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The objective of this study was to evaluate the construct validity and reliability of the Healthy Eating Food Index-2019 (HEFI-2019), which was developed to measure adherence to Canada’s Food Guide 2019 (CFG-2019) recommendations on healthy food choices. Dietary intake data from 24-hour dietary recalls in the 2015 Canadian Community Health Survey-Nutrition were used for that purpose. Multidimensionality was examined using principal component analysis. Mean scores were compared among subgroups of the population. The association between scores and energy intake was assessed using Pearson correlations. Cronbach’s alpha was calculated to assess reliability. The estimated mean HEFI-2019 score (/80) was 43.1 (95% CI, 42.7 to 43.6) among Canadians aged 2 years and older. The first and 99th percentiles were 22.1 and 62.9 points. The mean HEFI-2019 score for smokers was 7.2 points lower than for non-smokers (95% CI, –8.5 to –5.9). The HEFI-2019 was weakly correlated with energy intake (r = –0.13; 95% CI, –0.20 to –0.06). The principal components analysis revealed at least 4 dimensions. Cronbach’s alpha was 0.66 (95% CI, 0.63 to 0.69). Evidence of construct validity and internal consistency support the use of the HEFI-2019 to assess adherence to CFG-2019’s recommendations on healthy food choices. Novelty: Examination of the HEFI-2019’s psychometric properties is needed prior to implementation. Analyses support the construct validity and internal consistency of the HEFI-2019. Interpretation of the total HEFI-2019 score must be accompanied by its components’ scores, considering it assesses multiple dimensions of food choices.

Patients routinely seek physicians’ guidance about diet and the relation between nutrition and the prevention and treatment of disease. However, the adequacy of nutrition instruction in undergraduate medical education is questionable. The purpose of this study was to investigate Canadian medical students’ perceptions of and satisfaction with their education in nutrition. At 9 universities across Canada, a 23-item survey questionnaire was distributed in English and French to undergraduate medical students after at least 8 months of medical school. Overall, 9 of 17 universities participated in the survey, and 933 of the 3267 medical students approached completed the survey (response rate, 28.6%). Mean satisfaction with nutrition instruction received during medical school was 4.7 (±0.06) on a scale of 1–10, where 1 is very dissatisfied and 10 is very satisfied, and there were significant differences among schools (p < 0.0001). Students were comfortable in their ability to counsel patients regarding basic nutrition concepts and the role of nutrition in prevention of disease, but were much less comfortable discussing the role of nutrition in the treatment of disease and nutrient requirements across the lifecycle, and in identifying credible sources of nutrition information. Of the 933 respondents, 87.2% believe that their undergraduate program should dedicate more time to nutrition education. The amount of nutrition instruction correlated with student satisfaction (p < 0.0001), but varied among schools. A significant number of students are dissatisfied with the nutrition education they receive and their ability to provide relevant and appropriate nutrition counselling. This study paves the way for further discussions and development of strategies to improve nutrition education in medical schools in Canada.

Although obesity was rarely observed among children 30 years ago, it is now evident among Canadian children of all ages. Currently, 15.2% of 2- to 5-year-old children are overweight, whereas 6.3% are obese. Limited data suggest that poor dietary and physical activity patterns are increasing obesity risk among these young children. Body weight and lifestyle behaviours are known to track from childhood to adulthood, thereby increasing the risk for obesity and other chronic diseases later in life. Intrauterine life, infancy, and the preschool years may all include critical periods that program the long-term regulation of energy balance, and therefore obesity-prevention strategies should be initiated in utero and continue throughout childhood and adolescence. Although single-strategy obesity-prevention initiatives have had limited success, programs that target multiple behaviours may help reduce body weight and body fat among young children. Parental involvement is key to the success of obesity-prevention programs at a young age, as parents have primary control over their children's food and activity environments. Accordingly, parental obesity is the best predictor of childhood obesity. Parents should be encouraged to teach and role model healthy lifestyle behaviours for their young children. Health professionals can also be involved in obesity prevention, as they are ideally placed to identify young children at risk for obesity. By calculating and plotting the body mass index for all children, and initiating obesity-prevention strategies in utero, health professionals can help curb the rise in overweight and obesity among young children.