Day-to-day variability in dietary intake makes it difficult to measure accurately the "usual" intake of foods and nutrients. The objectives of the present study were to estimate within- and between-subject variability for foods and nutrients by adjusted and unadjusted models and to assess the number of days required to assess nutrient and food group intakes accurately by two different methods. Adult men and women aged 18-65 y (n = 1543) in the Food Habits of Canadians Study provided a 24-h recall. A repeat interview was conducted in a subsample to estimate components of variability. Within- and between-subject variability were determined by mixed model procedure (crude and adjusted for age, gender, education, smoking, family size and season). The number of days required to obtain various degrees of accuracy was ascertained by two methods, one that uses the variance ratio for groups and one that considers within-subject variability alone for individuals. Variance ratios were higher using the adjusted compared with the unadjusted method (e.g., for men, energy 1.07 vs. 0.49). More days were required to reflect usual intake with accuracy using the adjusted model (energy 5 vs. 2 d), indicating the need to control for confounders to obtain reliable estimates of intakes.
The number of individuals and families accessing food assistance programs has continued to grow throughout the 1990s. Despite the increased health risk among low-income people, few studies have addressed nutrient intake throughout the month or at the end of the month when food and financial resources are thought to be compromised, and no study has described dietary status of a random sample of food bank users. Nutrient intakes of adult female and male food bank users in metropolitan Montreal, Quebec, Canada, were monitored week-by-week over a month by dietitian-administered 24-h recall interviews. A total of 428 participants from a stratified random sample of 57 urban area food banks completed all four interviews. Mean energy intake, as an indicator of diet quantity, was similar to other adult populations (10.2 +/- 4.8 and 7.9 +/- 3.6 MJ for men and women, respectively, age 18-49 y) and not related to sociodemographic variables except the expected biological variation of age and sex. Macronutrient intake was stable throughout the month. Overall median intakes of calcium, vitamin A, and zinc were below recommended levels for all age and sex groups. Intakes of several micronutrients were related to frequency of food bank use, household size, smoking, education, and country of birth. High nutrient intake variability characterized these adult food bank users.
Understanding differences in dietary patterns by smoking status is important for nutritionists and health educators involved in helping individuals to make healthy dietary and lifestyle choices. Although smokers have a poor quality diet compared with nonsmokers, no study has examined nutritional adequacy and variability in the nutrient intake of smokers. The aim of this study was to compare dietary habits of smokers with nonsmokers in terms of nutrient intake, food groups contributing to nutrient intake, nutritional adequacy and day-to-day variation in nutrient intake. Noninstitutionalized adults aged 18--65 y (n = 1543) who participated in the Food Habits of Canadians Survey (1997--1998) were studied. Subjects, selected from across Canada using a multistage, random-sampling strategy, completed an in-home 24-h dietary recall. Repeat interviews were conducted in a subsample to estimate variability in nutrient intake. Smokers had higher intakes of total and saturated fat, and lower intakes of folate, vitamin C and fiber than nonsmokers. There were no significant differences in calcium, zinc and vitamin A intakes or day-to-day variation in nutrient intake by smoking status. Smokers consumed significantly fewer fruits and vegetables than nonsmokers, leading to lower intakes of folate and vitamin C. In conclusion, smokers have a less healthy diet than nonsmokers, placing them at higher risk for chronic disease as a result of both dietary and smoking habits. Diet may act as a confounder in smoking-disease relationships.
The iron status and diet of Inuit infants living in northern Quebec who were part of a prospective cohort study was described. The prevalence of anemia (hemoglobin values > 2 SD below the reference mean) was 21.1% (23/109), 47.4% (55/116) and 37.7% (46/122) at 2, 6 and 12 months, respectively. The corresponding prevalence of microcytic anemia was 0.0%, 4.3% and 21.3%. At 2, 6 and 12 months, iron-deficiency anemia (serum ferritin
Assess sensitivity and specificity of each of the 18 US Department of Agriculture (USDA) Household Food Security Scale Module (HFSSM) questionnaire items to determine whether a rapid assessment of child and adult food insecurity is feasible in an Inuit population.
Food insecurity prevalence was assessed by the 18-item USDA HFSSM in a randomized sample of Inuit households participating in the Inuit Health Survey and the Nunavut Inuit Child Health Survey. Questions were evaluated for sensitivity, specificity, predictive value (+/2), and total percent accuracy for adult and child food insecurity (yes/no). Child food security items were evaluated for both surveys.
For children, the question “In the last 12 months, were there times when it was not possible to feed the children a healthy meal because there was not enough money?” had the best performance in both samples with a sensitivity and specificity of 92.3% and 97.3%, respectively, for the Inuit Health Survey, and 88.5% and 95.4% for the Nunavut Inuit Child Health Survey. For adults, the question “In the last 12 months, were there times when the food for you and your family just did not last and there was no money to buy more?” demonstrated a sensitivity of 93.0% and a specificity of 93.4%.
Rapid assessment of child and adult food insecurity is feasible and may be a useful tool for health care and social service providers. However, as prevalence and severity of food insecurity change over time, rapid assessment techniques should not replace periodic screening by using the full USDA HFSSM questionnaire.
School of Dietetics and Human Nutrition and Centre for Indigenous Peoples' Nutrition and Environment, McGill University, Macdonald Campus, 21,111 Lakeshore Road, Ste Anne de Bellevue, H9X 3V9, Québec, Canada.
To describe dietary habits and extent of overweight and obesity among Cree youth.
Dietary intake and habits were assessed by a 24 h recall and FFQ as part of a cross-sectional survey.
Three Cree communities in northern Québec, Canada.
A total of 125 youth aged 9-18 years.
Overall 67·6 % of the study population was either at risk of overweight or overweight. Over 98 % had a usual saturated fat intake over 10 % of energy while 65 % had a lower consumption of fruit/vegetables and 95 % had a lower consumption of milk and milk products than recommended by Canada's Food Guide. The majority (96·8 %) consumed high-fat foods (>40 % of total energy as fat), which accounted for 39 % of total energy intake (EI). Similarly, 92·8 % consumed high-sugar food and beverages (>25 % of total energy as sugar), which accounted for 12·8 % of total EI. Furthermore, 95 % of the youth had a Healthy Eating Index (HEI) below the recommended score of 80 or above. Certain measures of diet quality (traditional food (TF) consumption, HEI and vegetables and fruit consumption) were significantly correlated with adiposity measures.
A high prevalence of low-diet quality was found with a high degree of sugar and fat intake and a low consumption of vegetables/fruit and milk/milk alternates and any weekly TF. Dietary interventions are sorely needed.
Accelerated loss of traditional lifestyles may place Inuit at risk of iron depletion given that anemia has been observed among Arctic men. The objectives of this study were to determine the prevalence of anemia, storage iron depletion, and iron overload and to identify correlates of iron status in Canadian Inuit men. In a cross-sectional survey of 994 men in the International Polar Year Inuit Health Survey, 2007-2008, hemoglobin, serum ferritin (SF), soluble transferrin receptor (on a subset), CRP, RBC fatty acid composition, and Helicobacter pylori serology were measured in venous blood drawn from fasting men. Anthropometric, dietary, sociodemographic, and health data were collected. Dietary and nondietary correlates of iron status were assessed with multiple linear and logistic models. For men with CRP =10 mg/L (n = 804), 6.5% had depleted, 19.8% had low, and 10.3% had elevated iron stores. Anemia was moderately prevalent (16.1%), but iron deficiency anemia was less common (2.4%). There was a low probability of dietary iron inadequacy (2.4% Tolerable Upper Intake Level). Food-insecure men and those without a household hunter had a higher risk of low or depleted iron stores. Adiposity, traditional food intake, long-chain RBC PUFA status, and inflammation were positively associated with SF and food insecurity, smoking, and H. pylori seropositivity were negatively associated with SF. Despite a moderate prevalence of anemia, iron stores are largely adequate in this population, although lower than expected based on iron intake. The regulation of iron metabolism in this population and the high prevalence of anemia in older men warrants further investigation.