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Un apport alimentaire trop eleve en sodium constitue un important facteur de risque de mortalite et d'invalidite partout dans le monde, en raison de son impact negatif sur la sante [...]

Key points * The World Health Organization prioritized dietary sodium reduction and declared a '30% reduction in population sodium intakes by 2025' as 1 of 9 global targets for noncommunicable [...]

Objective: The aim of this study was to describe sugary drink (beverages with free sugars), sugar-sweetened beverage (beverages with added sugars, SSB) and 100% juice (beverages with natural sugars) consumption across socioeconomic position (SEP) among Canadians. Methods: We conducted a cross-sectional analysis of 19,742 respondents of single-day 24-h dietary recalls in the nationally representative 2015 Canadian Community Health Survey–Nutrition. Poisson regressions were used to estimate the prevalence of consuming each beverage type on a given day. Among consumers on a given day, linear regressions were used to estimate mean energy intake. Models included household education, food security and income quintiles as separate unadjusted exposures. Sex-specific models were estimated separately for children/adolescents (2–18 years) and adults (19 +). Results: Among female children/adolescents, the prevalence of consuming sugary drinks and, separately, SSB ranged from 11 to 21 and 8 to 27 percentage-points higher among lower education compared to ‘Bachelor degree or above’ households. In female adults, the prevalence of consuming sugary drinks and, separately, SSB was 10 (95% CI: 1, 19) and 14 (95% CI: 2, 27) percentage-points higher in food insecure compared to secure households. In males, the prevalence of consuming 100% juice was 9 (95% CI: − 18, 0) percentage-points lower among food insecure compared to secure households. Social inequities in energy intake were observed in female adult consumers, among whom mean energy from sugary drinks was 27 kcal (95% CI: 3, 51) higher among food insecure compared to secure and 35 kcal (95% CI: 2, 67) higher from 100% juice among ‘less than high school’ education compared to ‘Bachelor degree or above’ households. Conclusion: Social inequities in sugary drink consumption exist in Canada. The associations differed by SEP indicator. Equitable interventions to reduce consumption are warranted.

Background:Adherence to diet and medical therapies are key to improving heart failure (HF) outcomes; however, nonadherence is common. While mobile apps may be a promising way to support patients with adherence via education and monitoring, little is known about HF patient opinions regarding adoption of apps for HF management; which is critical to understand for these tools to be successfully developed, implemented, and adopted.Objective:To determine patients’ needs, motivations and challenges on the use of mobile apps to support HF management.Methods:A qualitative descriptive study using focus groups (n=4,60 minutes) was conducted among HF patients (aged ≥18 yrs, smartphone/tablet users, on stable medical therapy without hospital admission for ≥ 6 months) from outpatient HF clinics in Toronto, Canada. The Diffusion of Innovation theory informed a ten-question interview guide. Interview transcripts were independently coded by two researchers and analyzed using content analysis.Results:Nineteen HF patients (65 ± 10 yrs, 12 men) identified technology and app use behaviours, opportunities and challenges across six main themes: 1)‘Patient usage of technology’, many patients already used technology for daily activities and monitoring health; 2) ‘Patient views on adopting new technology’, some patients reported being early adopters of technology, while others would wait; 3) ‘Factors impacting technology use by patients’, included access to accurate information, easy and accessible user-interface; 4) ‘Providing patient support through access to information and self-monitoring’, apps could provide education on HF-related content (e.g., diet, medication, exercise, symptoms); 5) ‘Facilitating connection and communication’, apps could help information sharing with healthcare providers and connect with other patients; 6) ‘Patient preferences of app features’, app features such as reminders for medication, and visuals to show changes in HF symptoms were favoured.Conclusions:HF patients perceive several benefits to app use for HF self-management. Capitalizing on the opportunities apps offer may maximize their adoption by patients and support adherence to diet and medical therapies to improve HF outcomes.

Both the US Institute of Medicine and the Canadian Standing Committee on Health have called for simple, standardized front-of-package (FOP) nutrition labelling systems on packaged foods. However, despite scientific evidence and expert consensus on the topic, Canada’s Minister of Health has dismissed these recommendations, stating that Canadian consumers already have “the tools they need to make healthy food choices when they shop for groceries”. This is relevant since existing evidence suggests that the current regulated nutrition labelling tools may not meet their intended objectives. Furthermore, Canada’s current FOP labelling environment — characterized by a variety of FOP labels with varying criteria — does not support the objectives of good nutrition labelling defined by Health Canada. Evidence suggests that well-designed FOP systems are capable of positively influencing consumer purchases as well as product reformulations by manufacturers. The US Institute of Medicine suggests a standardized, simple, interpretive, and ordinal FOP symbol as the ideal FOP labelling system. Although additional research is required, such a system should be considered in Canada, as it may be capable of addressing the shortcomings of existing nutrition labelling tools found in the Canadian marketplace. Tant l’Institute of Medicine des États-Unis que le Comité permanent de la santé du Canada ont réclamé des systèmes d’étiquetage nutritionnel «sur le devant de l’emballage» (SLDDE) simples et standardisés pour les aliments emballés. Toutefois, malgré les preuves scientifiques et le consensus des spécialistes sur le sujet, la ministre de la Santé du Canada a rejeté ces recommandations en disant que les consommateurs canadiens possèdent déjà «les outils dont ils ont besoin pour choisir des aliments sains quand ils font l’épicerie». C’est un élément pertinent, car les données existantes portent à croire que les outils actuels de réglementation de l’étiquetage nutritionnel pourraient ne pas respecter leurs objectifs prévus. De plus, l’environnement d’étiquetage SLDDE actuel du Canada — caractérisé par diverses étiquettes SLDDE choisies selon divers critères — n’appuie pas l’objectif d’un bon étiquetage nutritionnel défini par Santé Canada. Les faits montrent que des systèmes SLDDE bien conçus sont capables d’influencer positivement les achats des consommateurs ainsi que les reformulations de produits par les fabricants. Selon l’Institute of Medicine américain, le système d’étiquetage SLDDE idéal est un symbole SLDDE standardisé, simple, interprétatif et ordinal. Il faudrait pousser la recherche, mais un tel système mérite qu’on s’y intéresse au Canada, car il pourrait combler les carences des outils d’étiquetage nutritionnel que l’on trouve actuellement sur le marché canadien.