Dietary patterns associated with diet quality among First Nations women living on reserves in British Columbia

Les Indigènes canadiens vivent une rapide transition nutritionnelle marquée par une consommation accrue des produits commercialisés au dépit des aliments traditionnels. Ce mémoire cherche à identifier les patrons alimentaires associés à une meilleure alimentation des femmes autochtones vivant dans les réserves en Colombie Britannique. L’échantillon (n=493) a été sélectionné de l’étude ‘First Nations Food, Nutrition, and Environment Study’. L’étude a utilisé des rappels alimentaires de 24 heures. Pour identifier les patrons alimentaires, un indice de qualité alimentaire (QA) basé sur 10 éléments nutritionnels (fibre alimentaire, gras totaux/saturés, folate, magnésium, calcium, fer, vitamines A, C, D) a permis de classifier les sujets en trois groupes (tertiles). Ces groupes ont été comparés sur leur consommation de 25 groupes alimentaires (GAs) en employant des tests statistiques non-paramétriques (Kruskal-Wallis et ANCOVA). Une analyse discriminante (AD) a confirmé les GAs associés à la QA. La QA des sujets était globalement faible car aucun rappel n’a rencontré les consommations recommandées pour tous les 10 éléments nutritionnels. L'AD a confirmé que les GAs associés de façon significative à la QA étaient ‘légumes et produits végétaux’, ‘fruits’, ‘aliments traditionnels’, ‘produits laitiers faibles en gras’, ‘soupes et bouillons’, et ‘autres viandes commercialisées’ (coefficients standardisés= 0,324; 0,295; 0,292; 0,282; 0,157; -0.189 respectivement). Le pourcentage de classifications correctes était 83.8%. Nos résultats appuient la promotion des choix alimentaires recommandés par le « Guide Alimentaire Canadien- Premières Nations, Inuits, et Métis ». Une consommation accrue de légumes, fruits, produits laitiers faibles en gras, et aliments traditionnels caractérise les meilleurs patrons alimentaires.

Designing dietary interventions: a reappraisal of the demographic and socio-economic determinants of dietary choice in the UK

The facilitation of healthier dietary choices by consumers is one of the key elements of the UK Government’s food strategy. Designing and targeting dietary interventions requires a clear understanding of the determinants of dietary choice. Conventional analysis of the determinants of dietary choice has focused on mean response functions which may mask significant differences in the dietary behaviour of different segments of the population. In this paper we use a quantile regression approach to investigate how food consumption behaviour varies amongst UK households in different segments of the population, especially in the upper and lower quantiles characterised by healthy or unhealthy consumption patterns. We find that the effect of demographic determinants of dietary choice on households that exhibit less healthy consumption patterns differs significantly from that on households that make healthier consumption choices. A more nuanced understanding of the differences in the behavioural responses of households making less-healthy eating choices provides useful insights for the design and targeting of measures to promote healthier diets.

Can adherence to dietary guidelines address excess caloric intake? An empirical assessment for the UK

The facilitation of healthier dietary choices by consumers is a key element of government strategies to combat the rising incidence of obesity in developed and developing countries. Public health campaigns to promote healthier eating often target compliance with recommended dietary guidelines for consumption of individual nutrients such as fats and added sugars. This paper examines the association between improved compliance with dietary guidelines for individual nutrients and excess calorie intake, the most proximate determinant of obesity risk. We apply quantile regressions and counterfactual decompositions to cross-sectional data from the National Diet and Nutrition Survey (2000-01) to assess how excess calorie consumption patterns in the UK are likely to change with improved compliance with dietary guidelines. We find that the effects of compliance vary significantly across different quantiles of calorie consumption. Our results show that compliance with dietary guidelines for individual nutrients, even if successfully achieved, is likely to be associated with only modest shifts in excess calorie consumption patterns. Consequently, public health campaigns that target compliance with dietary guidelines for specific nutrients in isolation are unlikely to have a significant effect on the obesity risk faced by the population.

Food choices and practices during pregnancy of immigrant and Aboriginal women in Canada: a study protocol

Abstract Background Facilitating the provision of appropriate health care for immigrant and Aboriginal populations in Canada is critical for maximizing health potential and well-being. Numerous reports describe heightened risks of poor maternal and birth outcomes for immigrant and Aboriginal women. Many of these outcomes may relate to food consumption/practices and thus may be obviated through provision of resources which suit the women's ethnocultural preferences. This project aims to understand ethnocultural food and health practices of Aboriginal and immigrant women, and how these intersect with respect to the legacy of Aboriginal colonialism and to the social contexts of cultural adaptation and adjustment of immigrants. The findings will inform the development of visual tools for health promotion by practitioners. Methods/Design This four-phase study employs a case study design allowing for multiple means of data collection and different units of analysis. Phase 1 consists of a scoping review of the literature. Phases 2 and 3 incorporate pictorial representations of food choices (photovoice in Phase 2) with semi-structured photo-elicited interviews (in Phase 3). The findings from Phases 1-3 and consultations with key stakeholders will generate key understandings for Phase 4, the production of culturally appropriate visual tools. For the scoping review, an emerging methodological framework will be utilized in addition to systematic review guidelines. A research librarian will assist with the search strategy and retrieval of literature. For Phases 2 and 3, recruitment of 20-24 women will be facilitated by team member affiliations at perinatal clinics in one of the city's most diverse neighbourhoods. The interviews will reveal culturally normative practices surrounding maternal food choices and consumption, including how women negotiate these practices within their own worldview and experiences. A structured and comprehensive integrated knowledge translation plan has been formulated. Discussion The findings of this study will provide practitioners with an understanding of the cultural differences that affect women's dietary choices during maternity. We expect that the developed resources will be of immediate use within the women's units and will enhance counseling efforts. Wide dissemination of outputs may have a greater long term impact in the primary and secondary prevention of these high risk conditions.

IPH response to DHSSPS and Food Standards Agency (NI) Front of Pack Labelling consultation

From 2016, it will be mandatory for most pre-packed food to carry nutrition labelling.  This provides an opportunity to review the provision of additional nutrition labelling that is provided voluntarily on the front of packs.  The Governments across the UK are committed to the provision of nutritional information to help consumers make better informed food choices. Key points from IPH response Obesity and related chronic conditions are already very prevalent and are expected to increase over the next decade, placing greater financial burden on health care services. Helping consumers to make informed choices about their diet is an important aspect of tackling obesity. Providing clear consistent and easy to understand front of pack (FoP) nutrition information is important in helping consumers to make healthy choices. IPH would support FoP nutrition information using the traffic light labelling scheme and High/Medium/Low text. FoP nutrition labelling should be supported by a public information campaign to educate consumers about portion sizes and recommended daily intakes of fat, sugar and salt. IPH would support a nutrition labelling approach which empowers and enables consumers to take responsibility for their own health through informed dietary choices. The FoP traffic light labelling scheme has the potential to encourage healthier product formulation as manufacturers pursue market share. This in turn would contribute to wider availability of healthier products.

Sociodemographic determinants of diet quality of the EU elderly: a comparative analysis in four countries

Objective: To investigate the sociodemographic determinants of diet quality of the elderly in four EU countries. Design: Cross-sectional study. For each country, a regression was performed of a multidimensional index of dietary quality v. sociodemographic variables. Setting In Finland, Finnish Household Budget Survey (1998 and 2006); in Sweden, SNAC-K (2001–2004); in the UK, Expenditure & Food Survey (2006–07); in Italy, Multi-purpose Survey of Daily Life (2009). Subjects: One- and two-person households of over-50s (Finland, n 2994; UK, n 4749); over-50 s living alone or in two-person households (Italy, n 7564); over-60 s (Sweden, n 2023). Results: Diet quality among the EU elderly is both low on average and heterogeneous across individuals. The regression models explained a small but significant part of the observed heterogeneity in diet quality. Resource availability was associated with diet quality either negatively (Finland and UK) or in a non-linear or non-statistically significant manner (Italy and Sweden), as was the preference for food parameter. Education, not living alone and female gender were characteristics positively associated with diet quality with consistency across the four countries, unlike socio-professional status, age and seasonality. Regional differences within countries persisted even after controlling for the other sociodemographic variables. Conclusions: Poor dietary choices among the EU elderly were not caused by insufficient resources and informational measures could be successful in promoting healthy eating for healthy ageing. On the other hand, food habits appeared largely set in the latter part of life, with age and retirement having little influence on the healthiness of dietary choices.

Profile of European adults interested in internet-based personalized nutrition: The Food4Me Study

Purpose Personalised intervention may have greater potential for reducing the global burden of non-communicable diseases and for promoting better health and wellbeing across the life-span than the conventional “one size fits all” approach. However, the characteristics of individuals interested in personalised nutrition (PN) are unclear. Therefore, the aim of this study was to describe the characteristics of European adults interested in taking part in an internet-based PN study. Methods Individuals from seven European countries (UK, Ireland, Germany, the Netherlands, Spain, Greece and Poland) were invited to participate in the study via the Food4Me website (http://www.food4me.org). Two screening questionnaires were used to collect data on socio-demographic, anthropometric and health characteristics as well as dietary intakes. Results A total of 5662 individuals expressed an interest in the study (mean age 40 ± 12.7; range 15-87 years). Of these 64.6% were female and 96.9% were Caucasian. Overall, 12.9% were smokers and 46.8% reported the presence of a clinically diagnosed disease. Furthermore, 46.9% were overweight or obese and 34.9% were sedentary during leisure time. Assessment of dietary intakes showed that 54.3% of individuals reported consuming at least 5 portions of fruit and vegetables per day, 45.9% consumed more than 3 servings of wholegrains and 37.2% limited their salt intake to less than 5.75g per day. Conclusions Our data indicate that individuals volunteering to participate in an internet-based PN study are broadly representative of the European adult population, most of whom had adequate nutrient intakes but who could benefit from improved dietary choices and greater physical activity. Future use of internet-based PN approaches is thus relevant to a wide target audience.

Comparison of the portion size and frequency of consumption of 156 foods across seven European countries: insights from the Food4ME study

There are no standardised serving/portion sizes defined for foods consumed in the European Union (EU). Typical serving sizes can deviate significantly from the 100 g/100 ml labelling specification required by the EU legislation. Where the nutritional value of a portion is specified, the portion size is determined by the manufacturers. Our objective was to investigate the potential for standardising portion sizes for specific foods, thereby ensuring complementarity across countries. We compared portion size for 156 food items measured using a food frequency questionnaire across the seven countries participating in the Food4me study. The probability of consuming a food and the frequency of consumption differed across countries for 93% and 58% of the foods, respectively. However, the individual country mean portion size differed from the average across countries in only 16% of comparisons. Thus, although dietary choices vary markedly across countries, there is much less variation in portion sizes. Our results highlight the potential for standardisation of portion sizes on nutrition labels in the EU

Un’analisi statistico – economica dell’impatto delle norme WHO su nutrizione e salute

I comportamenti nutrizionali stanno assumendo sempre maggiore rilievo all’interno delle politiche comunitarie e questo sottolinea che la dieta sta avendo, negli ultimi anni, una maggiore importanza come fattore di causa e allo stesso tempo prevenzione nella diffusione di malattie croniche come il cancro, malattie cardiovascolari, diabete, osteoporosi e disturbi dentali. Numerosi studi mostrano infatti che i tassi di obesità sono triplicati nelle ultime due decadi e si è stimato che, se i livelli di obesità continueranno a crescere allo stesso tasso del 1990, nel 2010 il numero di persone obese raggiungerà i 150 milioni tra gli adulti e i 15 milioni tra bambini e adolescenti. I governi nazionali stanno quindi cercando di risolvere questo problema, a cui sono inoltre legati alti costi nazionali, tramite l’implementazione di politiche nutrizionali. Analisi di tipo cross-section sono già state evidenziate da studiosi come Schmidhuber e Traill (2006), i quali hanno effettuato un’analisi di convergenza a livello europeo per esaminare la distanza tra le calorie immesse da 426 prodotti diversi. In quest’analisi hanno così dimostrato la presenza di una similarità distinta e crescente tra i paesi europei per quanto riguarda la composizione della dieta. Srinivasan et al. invece hanno osservato la relazione esistente tra ogni singolo prodotto alimentare consumato e le norme nutrizionali dell’ Organizzazione Mondiale della Sanità (World Health Organization, WHO) Lo scopo di questa tesi è quello di evidenziare il problema a livello di aggregati nutritivi e di specifiche componenti nutrizionali come zucchero, frutta e verdura e non relativamente ad ogni singolo prodotto consumato. A questo proposito ci si è basati sulla costruzione di un indicatore (Recommendation Compliance Index) in modo da poter misurare le distanze tra la dieta media e le raccomandazioni del WHO. Lo scopo è quindi quello di riuscire a quantificare il fenomeno del peggioramento della dieta in diverse aree del mondo negli ultimi quattro decenni, tramite un’analisi panel, basandosi sui dati sui nutrienti consumati, provenienti dal database della FAO (e precisamente dal dataset Food Balance Sheets – FBS). Nella prima fase si introduce il problema dell’obesità e delle malattie croniche correlate, evidenziando dati statistici in diversi paesi europei e mondiali. Si sottolineano inoltre le diverse azioni dei governi e del WHO, tramite l’attuazione di campagne contro l’obesità e in favore di una vita più salutare e di una maggiore attività fisica. Nella seconda fase si è costruito un indicatore aggregato (Recommendation Compliance Index) in modo da analizzare le caratteristiche nella dieta dei diversi Paesi a livello mondiale rispetto alle norme del WHO. L’indicatore si basa sui dati ottenuti da FAOSTAT ed è calcolato per 149 paesi del database dell’FBS per il periodo 1961-2002. Nell’analisi si sono utilizzati i dati sulle percentuali di energia prodotta dalle varie componenti nutritive, quali grassi, grassi saturi e transaturi, zuccheri, carboidrati, proteine e le quantità di frutta e verdura consumate. Inoltre si è applicato un test statistico per testare se il valore del RCI è significativamente cambiato nel tempo, prendendo in considerazione gruppi di Paesi (Paesi OECD, Paesi in via di sviluppo e sottosviluppati). Si è voluto poi valutare la presenza o meno di un processo di convergenza, applicando l’analisi di σ-convergenza per osservare ad esempio se la variabilità è diminuita nel tempo in modo significativo. Infine si è applicato l’indicatore ad un livello micro, utilizzando il database del National Diet and Nutrition Survey, che raccoglie dati di macrocomponenti nutritive e misure antropometriche della popolazione inglese dai 16 ai 64 anni per il periodo 2000-2001. Si sono quindi effettuate analisi descrittive nonché analisi di correlazione, regressione lineare e ordinale per osservare le relazioni tra l’indicatore, i macronutrienti, il reddito e le misure antropometriche dell’ Indice di Massa Corporea (Body Mass Index, BMI) e del rapporto vita-fianchi (Waist-hip ratio, WHR).

The Gut Microbiome and Cirrhosis: Basic Aspects

In this chapter the basic aspects helping to understand the microbiome in terms of quantity, diversity, complexity, function, and interaction with the host are discussed. First the nomenclature, definitions of taxa, and measures of diversity as well as methods to unravel this kingdom are outlined. A brief summary on its physiological relevance for general health and the functions exerted specifically by the microbiome is presented. Differences in the composition of the microbiome along the gastrointestinal tract and across the gut wall and its interindividual variations, enterotypes, and stability are highlighted. The reader will be familiarized with all different modulators impacting on the microbiome, namely, intrinsic and extrinsic factors. Intrinsic factors include gastrointestinal secretions (gastric acid, bile, pancreatic juice, mucus), antimicrobial peptides, motility, enteric nervous system, and host genotype. Extrinsic factors are mainly dietary choices, hygiene, stress, alcohol consumption, exercise, and medications. The second part of the chapter focuses on quantitative and qualitative changes in microbiome in liver cirrhosis. The mechanisms contributing to dysbiosis, small intestinal bacterial overgrowth, and bacterial translocation are delineated underscoring their role for the liver-gut axis.

The socioeconomic status of families of hyperglycemic versus non-hyperglycemic children: A descriptive analysis

The proportion of children and adolescents living with type 2 diabetes mellitus (DM) is rising at an alarming rate. Studies have shown that poor dietary choices and sedentary behaviors account for progression of some of the most prevalent diseases in America, including obesity, heart disease and diabetes. Other studies have shown that genetics plays a role in the diabetic determination of an individual, although not very common. What are some of the differentiating factors between elevated and non-elevated fasting capillary glucose (FCG) levels in children of similar ages, knowing they spend a majority of their lives at home or at school? Why are some children acquiring diabetes while others are not? This study utilized an IRB-approved Family Demographic Survey to determine gender, family income, parent education levels, sedentary practices, and household size. Only those families who gave consent to take part in the study received a questionnaire. The statistical results were used to test the hypothesis that children living with elevated FCG levels are more likely to descend from families with lower incomes, and lower levels of education.^ With regard to household income and FCG status of non-hyperglycemic and hyperglycemic children (Table 4b), there are 10.4% more hyperglycemic children in the lower income bracket than non-hyperglycemic children in the same income bracket.^ With regard to maternal education and FCG status (Table 5b), there are 7.0% more hyperglycemic children in the high school or less maternal educational attainment level than non-hyperglycemic children in the same maternal educational level. The Pearson correlation of maternal education and FCG status showed a negative correlation value of -.035 (Table 5d). The higher the occurrence of hyperglycemia in a child, the lower the maternal educational status is. Household size ranges and averages are nearly identical in families of both hyperglycemic and non-hyperglycemic children. ^

Leakage of nitrous oxide emissions within the Spanish agro-food system in 1961-2009

Abstract In this paper we examine the trends of nitrous oxide (N2O) emissions of the Spanish agricultural sector related to national production and consumption in the 1961?2009 period.The comparison between production- and consumption-based emissions at the national level provides a complete overview of the actual impact resulting from the dietary choices of a given country and allows the evaluation of potential emission leakages. On average, 1.5 % of the new reactive nitrogen that enters Spain every year is emitted as N2O. Production- and consumption-based emissions have both significantly increased in the period studied and nowadays consumption-based emissions are 45 % higher than production-based emissions. A large proportion of the net N2O emissions associated with imported agricultural godos comes from countries that are not committers for the United Nations Framework Convention on Climate Change Kyoto Protocol Annex I. An increase in feed consumption is the main driver of the changes observed, leading to a arkable emission leakage in the Spanish agricultural sector. The complementary approach used here is essential to achieve an effective mitigation of Spanish greenhouse gas emissions.

Blood glucose self-monitoring in non-insulin-treated type 2 diabetes:a qualitative study of patients' perspectives

Background: Self-monitoring of blood glucose is controversial in the management of type 2 diabetes. Some research suggests that self-monitoring improves glycaemic control, whereas other research is sceptical about its value for people with type 2 diabetes who are not on insulin. Although blood glucose meters are widely available and used by this group, patients' own views are absent from the debate. Aim: To explore the pros and cons of glucose monitoring from the patients' perspectives. Design of study: Qualitative repeat-interview study. Setting: Patients were recruited from 16 general practices and three hospital clinics within four local healthcare cooperatives in Lothian, Scotland. Method: Interview data from 40 patients diagnosed with type 2 diabetes within the previous 6 months were analysed using thematic analysis informed by grounded theory. We report findings from round 1 and round 2 interviews. Results: Glucose monitoring can heighten patients' awareness of the impact of lifestyle; for example, dietary choices, on blood glucose levels. Glucose monitoring amplifies a sense of 'success' or 'failure' about self-management, often resulting in anxiety and self-blame if glucose readings remain consistently high. Moreover, monitoring can negatively effect patients' self-management when readings are counter-intuitive. Conclusion: Our analysis highlights the importance of understanding the meanings that newly diagnosed patients attach to glucose self-monitoring. To maximise the positive effects of self-monitoring, health professionals should ensure that patients understand the purpose of monitoring and should clarify with patients how readings should be interpreted. © British Journal of General Practice.

The influence of socio-demographic, psychological and knowledge-related variables alongside perceived cooking and food skills abilities in the prediction of diet quality in adults: a nationally representative cross-sectional study

Background: Interventions to increase cooking skills (CS) and food skills (FS) as a route to improving overall diet are popular within public health. This study tested a comprehensive model of diet quality by assessing the influence of socio-demographic, knowledge- and psychological-related variables alongside perceived CS and FS abilities. The correspondence of two measures of diet quality further validated the Eating Choices Index (ECI) for use in quantitative research.
Methods: A cross-sectional survey was conducted in a quota-controlled nationally representative sample of 1049 adults aged 20–60 years drawn from the Island of Ireland. Surveys were administered in participants’ homes via computer-assisted personal interviewing (CAPI) assessing a range of socio-demographic, knowledge- and psychological-related variables alongside perceived CS and FS abilities. Regression models were used to model factors influencing diet quality. Correspondence between 2 measures of diet quality was assessed using chi-square and Pearson correlations.
Results: ECI score was significantly negatively correlated with DINE Fat intake (r = -0.24, p < 0.001), and ECI score was significantly positively correlated with DINE Fibre intake (r = 0.38, p < 0.001), demonstrating a high agreement. Findings indicated that males, younger respondents and those with no/few educational qualifications scored significantly lower on both CS and FS abilities. The relative influence of socio-demographic, knowledge, psychological variables and CS and FS abilities on dietary outcomes varied, with regression models explaining 10–20 % of diet quality variance. CS ability exerted the strongest relationship with saturated fat intake (β = -0.296, p < 0.001) and was a significant predictor of fibre intake (β = -0.113, p < 0.05), although not for healthy food choices (ECI) (β = 0.04, p > 0.05).
Conclusion: Greater CS and FS abilities may not lead directly to healthier dietary choices given the myriad of other factors implicated; however, CS appear to have differential influences on aspects of the diet, most notably in relation to lowering saturated fat intake. Findings suggest that CS and FS should not be singular targets of interventions designed to improve diet; but targeting specific sub-groups of the population e.g. males, younger adults, those with limited education might be more fruitful. A greater understanding of the interaction of factors influencing cooking and food practices within the home is needed.

Teen Girls’ Perspectives on Their Current Dietary Habits and Food Choices: A Qualitative Study in Jeddah, Saudi Arabia

Rapid socioeconomic development in Saudi Arabia, as a result of oil revenues, has had profound effects on people’s lifestyles, including the transformation of people’s dietary habits. Such dietary transformations, known as the nutrition transition, are common in countries undergoing rapid socioeconomic changes. This transition is significant in Saudi Arabia as the traditional Saudi diet is considered a healthy one. Adoption of the Western diet has had negative health effects on the Saudi population, especially adolescents. As evidenced in many studies, adolescents are the most affected population when it comes to changes in dietary habits and physical activity. Adolescence is a vulnerable stage of life when dietary habits are developed, often lasting into adulthood, and may not be easily changed. In the case of Saudi Arabia, youth or adolescents represent almost 60% of the population; therefore, the eating habits they develop now could have profound consequences for population health in the future. To develop effective health promotion strategies, it is important to understand the sociocultural factors that influence the dietary habits and food choices of Saudi teens. I conducted two semi-structured, open-ended interviews, using photo-elicitation techniques, with 12 Saudi girls, aged 15-16 years. Analysis of the data shows four factors that pulled the participants toward eating home cooked traditional food and five factors that pushed participants away from eating home cooked traditional foods. The research suggests that despite the attractiveness of modern, Western ways of eating for Saudi teen girls, parents still play a key role in encouraging and supporting them to eat healthy food.