Public health policies promote healthy nutrition but evaluations of children's adherence to dietary recommendations and studies of risk factors of poor nutrition are scarce, despite the importance of diet for the temporal increase in the prevalence of childhood obesity. Here we examine dietary intake and risk factors for poor diet quality among children in Nova Scotia to provide direction for health policies and prevention initiatives.
In 2003, we surveyed 5,200 grade five students from 282 public schools in Nova Scotia, as well as their parents. We assessed students' dietary intake (Harvard's Youth Adolescent Food Frequency Questionnaire) and compared this with Canadian food group and nutrient recommendations. We summarized diet quality using the Diet Quality Index International, and used multilevel regression methods to evaluate potential child, parental and school risk factors for poor diet quality.
In Nova Scotia, 42.3% of children did not meet recommendations for milk products nor did they meet recommendations for the food groups 'Vegetables and fruit' (49.9%), 'Grain products' (54.4%) and 'Meat and alternatives' (73.7%). Children adequately met nutrient requirements with the exception of calcium and fibre, of which intakes were low, and dietary fat and sodium, of which intakes were high. Skipping meals and purchasing meals at school or fast-food restaurants were statistically significant determinants of poor diet. Parents' assessment of their own eating habits was positively associated with the quality of their children's diets.
Dietary intake among children in Nova Scotia is relatively poor. Explicit public health policies and prevention initiatives targeting children, their parents and schools may improve diet quality and prevent obesity.
The purpose of this study was to compare the newly released dietary reference intakes with the 1990 Nova Scotia Nutrition Survey and identify characteristics that influence compatibility with these new recommendations. For each of 17 nutrient recommendations, we calculated the proportion of participants who consumed intakes within the recommended range. We constructed a score reflecting overall compatibility between the new recommendations and the Nova Scotia Nutrition Survey data. Using this score as the dependent variable, we conducted multivariate regression analysis to evaluate the importance of demographic and behavioural factors for compatibility with the dietary reference intakes. Results indicate that compatibility with the dietary reference intakes was poor among Nova Scotians, particularly for magnesium, vitamins C and E, and macronutrients. Compatibility was lower among females than among males, and differed independently by age, body mass index, socioeconomic factors, smoking status, and alcohol consumption. Dietary intervention is needed in Nova Scotia. Reduced fat intake and increased intake of specific vitamins should be promoted. We recommend that nutrition education campaigns coinciding with the introduction of the dietary reference intakes in Nova Scotia target younger people, those of lower socioeconomic background, smokers, and those who are obese.
Cancer rates in the province of Nova Scotia, Canada, are among the highest in the country and coincide with elevated rates of risk factors such as smoking, poor diet, and obesity. To investigate the importance of diet on cancer, using data from the 1990 Nova Scotia Nutrition Survey, we developed a diet quality score reflecting compliance with 17 nutrient recommendations. The survey data were subsequently linked with the provincial cancer registry, and the relationship between diet quality and cancer was quantified using logistic regression. Our results support an inverse relationship between diet quality and cancer, although limited statistical power resulting from our small study sample did not reveal any statistically significant relationships. We estimated that cancer incidence could potentially be reduced by approximately 35% through improved diet quality. On the basis of poor diet, nutrition-related factors (high body mass index), our estimates of the preventable fraction of cancer, and the high provincial cancer rates, we recommend health promotion strategies aimed at improving diet quality in Nova Scotia.