiber scores the ICC was 0.66 (95% confidence interval 0.48, 0.79) and for fat scores the intraclass correlation coefficient was 0.74 (95% confidence interval 0.59, 0.84). Validity was assessed by correlating the completed questionnaire at recruitment with a 3-day food diary. The daily fat and fiber scores from the questionnaire were correlated with the corresponding average daily fat and fiber scores from the 3-day food diary by means of the Spearman correlation coefficient. For fiber scores, Spearman rho was 0.53 (P