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The impact of a population-level school food and nutrition policy on dietary intake and body weights of Canadian children.

https://arctichealth.org/en/permalink/ahliterature108403
Source
Prev Med. 2013 Dec;57(6):934-40
Publication Type
Article
Date
Dec-2013
Author
Christina Fung
Jessie-Lee D McIsaac
Stefan Kuhle
Sara F L Kirk
Paul J Veugelers
Author Affiliation
University of Alberta, School of Public Health, 3-50 University Terrace, 8303-112 Street, Edmonton, Alberta T6G 2T4, Canada. Electronic address: Christina.Fung@ualberta.ca.
Source
Prev Med. 2013 Dec;57(6):934-40
Date
Dec-2013
Language
English
Publication Type
Article
Keywords
Body Weight
Child
Diet - statistics & numerical data
Eating
Female
Humans
Male
Nova Scotia - epidemiology
Nutrition Policy
Nutrition Surveys
School Health Services
Abstract
The objective of this study is to assess population-level trends in children's dietary intake and weight status before and after the implementation of a provincial school nutrition policy in the province of Nova Scotia, Canada.
Self-reported dietary behavior and nutrient intake and measured body mass index were collected as part of a population-level study with grade 5 students in 2003 (n=5215) and 2011 (5508), prior to and following implementation of the policy. We applied random effects regression methods to assess the effect of the policy on dietary and health outcomes.
In 2011, students reported consuming more milk products, while there was no difference in mean consumption of vegetables and fruits in adjusted models. Adjusted regression analysis revealed a statistically significant decrease in sugar-sweetened beverage consumption. Despite significant temporal decreases in dietary energy intake and increases in diet quality, prevalence rates of overweight and obesity continued to increase.
This population-level intervention research suggests a positive influence of school nutrition policies on diet quality, energy intake and healthy beverage consumption, and that more action beyond schools is needed to curb the increases in the prevalence of childhood obesity.
Notes
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PubMed ID
23891787 View in PubMed
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Dietary intake and risk factors for poor diet quality among children in Nova Scotia.

https://arctichealth.org/en/permalink/ahliterature174637
Source
Can J Public Health. 2005 May-Jun;96(3):212-6
Publication Type
Article
Author
Paul J Veugelers
Angela L Fitzgerald
Elizabeth Johnston
Author Affiliation
Department of Community Health & Epidemiology, Dalhousie University, Halifax, NS.
Source
Can J Public Health. 2005 May-Jun;96(3):212-6
Language
English
Publication Type
Article
Keywords
Child
Child Nutritional Physiological Phenomena
Diet - statistics & numerical data
Energy intake
Feeding Behavior
Female
Humans
Male
Nova Scotia
Nutrition Policy
Nutrition Surveys
Questionnaires
Risk factors
Schools
Students
Abstract
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.
PubMed ID
15913088 View in PubMed
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Dietary reference intakes: a comparison with the Nova Scotia Nutrition Survey.

https://arctichealth.org/en/permalink/ahliterature187315
Source
Can J Diet Pract Res. 2002;63(4):176-83
Publication Type
Article
Date
2002
Author
Angela L Fitzgerald
David R Maclean
Paul J Veugelers
Author Affiliation
Dalhousie University.
Source
Can J Diet Pract Res. 2002;63(4):176-83
Date
2002
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Dietary Fats - administration & dosage
Female
Food Habits
Humans
Male
Middle Aged
Nova Scotia
Nutrition Assessment
Nutrition Policy
Nutrition Surveys
Nutritional Requirements
Population Surveillance
Sex Factors
Abstract
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.
PubMed ID
12493140 View in PubMed
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Diet quality and cancer incidence in Nova Scotia, Canada.

https://arctichealth.org/en/permalink/ahliterature186633
Source
Nutr Cancer. 2002;43(2):127-32
Publication Type
Article
Date
2002
Author
Angela L Fitzgerald
Ron A Dewar
Paul J Veugelers
Author Affiliation
Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada B3H 4H7.
Source
Nutr Cancer. 2002;43(2):127-32
Date
2002
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Diet - standards
Female
Health promotion
Humans
Incidence
Logistic Models
Male
Mental Recall
Middle Aged
Neoplasms - epidemiology - etiology - prevention & control
Nova Scotia - epidemiology
Nutrition Surveys
Risk factors
Abstract
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.
PubMed ID
12588692 View in PubMed
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Diet quality and academic performance.

https://arctichealth.org/en/permalink/ahliterature158304
Source
J Sch Health. 2008 Apr;78(4):209-15; quiz 239-41
Publication Type
Article
Date
Apr-2008
Author
Michelle D Florence
Mark Asbridge
Paul J Veugelers
Author Affiliation
Department of Community Health and Epidemiology, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada. michelle.florence@dal.ca
Source
J Sch Health. 2008 Apr;78(4):209-15; quiz 239-41
Date
Apr-2008
Language
English
Publication Type
Article
Keywords
Body mass index
Child
Child Nutritional Physiological Phenomena
Diet
Educational Measurement
Female
Humans
Learning - physiology
Male
Nova Scotia
Nutrition Surveys
Schools
Sex Factors
Socioeconomic Factors
Students - statistics & numerical data
Abstract
Although the effects of nutrition on health and school performance are often cited, few research studies have examined the effect of diet quality on the academic performance of children. This study examines the association between overall diet quality and academic performance.
In 2003, 5200 grade 5 students in Nova Scotia, Canada, and their parents were surveyed as part of the Children's Lifestyle and School-performance Study. Information on dietary intake, height, and weight and sociodemographic variables were linked to results of a provincial standardized literacy assessment. Diet Quality Index-International was used to summarize overall diet quality. Multilevel regression methods were used to examine the association between indicators of diet quality and academic performance while adjusting for gender and socioeconomic characteristics of parents and residential neighborhoods.
Across various indicators of diet quality, an association with academic performance was observed. Students with decreased overall diet quality were significantly more likely to perform poorly on the assessment. Girls performed better than boys as did children from socioeconomically advantaged families. Children attending better schools and living in wealthy neighborhoods also performed better.
These findings demonstrate an association between diet quality and academic performance and identify specific dietary factors that contribute to this association. Additionally, this research supports the broader implementation and investment in effective school nutrition programs that have the potential to improve student access to healthy food choices, diet quality, academic performance, and, over the long term, health.
PubMed ID
18336680 View in PubMed
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Dietary iron as a risk factor for myocardial infarction. Public health considerations for Nova Scotia.

https://arctichealth.org/en/permalink/ahliterature189151
Source
Can J Public Health. 2002 Jul-Aug;93(4):267-70
Publication Type
Article
Author
Darshaka Malaviarachchi
Paul J Veugelers
Alexandra M Yip
David R MacLean
Author Affiliation
Department of Community Health and Epidemiology, Dalhousie University.
Source
Can J Public Health. 2002 Jul-Aug;93(4):267-70
Language
English
Publication Type
Article
Keywords
Adult
Diet
Female
Humans
Iron - administration & dosage - adverse effects
Logistic Models
Male
Meat
Middle Aged
Myocardial Infarction - epidemiology - etiology
Nova Scotia - epidemiology
Nutrition Surveys
Public Health Practice
Risk factors
Abstract
Epidemiological and experimental studies have suggested that high levels of dietary iron and hemeiron can lead to myocardial injury. Lean meat, a primary source of iron and hemeiron, is promoted because it is lower in fat and cholesterol. Does lean meat put us at risk for myocardial infarction, and should we reconsider its promotion?
We analyzed the importance of dietary iron and hemeiron as a risk for myocardial infarction among 2,198 Nova Scotians who participated in a nutrition survey and who were followed for eight years, using logistic regression.
Acute myocardial infarction incidents occurred in 94 (4.3%) participants. We found no increased risk for myocardial infarction associated with high intake of iron and hemeiron.
Based on Nova Scotian data showing no increased risk for myocardial infarction with high intake of iron and hemeiron, there is no need for immediate reconsideration of promotion of lean meat.
PubMed ID
12154528 View in PubMed
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A province-wide school nutrition policy and food consumption in elementary school children in Prince Edward Island.

https://arctichealth.org/en/permalink/ahliterature144474
Source
Can J Public Health. 2010 Jan-Feb;101(1):40-3
Publication Type
Article
Author
Megan L Mullally
Jennifer P Taylor
Stefan Kuhle
Janet Bryanton
Kimberley J Hernandez
Debbie L MacLellan
Mary L McKenna
Robert J Gray
Paul J Veugelers
Author Affiliation
Holland College, Charlottetown, PEI.
Source
Can J Public Health. 2010 Jan-Feb;101(1):40-3
Language
English
Publication Type
Article
Keywords
Body mass index
Child
Confidence Intervals
Female
Food Habits
Health promotion
Humans
Linear Models
Male
Nutrition Policy
Nutrition Surveys
Nutritional Status
Obesity - epidemiology - prevention & control
Odds Ratio
Prince Edward Island
Questionnaires
School Health Services
Schools
Social Marketing
Students
Abstract
Although the majority of Canadian provinces have indicated that they have adopted new school nutrition policies, there have been few if any systematic evaluations of these policies. In Prince Edward Island, a nutrition policy for elementary schools was adopted province-wide in 2006. In the present study, we assessed the nutritional benefits of the new policy by examining changes in student food consumption prior to and one year following implementation of the policy.
We surveyed fifth and sixth grade children from 11 elementary schools in Prince Edward Island in 2001/02 (pre-policy implementation) and fifth and sixth grade children from the same 11 schools in 2007 (post-policy implementation). Food consumption was assessed using a self-administered validated food frequency questionnaire. We applied multilevel logistic regression to compare pre-/post-policy implementation differences in the proportion of students meeting Canada's Food Guide recommendations for vegetables and fruit (VF) and milk and alternatives (MA) and in the proportion of students consuming
PubMed ID
20364537 View in PubMed
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Nutrition and body weights of Canadian children watching television and eating while watching television.

https://arctichealth.org/en/permalink/ahliterature151247
Source
Public Health Nutr. 2009 Dec;12(12):2457-63
Publication Type
Article
Date
Dec-2009
Author
Tina Liang
Stefan Kuhle
Paul J Veugelers
Author Affiliation
School of Public Health, Population Health Intervention Research Unit, University of Alberta, 6-50 University Terrace, 8303-112 Street, Edmonton, Alberta, Canada.
Source
Public Health Nutr. 2009 Dec;12(12):2457-63
Date
Dec-2009
Language
English
Publication Type
Article
Keywords
Body Weight - physiology
Child
Child Nutritional Physiological Phenomena
Diet - standards - statistics & numerical data
Eating - physiology
Energy Intake - physiology
Feeding Behavior
Female
Health Behavior
Humans
Life Style
Logistic Models
Male
Multivariate Analysis
Nova Scotia - epidemiology
Nutrition Surveys
Overweight - epidemiology - etiology
Risk factors
Schools
Students
Television
Time Factors
Abstract
To examine whether eating while watching television poses a risk for poor nutrition and excess body weight over and above that of time spent watching television.
We analysed data of grade 5 students participating in a comprehensive population-based survey in the Canadian province of Nova Scotia. This survey included the Harvard's Youth Food Frequency Questionnaire, students' height and weight measurements, and a parent survey. We applied multivariable linear and logistic random effects models to quantify the associations of watching television and eating while watching television with diet quality and body weight.
The province of Nova Scotia, Canada.
Grade 5 students (n 4966).
Eating supper while watching television negatively affected the consumption of fruits and vegetables and overall diet quality. More frequent supper while watching television was associated with more soft drink consumption, a higher percentage energy intake from sugar out of total energy from carbohydrate, a higher percentage energy intake from fat, and a higher percentage energy intake from snack food. These associations appeared independent of time children spent watching television. Both watching television and eating while watching television were positively and independently associated with overweight.
Our observations suggest that both sedentary behaviours from time spent watching television as well as poor nutrition as a result of eating while watching television contribute to overweight in children. They justify current health promotion targeting time spent watching television and call for promotion of family meals as a means to avoid eating in front of the television.
PubMed ID
19405988 View in PubMed
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Children's preference for large portions: prevalence, determinants, and consequences.

https://arctichealth.org/en/permalink/ahliterature162714
Source
J Am Diet Assoc. 2007 Jul;107(7):1183-90
Publication Type
Article
Date
Jul-2007
Author
Cynthia K Colapinto
Angela Fitzgerald
L Janette Taper
Paul J Veugelers
Author Affiliation
Health Promotion Division, Sudbury & District Health Unit, Sudbury, Ontario, Canada.
Source
J Am Diet Assoc. 2007 Jul;107(7):1183-90
Date
Jul-2007
Language
English
Publication Type
Article
Keywords
Body mass index
Child
Child Nutrition Sciences - education
Child Nutritional Physiological Phenomena
Diet - standards
Eating - physiology - psychology
Energy intake
Feeding Behavior - physiology - psychology
Female
Food - classification
Food Preferences
Health promotion
Humans
Male
Mass Media
Nova Scotia - epidemiology
Nutrition Surveys
Obesity - epidemiology - etiology
Overweight
Prevalence
Regression Analysis
Schools
Size Perception
Vegetables
Abstract
Proliferation of large portions of snack and fast foods parallels dramatic increases in childhood obesity. This study investigates the prevalence, determinants, and consequences of large portions in children's diets.
As part of the 2003 Children's Lifestyle and School-performance Study, we surveyed 4,966 children in Nova Scotia regarding their usual portion sizes of french fries, meats, vegetables, and potato chips using three-dimensional graduated food models. We measured heights and weights and assessed dietary intake with the Harvard Youth Adolescent Food Frequency Questionnaire. Diet quality was summarized using the Diet Quality Index International (DQI-I). Parents were surveyed on food habits and socioeconomic background.
We used multilevel regression methods to examine determinants of children's large portion size choice and to evaluate the effect of this selection on energy intake, diet quality, and overweight.
Children reported preference for portions of french fries, meats, and potato chips that are larger and vegetable portions that are smaller than what is recommended. Children from socioeconomically disadvantaged families or who frequently eat while watching television and in fast-food restaurants preferred larger portions of french fries and potato chips. Consequences of consuming large portions of these foods included poor diet quality and increased energy intake. Consuming large portions of vegetables was associated with lower energy intake and better diet quality.
Successful marketing of large portions of french fries and potato chips may be at the expense of diet quality and appropriate energy intake. Policy regulations and nutrition education emphasizing appropriate portion sizes provide opportunities to prevent overweight and improve future health.
Notes
Comment In: J Am Diet Assoc. 2007 Jul;107(7):1107-1017604739
PubMed ID
17604749 View in PubMed
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