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Objectives: A number of studies have pointed to the pressure that housing costs can exert on the resources available for food. The objectives of the present study were to characterise the relationship between the proportion of income absorbed by housing and the adequacy of household food expenditures across the Canadian population and within income quintiles; and to elucidate the impact of receipt of a housing subsidy on adequacy of food expenditures among low-income tenant households.Design: The 2001 Survey of Household Spending, conducted by Statistics Canada, was a national cross-sectional survey that collected detailed information on expenditures on goods and services. The adequacy of food spending was assessed in relation to the cost of a basic nutritious diet.Setting: Canada.Subjects: The person with primary responsibility for financial maintenance from 15 535 households from all provinces and territories.Results: As the proportion of income allocated to housing increased, food spending adequacy declined significantly among households in the three lowest income quintiles. After accounting for household income and composition, receipt of a housing subsidy was associated with an improvement in adequacy of food spending among low-income tenant households, but still mean food spending fell below the cost of a basic nutritious diet even among subsidised households.Conclusions: This study indicates that housing costs compromise the food access of some low-income households and speaks to the need to re-examine policies related to housing affordability and income adequacy. [ABSTRACT FROM AUTHOR]

Objective: To determine the extent to which identified nutrient inadequacies in the dietary intakes of a sample of food-insecure women could be ameliorated by increasing their access to the 'healthy' foods they typically eat.Design: Merged datasets of 226 food-insecure women who provided at least three 24-hour dietary intake recalls over the course of a month. Dietary modelling, with energy adjustment for severe food insecurity, explored the effect of adding a serving of the woman's own, and the group's typically chosen, nutrient-rich foods on the estimated prevalence of nutrient inadequacy.Setting and Subjects: One study included participants residing in 22 diverse community clusters from the Atlantic Provinces of Canada, and the second study included food bank attendees in Toronto, Ontario, Canada. Of the 226 participants, 78% lived alone with their children.Results: While nutritional vulnerability remained after modelling, adding a single serving of either typically chosen 'healthy' foods from women's own diets or healthy food choices normative to the population reduced the prevalence of inadequacy by at least half for most nutrients. Correction for energy deficits resulting from severe food insecurity contributed a mean additional 20% improvement in nutrient intakes.Conclusions: Food-insecure women would sustain substantive nutritional gains if they had greater access to their personal healthy food preferences and if the dietary compromises associated with severe food insecurity were abated. Increased resources to access such choices should be a priority. [ABSTRACT FROM AUTHOR]

Objectives: To examine the associations of adiposity, dietary restraint and other personal characteristics with energy reporting quality.Design/subjects: Secondary analysis of 230 women and 158 men from the 1997/98 Ontario Food Survey.Methods: Energy reporting quality was estimated by ratios of energy intake (EI) to both basal metabolic rate (BMR) and total energy expenditure (TEE). Multivariate regression analyses were conducted to examine energy reporting quality between two dietary recalls and in relation to body mass index (BMI) with adjustment for potential confounders. Energy reporting quality was explored across categories of age, BMI, income, education, dieting status and food insecurity through analysis of variance (ANOVA).Results: From the ANOVA, energy reporting quality was associated with BMI group, age category and weight loss for men and women, as well as with education among women (P 0.05). EI:BMR and EI:TEE on the first and second 24-hour recalls were positively related (P < 0.0001 for men and women). A higher proportion of variance in energy reporting quality was explained for women than for men (R2 = 0.19 and 0.14, respectively).Conclusions: Studies of diet and adiposity are probably hindered to some extent by BMI-related variation in energy reporting quality. Methods to address this issue are urgently needed if population surveys will continue to serve as the primary source of dietary intake data. [ABSTRACT FROM AUTHOR]

Objectives: To compare food expenditure patterns between low-income households and higher- income households in the Canadian population, and to examine the relationship between food expenditure patterns and the presence or absence of housing payments among low-income households.Design: Secondary data analysis of the 1996 Family Food Expenditure Survey conducted by Statistics Canada.Setting: Sociodemographic data and 1-week food expenditure data for 9793 households were analysed.Subjects: Data were collected from a nationally representative sample drawn through stratified multistage sampling. Low-income households were identified using Statistics Canada's Low Income Measures.Results: Total food expenditures, expenditures at stores and expenditures in restaurants were lower among low-income households compared with other households. Despite allocating a slightly greater proportion of their food dollars to milk products, low-income households purchased significantly fewer servings of these foods. They also purchased fewer servings of fruits and vegetables than did higher-income households. The effect of low income on milk product purchases persisted when the sample was stratified by education and expenditure patterns were examined in relation to income within strata. Among low-income households, the purchase of milk products and meat and alternatives was significantly lower for households that had to pay rents or mortgages than for those without housing payments.Conclusions: Our findings indicate that, among Canadian households, access to milk products and fruits and vegetables may be constrained in the context of low incomes. This study highlights the need for greater attention to the affordability of nutritious foods for low-income groups. [ABSTRACT FROM AUTHOR]

Objective: The objective of this systematic review is to synthesise the evidence on public policy interventions and their ability to reduce household food insecurity (HFI) in Canada., Design: Four databases were searched up to October 2023. Only studies that reported on public policy interventions that might reduce HFI were included, regardless of whether that was the primary purpose of the study. Title and abstract screening, full-text screening, data extraction, risk of bias and certainty of the evidence assessments were conducted by two reviewers., Results: Seventeen relevant studies covering three intervention categories were included: income supplementation, housing assistance programmes and food retailer subsidies. Income supplementation had a positive effect on reducing HFI with a moderate to high level of certainty. Housing assistance programmes and food retailer studies may have little to no effect on HFI; however, there is low certainty in the evidence that could change as evidence emerges., Conclusion: The evidence suggests that income supplementation likely reduces HFI for low-income Canadians. Many questions remain in terms of how to optimise this intervention and additional high-quality studies are still needed.

Objective: To assess the prevalence, severity and socio-demographic predictors of household food insecurity among vulnerable women accessing the Canada Prenatal Nutrition Program (CPNP) and to examine associations between household food insecurity and breastfeeding practices to 6 months., Design: Cohort investigation pooling data from two studies which administered the 18-item Household Food Security Survey Module at 6 months postpartum and collected prospective infant feeding data at 2 weeks and 2, 4 and 6 months. Household food insecurity was classified as none, marginal, moderate or severe. Logistic regression analyses were performed to assess predictors of household food insecurity and associations between household food security (any and severity) and continued and exclusive breastfeeding., Setting: Three Toronto sites of the CPNP, a federal initiative targeting socially and/or economically vulnerable women., Participants: 316 birth mothers registered prenatally in the CPNP from 2017 to 2020., Results: Household food insecurity at 6 months postpartum was highly prevalent (44 %), including 11 % in the severe category. Risk of household food insecurity varied by CPNP site ( P < 0·001) and was higher among multiparous participants (OR 2·08; 95 % CI 1·28, 3·39). There was no association between the prevalence or severity of food insecurity and continued or exclusive breastfeeding to 6 months postpartum in the adjusted analyses., Conclusions: Household food insecurity affected nearly half of this cohort of women accessing the CPNP. Further research is needed on household food insecurity across the national CPNP and other similar programmes, with consideration of the implications for programme design, service delivery and policy responses.

Objective: To examine the relationship between the dietary quality of Canadian children and adults and household food insecurity status., Design: Dietary intake was assessed with one 24-h recall. Households were classified as food secure or marginally, moderately or severely food insecure based on their responses to the Household Food Security Survey Module. We applied multivariable analyses of variance to determine whether % energy from ultra-processed foods, fruit and vegetable intake, Healthy Eating Index (HEI) scores, macronutrient composition and micronutrient intakes per 1000 kcal differed by food insecurity status after accounting for income, education and region. Analyses were run separately for children 1-8 years and 9-18 years and men and women 19-64 years of age., Setting: Ten provinces in Canada., Participants: Respondents to the 2015 Canadian Community Health Survey-Nutrition, aged 1-64 years, with complete food insecurity data and non-zero energy intakes, N 15 909., Results: Among adults and children, % energy from ultra-processed foods was strongly related to severity of food insecurity, but no significant trend was observed for fruit and vegetable intake or HEI score. Carbohydrate, total sugar, fat and saturated fat intake/1000 kcal did not differ by food insecurity status, but there was a significant negative trend in protein/1000 kcal among older children, a positive trend in Na/1000 kcal among younger children and inverse associations between food insecurity severity and several micronutrients/1000 kcal among adults and older children., Conclusions: With more severe household food insecurity, ultra-processed food consumption was higher, and diet quality was generally lower among both adults and children.

Objective: The cost of food is a key influence on diet. The majority of diet cost studies match intake data from population-based surveys to a single source of food supply prices. Our aim was to examine the methodological significance of using food supply data to price dietary intakes., Methods: Nationally representative 24-hour dietary recall data from the 2015 Canadian Community Health Survey-Nutrition (CCHS-N) was matched to the 2015 Canadian Consumer Price Index (CPI) food price list. Proportions and means of reported intakes covered by the 2015 CPI price list were used to compare reported intakes of food groups and food components of interest and concern overall, and by quartile of CPI coverage., Setting: Canada., Participants: 20,487 Canadians ages one and older., Results: The CPI covered on average 76.3% of total dietary intake (g) without water. Staple food groups that were more commonly consumed had better CPI price coverage than those less commonly consumed. Yet some food groups (vegetables, additions, sweets) that were also commonly consumed by Canadians were not well covered by price data. Individuals in the poorest CPI coverage quartile reported consuming significantly greater fibre (g), gram weight (g), dietary fibre (g), and energy (kcal) as compared to those with the best coverage., Conclusions: Differential CPI price coverage exists among food components and commonly consumed food groups; additionally dietary intake differs significantly in the population by CPI coverage. Methodological refinements are needed to better account for error when using prices from food supply data to estimate diet costs.

Objective: Food insecurity is a potent determinant of health and indicator of material deprivation in many affluent countries. Food insecurity is associated with compromises in food and housing expenditures, but how it relates to other expenditures is unknown. The present study described households' resource allocation over a 12-month period by food insecurity status., Design: Expenditure data from the 2010 Survey of Household Spending were aggregated into four categories (basic needs, other necessities, discretionary, investments/assets) and ten sub-categories (food, clothing, housing, transportation, household/personal care, health/education, leisure, miscellaneous, personal insurance/pension, durables/assets). A four-level food insecurity status was created using the adult-specific items of the Household Food Security Survey Module. Mean dollars spent and budget share by food insecurity status were estimated with generalized linear models adjusted first for household size and composition, and subsequently for after-tax income quartiles., Setting: Canada., Subjects: Population-based sample of households from the ten provinces (n 9050)., Results: Food-secure households had higher mean total expenditures than marginally, moderately and severely food-insecure households (P-trend <0·0001). As severity of food insecurity increased, households spent less on all categories and sub-categories, except transportation, but they allocated a larger budget share to basic needs and smaller shares to discretionary spending and investments/assets. The downward trends for dollars spent on basic needs and other necessities became non-significant after accounting for income, but the upward trend in the budget shares for basic needs persisted., Conclusions: The spending patterns of food-insecure households suggest that they prioritized essential needs above all else.

Objective: Foods characterized by a high degree of processing are pervasive in the global food supply and concerns have been raised about their contribution to the escalating burden of diet-related disease. It has been suggested that the dominance of these products relates in part to their aggressive on-package marketing. The purpose of the present study was to assess the relationship between the extent and nature of front-of-package (FOP) nutrition references on products sold in Canadian supermarkets and the level of food processing., Design: FOP references were recorded from all packaged foods. Nutrition references were classified as 'negative' and 'positive' and further differentiated in terms of the use of regulated and unregulated text. Foods were coded for level of processing, using three different classification systems. Logistic and negative binomial regression analyses were conducted to assess associations., Setting: Three large Toronto supermarkets, from the top Canadian food retailers., Subjects: Packaged foods (n 20 520)., Results: Forty-one per cent of products had FOP nutrition references. Irrespective of the classification system considered, the most processed category comprised the greatest proportion of products and nearly half of these bore FOP references. Foods deemed most processed were more likely than less processed products to bear FOP references and regulated and unregulated references to negative ingredients, but they were equally or less likely to bear positive nutrition references, depending on the classification system., Conclusions: The greater frequency of FOP nutrition references on heavily processed foods raises questions about the extent to which discretionary FOP labelling supports public health efforts to promote healthy eating.

Objective: Although the sociodemographic characteristics of food-insecure households have been well documented, there has been little examination of neighbourhood characteristics in relation to this problem. In the present study we examined the association between household food security and neighbourhood features including geographic food access and perceived neighbourhood social capital., Design: Cross-sectional survey and mapping of discount supermarkets and community food programmes., Setting: Twelve high-poverty neighbourhoods in Toronto, Ontario, Canada., Subjects: Respondents from 484 low-income families who had children and who lived in rental accommodations., Results: Food insecurity was pervasive, affecting two-thirds of families with about a quarter categorized as severely food insecure, indicative of food deprivation. Food insecurity was associated with household factors including income and income source. However, food security did not appear to be mitigated by proximity to food retail or community food programmes, and high rates of food insecurity were observed in neighbourhoods with good geographic food access. While low perceived neighbourhood social capital was associated with higher odds of food insecurity, this effect did not persist once we accounted for household sociodemographic factors., Conclusions: Our findings raise questions about the extent to which neighbourhood-level interventions to improve factors such as food access or social cohesion can mitigate problems of food insecurity that are rooted in resource constraints. In contrast, the results reinforce the importance of household-level characteristics and highlight the need for interventions to address the financial constraints that underlie problems of food insecurity.

Objective: To describe homeless youths' experiences of food insecurity and examine the relation between chronic food deprivation and food acquisition practices., Design: A cross-sectional survey of homeless youths was conducted in 2003 to assess their nutritional vulnerability and describe their food acquisition practices., Setting: Toronto, Canada., Subjects: Two hundred and sixty-one youths, aged 16-24 years, who had spent ten or more of the past thirty nights sleeping in a temporary shelter, public space or friend's place, because they had no place of their own. Most participant recruitment (70%) occurred outdoors, but 30% were recruited in drop-in centres., Results: Over the past 30 d, 28% of males and 43% of females experienced chronic food deprivation (i.e. reduced food intake for > or =10 d), and 32% of females and 48% of males reported problems obtaining water to drink. Most youths routinely obtained meals at charitable programmes and panhandled for money for food, and many routinely stole food or ate day-old food obtained from restaurants. In contrast, eating food discarded by others and postponing debt payments were strategies of desperation, more common among youths experiencing chronic food deprivation. Additionally, for males, deliberately seeking the company of friends, relatives or acquaintances to obtain food, and for females, borrowing money or trading sex for food, were associated with chronic food deprivation., Conclusions: The pervasiveness and severity of food insecurity experienced by the youths and their desperate means of food acquisition highlight the need for more effective responses to the plight of homeless youths in Canadian cities.

Objective: To examine the effect of the new Canadian labelling regulations on the fat composition and prices of margarines., Study Design: A survey of all margarines sold in major supermarkets in the Greater Toronto area was conducted in 2006, and results were compared with those of a similar survey conducted in 2002. Average fat composition, proportion of 'trans fat-free' margarines and average prices of margarines were compared. A general linear model procedure was used to compare the relationship between price and fat composition in 2002 and 2006., Results: Average amounts of trans fatty acids (TFA) and MUFA decreased, while average amounts of PUFA increased significantly from 2002 to 2006. The proportion of margarines with less than 0.2 g TFA/10 g serving rose significantly from 31 % in 2002 to 69 % in 2006. Margarines lower in TFA on average cost significantly more than margarines with greater amounts of these fats, and this relationship appeared stronger in 2006 relative to 2002., Conclusions: There is evidence of reductions in TFA in margarines since new labelling regulations came into effect in Canada; however, TFA reductions appeared to be restricted to higher-priced margarines. Results suggest that voluntary approaches (i.e. manufacturer incentives via labelling) to reduce population intakes of TFA will yield little changes in TFA content of low-cost products and thus may have limited benefit for lower-income groups, who are at higher risk of heart disease.

Objectives: To assess the potential nutritional contribution of meals provided in a sample of community programmes for homeless individuals, to determine the effect of food donations on meal quality and to develop food-based guidance for meals that would meet adults' total nutrient needs., Setting: Toronto, Canada., Design: An analysis of weighed meal records from eighteen programmes. The energy and nutrient contents of meals were compared to requirement estimates to assess contribution to total needs, given that homeless people have limited access to nutritious foods. Mixed linear modelling was applied to determine the relationship between the use of food donations and meal quality. The composition of meals that would meet adults' nutrient requirements was determined by constructing simulated meals, drawing on the selection of foods available to programmes., Sample: In all, seventy meals, sampled from eighteen programmes serving homeless individuals., Results: On average, the meals contained 2.6 servings of grain products, 1.7 servings of meat and alternatives, 4.1 servings of vegetables and fruits and 0.4 servings of milk products. The energy and nutrient contents of most meals were below adults' average daily requirements. Most meals included both purchased and donated foods; the vitamin C content of meals was positively associated with the percentage of energy from donations. Increasing portion sizes improved the nutrient contribution of meals, but the provision of more milk products and fruits and vegetables was required to meet adults' nutrient requirements., Conclusions: The meals assessed were inadequate to meet adults' nutrient requirements. Improving the nutritional quality of meals requires additional resources.