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For the first time since its introduction, the 2019 Canada's Food Guide (2019-CFG) highlighted specific guidance on eating practices, i.e., recommendations on where, when, why, and how to eat. The Canadian Eating Practices Screener / Questionnaire court canadien sur les pratiques alimentaires was developed to assess eating practices based on the 2019-CFG healthy eating recommendations. The objective of this cross-sectional study was to assess the construct validity and reliability of the Canadian Eating Practices Screener. From July to December 2021, adults ( n  = 154) aged 18-65 years completed a sociodemographic questionnaire and the screener. Construct validity was assessed by examining variability in screener scores, by comparing screener scores among subgroups with hypothesized differences in eating practices, and by examining the correlation between screener scores and fruit and vegetable intake. Reliability, i.e., internal consistency, was assessed by calculating Cronbach's coefficient alpha. Screener item scores were summed to provide a total score ranging from 21 to 105. The mean screener score was 76 (SD = 8.4; maximum, 105), ranging from 53 (1st percentile) to 92 (99th percentile). Differences in total scores in hypothesized directions were observed by age ( p  = 0.006), perceived income adequacy ( p  = 0.09), educational attainment ( p  = 0.002), and smoking status ( p  = 0.09), but not by gender or health literacy level. The correlation between screener scores and fruit and vegetable intake was 0.29 ( p  = 0.002). The Cronbach's coefficient alpha was 0.79, suggesting acceptable to high internal consistency. Study findings provide preliminary evidence of the screener's construct validity and reliability, supporting its use to assess eating practices based on the 2019-CFG healthy eating recommendations., Competing Interests: This project was funded by Health Canada through a contract to JH. JH has received funding from the Canadian Foundation for Dietetic Research, CIHR, Danone Institute International, Danone Institute North America, Health Canada, and the National Institutes of Health. SIK has received funding from Agriculture and Agri-Food Canada, AI for Good, the Canadian Institutes of Health Research (CIHR), the Canadian Foundation for Dietetic Research, Health Canada, the National Institutes of Health, the Ontario Ministry of Research and Innovation, and the Social Sciences and Humanities Research Council of Canada. SIK is a member of the Health Canada Nutrition Science Advisory Committee and the CIHR Institute of Nutrition, Metabolism, and Diabetes Institute Advisory Board. SL has received funding from CIHR. BL has received funding from CIHR (ongoing), the Fonds de recherche du Québec—Santé (FRQS) (ongoing), Fonds de recherche du Québec—Nature et technologies (NT) (ongoing), the Ministère de la santé et des services sociaux (MSSS) du Québec (ongoing), Health Canada (completed in 2021), and Atrium Innovations (completed in 2019). BL is a member of the Canadian Nutrition Society Advisory Board. The remaining authors have no competing interests to disclose.

In 2019, Health Canada released a new iteration of Canada's Food Guide (2019-CFG), which, for the first time, highlighted recommendations regarding eating practices, i.e., guidance on where, when, why, and how to eat. The objective of this study was to develop a brief self-administered screener to assess eating practices recommended in the 2019-CFG among adults aged 18-65 years. Development of the screener items was informed by a review of existing tools and mapping of items onto 2019-CFG recommendations. Face and content validity were assessed with experts in public health nutrition and/or dietary assessment ( n  = 16) and individuals from Government of Canada ( n  = 14). Cognitive interviews were conducted with English-speaking ( n  = 16) and French-speaking ( n  = 16) adults living in Canada to assess face validity and understanding of the screener items. While some modifications were identified to improve relevance or clarity, overall, the screener items were found to be relevant, well-constructed, and clearly worded. This comprehensive process resulted in the Canadian Eating Practices Screener/Questionnaire court canadien sur les pratiques alimentaires, which includes 21 items that assess eating practices recommended in the 2019-CFG. This screener can facilitate monitoring and surveillance efforts of the 2019-CFG eating practices as well as research exploring how these practices are associated with various health outcomes., Competing Interests: This project was funded by Health Canada through a contract to JH. JH has received funding from the Canadian Foundation for Dietetic Research, CIHR, Danone Institute International, Danone Institute North America, Health Canada, and the National Institutes of Health. SIK has received funding from Agriculture and Agri-Food Canada, AI for Good, the Canadian Institutes of Health Research (CIHR), the Canadian Foundation for Dietetic Research, Health Canada, the National Institutes of Health, the Ontario Ministry of Research and Innovation, and the Social Sciences and Humanities Research Council of Canada. SIK is a member of the Health Canada Nutrition Science Advisory Committee and the CIHR Institute of Nutrition, Metabolism, and Diabetes Institute Advisory Board. SL has received funding from CIHR. BL has received funding from CIHR (ongoing), the Fonds de recherche du Québec—Santé (FRQS) (ongoing), Fonds de recherche du Québec—Nature et technologies (NT) (ongoing), the Ministère de la santé et des services sociaux (MSSS) du Québec (ongoing), Health Canada (completed in 2021), and Atrium Innovations (completed in 2019). BL is a member of the Canadian Nutrition Society Advisory Board. The remaining authors have no competing interests to disclose.

Novelty: The Canadian Food Intake Screener was developed to rapidly assess alignment of dietary intake with the Canada's Food Guide-2019 healthy food choices recommendations. Scoring is aligned with the Healthy Eating Food Index-2019 to the extent possible. Among a sample of adults, reasonable variation in screener scores was noted, mean screener scores differed between some subgroups with known differences in diet quality, and a moderate correlation between screener scores and total Healthy Eating Food Index-2019 scores based on repeat 24 h dietary recalls was observed. The Canadian Food Intake Screener has moderate construct validity for rapid assessment of overall alignment of adults' dietary intake with the Canada's Food Guide-2019 healthy food choices recommendations., Competing Interests: This project was funded by and conducted in collaboration with Health Canada through a contract to SIK. SIK has received funding from Agriculture and Agri-Food Canada, AI for Good, the Canadian Institutes of Health Research (CIHR), the Canadian Foundation for Dietetic Research, Health Canada, the National Institutes of Health, the Ontario Ministry of Research and Innovation, and the Social Sciences and Humanities Research Council of Canada. SIK is a member of the Health Canada Nutrition Science Advisory Committee and the CIHR Institute of Nutrition, Metabolism, and Diabetes Institute Advisory Board. SL has received funding from CIHR. BL has received funding from CIHR (ongoing), the Fonds de recherche du Québec—Santé (FRQS) (ongoing), Fonds de recherche du Québec—Nature et technologies (NT) (ongoing), the Ministère de la santé et des services sociaux (MSSS) du Québec (ongoing), Health Canada (completed in 2021), and Atrium Innovations (completed in 2019). BL is a member of the Canadian Nutrition Society Advisory Board. JH has received funding from the Canadian Foundation for Dietetic Research, CIHR, Danone Institute International, Danone Institute North America, Health Canada, and the National Institutes of Health. The remaining authors have no competing interests to disclose.

Novelty: The Canadian Food Intake Screener was developed to rapidly assess alignment of adults' dietary intake over the past month with the Food Guide's healthy food choices recommendations. The screener was developed and evaluated through an iterative process that included three rounds of cognitive interviews in each of English and French, along with ongoing feedback from external advisors and face and content validity testing with a separate panel of content experts. The 16-question screener is intended for use with adults, aged 18-65 years, with marginal and higher health literacy in research and surveillance contexts in which comprehensive dietary assessment is not possible., Competing Interests: This project was funded by and conducted in collaboration with Health Canada, through a contract to SIK. SIK has received funding from Agriculture and Agri-Food Canada, AI for Good, the Canadian Institutes of Health Research (CIHR), the Canadian Foundation for Dietetic Research, Health Canada, the National Institutes of Health, the Ontario Ministry of Research and Innovation, and the Social Sciences and Humanities Research Council of Canada. SIK is a member of the Health Canada Nutrition Science Advisory Committee and the CIHR Institute of Nutrition, Metabolism, and Diabetes Institute Advisory Board. SL has received funding from CIHR. BL has received funding from CIHR (ongoing), the Fonds de recherche du Québec—Santé (FRQS) (ongoing), Fonds de recherche du Québec—Nature et technologies (NT) (ongoing), the Ministère de la santé et des services sociaux (MSSS) du Québec (ongoing), Health Canada (completed in 2021), and Atrium Innovations (completed in 2019). BL is a member of the Canadian Nutrition Society Advisory Board. JH has received funding from the Canadian Foundation for Dietetic Research, CIHR, Danone Institute International, Danone Institute North America, Health Canada, and the National Institutes of Health. The remaining authors have no competing interests to disclose.

The release of Canada's Food Guide (CFG) in 2019 by Health Canada prompted the development of indices to measure adherence to these updated dietary recommendations for Canadians. This study describes the development and scoring standards of the Healthy Eating Food Index (HEFI-2019), which is intended to measure alignment of eating patterns with CFG-2019 recommendations on food choices among Canadians aged 2 years and older. Alignment with the intent of each key recommendation in the CFG-2019 was the primary principle guiding the development of the HEFI-2019. Additional considerations included previously published indices, data on Canadians' dietary intakes from the 2015 Canadian Community Health Survey-Nutrition, and expert judgement. The HEFI-2019 includes 10 components: Vegetables and fruits (20 points), Whole-grain foods (5 points), Grain foods ratio (5 points), Protein foods (5 points), Plant-based protein foods (5 points), Beverages (10 points), Fatty acids ratio (5 points), Saturated fats (5 points), Free sugars (10 points), and Sodium (10 points). All components are expressed as ratios (e.g., proportions of total foods, total beverages, or total energy). The HEFI-2019 score has a maximum of 80 points. Potential uses of the HEFI-2019 include research as well as monitoring and surveillance of food choices in population-based surveys. Novelty: The Healthy Eating Food Index-2019 was developed to measure adherence to the 2019 Canada's Food Guide recommendations on healthy food choices. The HEFI-2019 includes 10 components, of which 5 are based on foods, 1 on beverages and 4 on nutrients, for a total of 80 points.

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.

Canada has published food guides since 1942 and the latest version, Eating Well with Canada's Food Guide (EWCFG), was released in 2007. The EWCFG is largely based on meeting nutrient requirements, while we are now in need of a food guide with strong guidance on the role of diet in the prevention of chronic diseases. This article systematically analyses the process and assumptions behind the EWCFG and presents suggestions for needed revisions to the next food guide.