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Canadian post-secondary students are vulnerable to food insecurity, yet lack of examination of this issue has prevented identification of policy and program solutions. This mixed-methods study aimed to characterize the experience of food insecurity among undergraduate students by eliciting barriers to food security, strategies used to manage food and money shortages, and perceived implications for health and academic achievement. Surveys and in-depth interviews were conducted with 14 students who demonstrated compromised financial access to food. Students normalized experiences of food insecurity as typical of post-secondary education but expressed anxiety and frustration with financial inaccessibility to healthy food, and described negative implications for their physical and mental health and their ability to perform well in school. Ongoing attempts to adapt or adjust to food insecurity had limited success. Findings highlight the need to challenge the "starving student" ideology, which normalizes the lack of access to healthy food during higher education.

Measures that can provide reasonably accurate estimates of sugar-containing beverage (SCB) intake among children are needed. The primary objective of this study was to evaluate the relative validity of a short beverage screener (Nutrition and Health Questionnaire, NHQ) compared to a 24-hour recall (Automated Self-Administered 24-h (ASA24) Dietary Assessment Tool-Canada) for assessing parent proxy-reported daily SCB intake among children aged 4–14 years from the TARGet Kids! research network in Toronto, Canada. Children for whom a NHQ completed between March 2018 and June 2019 and an ASA24 completed within one year were included. A total of 471 parents who completed the NHQ beverage screener were also asked to complete the ASA24. One-hundred sixty-three completed the ASA24 and of this group, 109 were analyzed. Estimates of daily intake of 100% juices, sweetened drinks and soda, and total SCBs from the two measures were compared. The mean difference in beverage intake, Spearman correlations, and Bland-Altman plots were estimated for continuous measures. The kappa coefficient, sensitivity, and specificity were calculated for dichotomous measures of any daily intake versus none. The mean difference in total SCB intake between the NHQ and ASA24 was 0.14 cups/day (95% CI 0.01, 0.29) and the correlation was 0.43 (95% CI 0.26, 0.57). Sensitivity and specificity for any daily SCB intake were 0.63 and 0.76, respectively. Overall, parent proxy-reporting of children's total SCB intake from a beverage screener can provide reasonable estimates of SCB intake when detailed dietary assessment is not feasible. [ABSTRACT FROM AUTHOR]

Background: Dietary inequities in childhood may shape dietary and health inequities across the life course. Quantifying the magnitude and direction of trends in absolute and relative gaps and gradients in diet quality according to multiple indicators of socioeconomic position (SEP) can inform strategies to narrow these inequities.Objectives: We examined trends in absolute and relative gaps and gradients in diet quality between 2004 and 2015 according to 3 indicators of SEP among a nationally representative sample of children in Canada.Methods: Data from children (aged 2-17 y; n = 18,670) who participated in the cross-sectional Canadian Community Health Survey-Nutrition in 2004 or 2015 were analyzed. SEP was based on total household income, household educational attainment, and neighborhood deprivation. Dietary intake data from 1 interviewer-administered 24-h dietary recall were used to derive a Healthy Eating Index-2015 (HEI-2015) score for each participant as a measure of diet quality. Inequities in diet quality were quantified using 4 indices: absolute and relative gaps (between highest and lowest SEP) and absolute (Slope Index of Inequality) and relative gradients (Relative Index of Inequality). Overall and age-stratified multivariable linear regression and generalized linear models examined trends in HEI-2015 scores between 2004 and 2015.Results: Although mean HEI-2015 total scores improved from 52.3 to 57.3 (maximum 100 points; P < 0.001), absolute and relative gaps and gradients in diet quality remained mostly stable for all 3 SEP indicators. However, among children aged 6-11 y, absolute and relative gradients in diet quality according to household educational attainment and neighborhood deprivation widened.Conclusions: The diet quality of children in Canada was poor and inequitably patterned in 2004 and 2015. Although mean diet quality improved between 2004 and 2015, absolute and relative gaps and gradients in diet quality persisted, with some evidence of widening absolute and relative gradients among 6- to 11-y-olds. [ABSTRACT FROM AUTHOR]

Background Socioeconomic inequities in diet quality are stable or widening in the United States; however, these trends have not been well characterized in other nations. Moreover, purpose-developed indices of inequities that can provide a more comprehensive and precise perspective of trends in absolute and relative dietary gaps and gradients using multiple indicators of socioeconomic position (SEP) have not yet been used, and can inform strategies to narrow dietary inequities. Objectives We quantified nationally representative trends in absolute and relative gaps and gradients in diet quality between 2004 and 2015 according to 3 indicators of SEP among adults in Canada. Methods Adults (≥18 y old) who participated in the nationally representative, cross-sectional Canadian Community Health Survey—Nutrition in 2004 (n  = 20,880) or 2015 (n  = 13,970) were included. SEP was classified using household income (quintiles), education (5 categories), and neighborhood deprivation (quintiles). Dietary intake data from 24-h recalls were used to derive Healthy Eating Index-2015 (HEI-2015) scores. Dietary inequities were quantified using absolute and relative gaps (between the most and least disadvantaged) and absolute [Slope Index of Inequality (SII)] and relative gradients (Relative Index of Inequality). Overall and sex-stratified multivariable linear regression and generalized linear models examined trends in HEI-2015 scores between 2004 and 2015. Results Mean HEI-2015 scores improved from 55.3 to 59.0 (maximum: 100); however, these trends were not consistently equitable. Whereas inequities in HEI-2015 scores were stable in the total population and in females, the absolute gap [from 1.60 (95% CI: 0.09, 3.10) to 4.27 (95% CI: 2.20, 6.34)] and gradient [from SII = 2.09 (95% CI: 0.45, 3.73) to SII = 4.84 (95% CI: 2.49, 7.20)] in HEI-2015 scores for household income, and the absolute gradient for education [from SII = 8.06 (95% CI: 6.41, 9.71) to SII = 10.52 (95% CI: 8.73, 12.31)], increased in males. Conclusions Absolute and relative gaps and gradients in overall diet quality remained stable or widened between 2004 and 2015 among adults in Canada. [ABSTRACT FROM AUTHOR]

Objective: An absence of food literacy measurement tools makes it challenging for nutrition practitioners to assess the impact of food literacy on healthy diets and to evaluate the outcomes of food literacy interventions. The objective of the present scoping review was to identify the attributes of food literacy.Design: A scoping review of peer-reviewed and grey literature was conducted and attributes of food literacy identified. Subjects included in the search were high-risk groups. Eligible articles were limited to research from Canada, USA, the UK, Australia and New Zealand.Results: The search identified nineteen peer-reviewed and thirty grey literature sources. Fifteen identified food literacy attributes were organized into five categories. Food and Nutrition Knowledge informs decisions about intake and distinguishing between 'healthy' and 'unhealthy' foods. Food Skills focuses on techniques of food purchasing, preparation, handling and storage. Self-Efficacy and Confidence represent one's capacity to perform successfully in specific situations. Ecologic refers to beyond self and the interaction of macro- and microsystems with food decisions and behaviours. Food Decisions reflects the application of knowledge, information and skills to make food choices. These interdependent attributes are depicted in a proposed conceptual model.Conclusions: The lack of evaluated tools inhibits the ability to assess and monitor food literacy; tailor, target and evaluate programmes; identify gaps in programming; engage in advocacy; and allocate resources. The present scoping review provides the foundation for the development of a food literacy measurement tool to address these gaps. [ABSTRACT FROM AUTHOR]

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Household food insecurity constrains food selection, but whether the dietary compromises associated with this problem heighten the risk of nutrient inadequacies is unclear. The objectives of this study were to examine the relationship between household food security status and adults' and children's dietary intakes and to estimate the prevalence of nutrient inadequacies among adults and children, differentiating by household food security status. We analyzed 24-h recall and household food security data for persons aged 1-70 y from the 2004 Canadian Community Health Survey (cycle 2.2). The relationship between adults' and children's nutrient and food intakes and household food security status was assessed using regression analysis. Estimates of the prevalence of inadequate nutrient intakes by food security status and age/sex group were calculated using probability assessment methods. Poorer dietary intakes were observed among adolescents and adults in food-insecure households and many of the differences by food security status persisted after accounting for potential confounders in multivariate analyses. Higher estimated prevalences of nutrient inadequacy were apparent among adolescents and adults in food-insecure households, with the differences most marked for protein, vitamin A, thiamin, riboflavin, vitamin B-6, folate, vitamin B-12, magnesium, phosphorus, and zinc. Among children, few differences in dietary intakes by household food security status were apparent and there was little indication of nutrient inadequacy. This study indicates that for adults and, to some degree, adolescents, food insecurity is associated with inadequate nutrient intakes. These findings highlight the need for concerted public policy responses to ameliorate household food insecurity. [ABSTRACT FROM AUTHOR]

Background: Among adults and children consuming Western diets, beverages are significant sources of free sugars, saturated fats, excess calories, and alcohol, with relevance to chronic disease risk. The impact of recent healthy eating policies and beverage market evolutions on population-level consumption patterns in Canada is unknown. The current study examined trends in intake of a range of beverage types among a nationally-representative sample of Canadians, with stratification by socio-demographic characteristics.Methods: The 2004 (n = 34,775) and 2015 (n = 20,176) nutrition-focused cycles of the Canadian Community Health Surveys are cross-sectional surveys representative of the population of the 10 Canadian provinces. Based on a single multiple-pass 24-h dietary recall for each participant, fluids consumed as beverages were grouped into seven categories. Using linear regression, reported intake (volume, ml and energy, kcal) of each category was characterized over time and in relation to sex, age, ethnicity, income, body mass index (BMI), and province of residence.Results: In 2015, Canadians reported consuming an average of 1806 ml (275 kcal) fluids as beverages per day, including: plain water 867 ml (0 kcal); other unsweetened beverages, e.g. coffee, 364 ml (6 kcal); sugar-sweetened beverages (SSBs) 204 ml (99 kcal); plain milk 132 ml (64 kcal); alcoholic drinks 120 ml (71 kcal); 100% juice 74 ml (34 kcal); and diet or low calorie beverages 44 ml (2 kcal). Differential consumption was observed across socio-demographic groups, with high consumption of sugary drinks (i.e., SSBs and 100% juice) and alcohol across groups. From 2004 to 2015, the reported volumes of beverages consumed decreased by 10% (energy: - 24%). With adjustment for socio-demographic characteristics, there were significant changes (p < 0.001) over time in intake of: 100% juice - 40% (- 38%); plain milk - 37% (- 35%); SSBs - 26% (- 20%); diet or low calorie beverages (- 46%); and other unsweetened beverages - 11% (- 42%). The volume of plain water consumed increased by 10% (p < 0.0001). Intake of alcoholic (volume and energy) and diet or light beverages did not change significantly.Conclusions: Lower intake of beverages was reported by Canadians in 2015 versus 2004, with a shift towards plain water. Consumption of sugary drinks decreased, but these beverages continue to contribute substantially to Canadians' overall energy intake. The findings underscore the need for policies to further reduce the consumption of sugary and alcoholic beverages, as well as calories from beverages. [ABSTRACT FROM AUTHOR]

Background: School nutrition policies can encourage restrictions in sugar-sweetened beverage (SSB) availability in school food outlets in order to discourage students' SSB intake. The main objective was to examine how beverage availability in school vending machines changes over three school years across schools in distinct school nutrition policy contexts. Secondary objectives were to examine how students' weekday SSB intake varies with time and identify longitudinal associations between beverage availability and SSB intake. Methods: This longitudinal study used data from the COMPASS study (2013/14–2015/16), representing 7679 students from 78 Canadian secondary schools and three provincial school nutrition policy contexts (Alberta – voluntary guidelines, Ontario public – mandatory guidelines, and Ontario private schools – no guidelines). We assessed availability of 10 beverage categories in schools' vending machines via the COMPASS School Environment Application and participants' intake of three SSB varieties (soft drinks, sweetened coffees/teas, and energy drinks) via a questionnaire. Hierarchical regression models were used to examine whether: i) progression of time and policy group were associated with beverage availability; and, ii) beverage availability was associated with students' SSB intake. Results: Ontario public schools were significantly less likely than the other policy groups to serve SSBs in their vending machines, with the exception of flavoured milks. Vending machine beverage availability was consistent over time. Participants' overall SSB intake remained relatively stable; reductions in soft drink intake were partially offset by increased sweetened coffee/tea consumption. Relative to Ontario public schools, attending school in Alberta was associated with more frequent energy drink intake and overall SSB intake whereas attending an Ontario private school was associated with less frequent soft drink intake, with no differences in overall SSB intake. Few beverage availability variables were significantly associated with participants' SSB intake. Conclusions: Mandatory provincial school nutrition policies were predictive of more limited SSB availability in school vending machines. SSB intake was significantly lower in Ontario public and private schools, although we did not detect a direct association between SSB consumption and availability. The findings provide support for mandatory school nutrition policies, as well as the need for comprehensive school- and broader population-level efforts to reduce SSB intake. [ABSTRACT FROM AUTHOR]