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Background: Public health measures related to the COVID-19 pandemic have upended the way Canadians eat and shop for food. Since the pandemic began, many Canadians have reported consuming food away from home (FAFH) less often. FAFH tends to be less healthful than food prepared at home. Little is known about patterns of Canadians' FAFH consumption before the pandemic. This study used 2015 national-level nutrition data, the most recent available, to characterize patterns of FAFH consumption and selected markers of dietary intake., Data and Methods: National-level food intake data came from the first 24-hour dietary recall provided by 20,475 respondents aged 1 or older to the 2015 Canadian Community Health Survey-Nutrition. Mean daily intakes of selected food subgroups and nutrients, adjusted for total energy intake, were compared between those who had consumed any food in a restaurant on the previous day and those who had not. Estimates were generated overall and for eight age and sex groups., Results: In 2015, overall, 21.8% of Canadians had consumed FAFH in a restaurant on the previous day. Eating out was most common among males aged 19 to 54 (27.7%) and least common among young children aged 1 to 5 (8.4%). Compared with Canadians who had not eaten out on the previous day, those who had eaten out had consumed, on that day, fewer servings of whole fruit; whole grains; dark green and orange vegetables; other vegetables (excluding potatoes); milk and fortified soy-based beverages; and legumes, nuts and seeds, on average. Those who had eaten out had consumed, on average, less fibre and total sugar, and more total fat, saturated fat and sodium on that day. There were few differences for meat and poultry, fish and seafood, and protein intake., Discussion: On the day that Canadians ate out in a restaurant, their dietary intake was generally less favourable than that of Canadians who did not eat out. If Canadians continue to eat at home more and to consume less FAFH, as early pandemic-period reports suggest, then results can be used to gauge the potential dietary implications of these shifts.

Background: A larger share of ultra-processed foods and drinks (UPF) in the diet is increasingly linked with poor diet quality, weight gain and elevated risk of diet-related chronic disease. This study used 2015 national-level data, the most recent available, to characterize the intake of UPF among Canadians and to examine changes since 2004., Data and Methods: The 2004 and 2015 Canadian Community Health Surveys provided 24-hour dietary recall data for Canadians aged 2 or older. All food and drink items were classified according to type of food processing using the NOVA classification. The mean energy contribution of UPF (as a percentage of total daily energy intake) was compared across survey years for the overall population and for eight age-sex groups. The National Cancer Institute's methodology was used to assess the distribution of usual energy contributed by UPF., Results: On average, UPF contributed 47.8% (95% CI: 47.3% to 48.3%) of total daily energy in 2004 and 45.7% (95% CI: 45.0% to 46.4%) in 2015 among the overall population, and more than half of total daily energy among children and adolescents. Both the mean energy contribution of UPF and their usual energy distribution shifted downward since 2004 for all age-sex groups, except among adults aged 55 or older. The energy contributions of soft drinks, fruit juices and fruit drinks declined, particularly among children and adolescents. Ultra-processed breads contributed more energy in 2015 for nearly all age-sex groups., Discussion: As in 2004, the overall dietary share of UPF in Canada remained high in 2015, but intakes of some UPF, particularly beverages, declined. The energy contribution of UPF remained highest among children and adolescents, and increased among adults aged 55 or older.

Introduction: The epidemic of non-communicable diseases including cardiovascular diseases and type 2 diabetes is attributable in large part to unhealthy eating and physical inactivity. In the fall of 2016, the Québec government launched its first-ever Government Health Prevention Policy (Politique gouvernementale de prévention en santé (PGPS)) to influence factors that lead to improved health status and quality of life as well as reduced social inequalities in health in the population of Québec. NutriQuébec is a web-based prospective open cohort study whose primary aim is to provide essential data for the evaluation of the PGPS on the Québec population's eating and other lifestyle behaviours over time., Methods and Analysis: Over a first phase of 3 years, NutriQuébec will enrol 20 000 adults living in the province of Québec in Canada through a multimedia campaign designed to reach different segments of the population, including subgroups with lower socioeconomic status. Participants will be invited to complete on a web platform nine core questionnaires on a yearly basis. Questionnaires will assess several dimensions related to lifestyle, including eating and physical activity behaviours, as well as a large number of personal characteristics and global health status. Temporal trends in eating and lifestyle behaviours will be analysed in relation to the implementation of the PGPS to provide essential data for its evaluation at a population level. Data analyses will use sociodemographic weights to adjust responses of participants to achieve, so far as is possible, representativeness of the adult Québec population., Ethics and Dissemination: Université Laval Research Ethics Board approved the NutriQuébec project. Data analysis, presentations in conferences and publication of manuscripts are scheduled to start in 2020., Trial Registration Number: NCT04140071., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Eating plenty of vegetables and fruits on a daily basis is the foundation of a healthy diet. This study investigated patterns in Canadians' vegetable and fruit consumption in 2015 and compared these with 2004 data., Data and Methods: The 2015 Canadian Community Health Survey (CCHS) - Nutrition and the 2004 CCHS - Nutrition (Cycle 2.2) provided nationally representative 24-hour dietary recall data on Canadians' vegetable and fruit intakes. The frequency of consumption and the average quantity of daily intake for total vegetables, fruits and subgroups were calculated overall and by age and sex group for each survey year. The National Cancer Institute's methodology was used to assess the distribution of usual total vegetable and fruit intake and how it relates to recommendations in the 2007 Canada's Food Guide., Results: Overall, Canadians reported consuming fewer total servings of vegetables and fruits in 2015 (4.5 average daily servings) than in 2004 (5.3 average daily servings). Lower total fruit intakes were explained by significantly lower intakes of fruit juice across nearly all age and sex groups, resulting in a decline of 0.3 average total daily fruit servings in the overall population. Lower vegetable consumption was largely driven by lower intakes of potatoes and, to a lesser extent, lettuce. Intakes of whole fruits and other vegetables remained largely unchanged. In both years, the majority of Canadians did not usually consume the number of total vegetable and fruit servings recommended for their age and sex group in the 2007 Canada's Food Guide., Discussion: Canadians reported consuming fewer vegetables and fruits in 2015 compared with 2004. This was largely driven by substantially lower consumption of fruit juice and, to a lesser extent, potatoes. These findings can serve as valuable baseline data to assess any changes in patterns of vegetable and fruit consumption in Canada.

Background: Beverage consumption, especially water, is critical to a healthy diet. The 2007 Canada's Food Guide (CFG) makes specific recommendations regarding the intake of water, fruit juice, milk and energy-dense beverages. Earlier comparisons of 2004 and 2015 dietary data show that changing patterns in beverage intake can explain some of the changes in energy and sugar intake observed in the Canadian population. The objective of this study is to describe any changes in beverage consumption between 2004 and 2015, and how these changes relate to existing recommendations in the 2007 CFG., Data and Methods: Data are from the Canadian Community Health Survey - Nutrition for 2004 and 2015. To estimate any change in the proportion of Canadians consuming a beverage the day before and the quantity consumed, 19 beverage categories were derived using the Bureau of Nutritional Science categories. The CFG classification was used to estimate the relative share of juice intake from total servings of vegetables and fruit, and the intake of milk from milk subcategories. The National Cancer Institute method was used to estimate usual intake., Results: Water intake was higher in 2015 than in 2004. Consumption of milk, fruit juice, and energy-dense beverages such as fruit drinks and soft drinks was lower in 2015. Changes in water, soft drink and fruit drink consumption mostly reflect changes in the proportion of Canadians consuming these specific beverages the day before reporting, while changes in milk and fruit juice mostly reflect a change in the quantity consumed. In 2015, the majority of the population was consuming more whole vegetables and fruit than juice, which is in line with 2007 CFG recommendations., Discussion: Beverage consumption patterns in Canada changed between 2004 and 2015. Some of these changes are in line with recommendations from the 2007 CFG, the food guide that was available at the time of the 2015 survey.

Objective: To evaluate the Canadian Diet History Questionnaire I (C-DHQ I) food list and to adapt the US DHQ II for Canada using Canadian dietary survey data., Design: Twenty-four-hour dietary recalls reported by adults in a national Canadian survey were analysed to create a food list corresponding to C-DHQ I food questions. The percentage contribution of the food list to the total survey intake of seventeen nutrients was used as the criterion to evaluate the suitability of the C-DHQ I to capture food intake in Canadian populations. The data were also analysed to identify foods and to modify portion sizes for the C-DHQ II., Setting: The Canadian Community Health Survey (CCHS) - Cycle 2.2 Nutrition (2004)., Subjects: Adults (n 20 159) who completed 24 h dietary recalls during in-person interviews., Results: Four thousand five hundred and thirty-three foods and recipes were grouped into 268 Food Groups, of which 212 corresponded to questions on the C-DHQ I. Nutrient intakes captured by the C-DHQ I ranged from 79 % for fat to 100 % for alcohol. For the new C-DHQ II, some food questions were retained from the original US DHQ II while others were added based on foods reported in CCHS and foods available on the Canadian market since 2004. Of 153 questions, 143 were associated with portion sizes of which fifty-three were modified from US values. Sex-specific nutrient profiles for the C-DHQ II nutrient database were derived using CCHS data., Conclusions: The C-DHQ I and II are designed to optimize the capture of foods consumed by Canadian populations.

Background: To calculate total intake of a nutrient and estimate inadequate intake for a population, the amounts derived from food/beverages and from vitamin/mineral supplements must be combined. The two methods Statistics Canada has suggested present problems of interpretation., Data and Methods: Data collected from 34,386 respondents to the 2004 Canadian Community Health Survey-Nutrition were used to compare four methods of combining nutrient intake from food/beverages and vitamin/mineral supplements: adding average intake from supplements to the 24-hour food/beverage recall and estimating the usual distribution in the population (Method 1); estimating usual individual intake from food? beverages and adding intake from supplements (Method 2); and dividing the population into supplement users and non-users and applying Method 1 or Method 2 and combining the estimates based on the percentages of users and non-users (Methods 3 and 4)., Results: Interpretation problems arise with Methods 1 and 2; for example, the percentage of the population with inadequate intake of vitamin C and folate equivalents falls outside the expected minimum-maximum range. These interpretation problems are not observed with Methods 3 and 4., Interpretation: Interpretation problems that may arise in combining food and supplement intake of a given nutrient are overcome if the population is divided into supplement users and non-users before Method 1 or Method 2 is applied.

Background: The contribution of specific nutrients to obesity has not been definitively established. The objective of this study was to determine if an association exists between obesity and the relative percentages of fats, carbohydrates, protein and fibre in the diets of Canadians., Data and Methods: The data are from the 2004 Canadian Community Health Survey--Nutrition. The analysis pertains to 6454 respondents aged 18 or older who provided valid 24-hour dietary recall information and measured height and weight, and whose reported energy intake was considered plausible based on their predicted energy expenditure. Logistic regression models with obesity status as the main outcome were conducted, controlling for potential confounders. All analyses were based on weighted estimates., Results: When the effect of the control variables was taken into account, total kilocalories consumed increased the odds of obesity in men, and fibre intake decreased the odds. Among women, only total kilocalories consumed was significantly associated with increased odds of obesity., Interpretation: Higher consumption of kilocalories increased the odds of obesity, but the relative amounts of fats, carbohydrates and protein were generally not significant. The sole exception was an association between higher fibre intake and lower rates of obesity among men.

Background: In addition to recommendations about the consumption of specific foods and nutriens, a measure of overall diet quality is useful. Over the years, a number of countries, but not Canada, have developed indexes to evaluate diet quality., Data and Methods: The American Healthy Eating Index was adapted to conform to recommendations in Canada's Food Guide. Data from 33,664 respondents to the 2004 Canadian Community Health Survey-Nutrition were used. Usual index scores were calculated with the Software for Intake Distribution Estimation program. Multiple linear regression models were used to examine associations between index scores and various characteristics, particularly the frequency of vegetable and fruit consumption., Results: For the population aged 2 or older, the average score on the Canadian adaptation of the Healthy Eating Index in 2004 was 58.8 out of a possible 100 points. Children aged 2 to 8 had the highest average scores (65 or more). Average scores tended to fall into early adolescence, stabiilizing around 55 at ages 14 to 30. A gradual upturn thereafter brought the average score to around 60 at age 71 or older. At all ages, women's scores exceeded those of men. The frequency of vegetable and fruit consumption was linked to index scores., Interpretation: The American Healthy Eating Index can be adapted to Canadian food intake recommendations. Canadian Community Health Survey questions about the frequency of vegetable and fruit consumption can be used as an approximation of diet quality.

According to results from the 2004 Canadian Community Health Survey-Nutrition, total beverage consumption among adults declined steadily with age. This reflects drops in the percentage of adults consuming most beverages and in the amounts consumed. While water was the beverage consumed most frequently and in the greatest quantity by adults, for many of them, coffee ranked second. Largely as a result of drinking coffee, more than 20% of men and 15% of women aged 31 to 70 exceeded the recommended maximum of 400 milligrams of caffeine per day. About 20% of men aged 19 to 70 consumed more than two alcoholic drinks a day. Owing to declines in the consumption of soft drinks and alcohol, the contribution of beverages to adults' total calorie intake falls at older ages. Regardless of age, men were generally more likely than women to report drinking most beverages, and those who did, drank more. There were, however, a few exceptions, with higher percentages of women than men reporting that they drank water and tea.

Objectives: This article compares rates of overweight/obesity and obesity and food consumption patterns of off-reserve Aboriginal and non-Aboriginal people aged 19 to 50 in Ontario and the western provinces. DATA SOURCES; The data are from the 2004 Canadian Community Health Survey: Nutrition (cycle 2.2)., Analytical Techniques: Cross-sectional analyses were used to estimate the percentages of individuals who were overweight/obese or obese and average nutrient consumption, based on Aboriginal identity and other selected characteristics. Logistic regression was used to determine the independent influence of Aboriginal identity on overweight/obesity and obesity., Main Results: In 2004, the overweight/obesity and obesity rates of off-reserve Aboriginal people aged 19 to 50 were higher than those of the non-Aboriginal population. These overall differences primarily reflected higher rates of overweight/obesity and obesity among Aboriginal women. At ages 19 to 30, these differences can partly be explained by higher calorie intake by Aboriginal women, despite identical energy needs, based on height, weight, age and physical activity. Most of the excess calories are eaten as snacks and come from "other foods".

Background: Estimates of energy intake are lower in 2015 compared with 2004. The difference observed is too large to be explained by a change in energy requirements or physical activity at the population level. Self-reported dietary intake is subject to misreporting and may explain part of this difference. The objectives of this study are to assess how misreporting has changed from 2004 to 2015 and to demonstrate how these changes may affect the interpretation of the national intake data of Canadians. Data and methods: Data from the 2004 Canadian Community Health Survey - Nutrition (CCHS - Nutrition) and the 2015 CCHS - Nutrition were used to estimate energy intake and requirements for all participants aged 2 or older. The ratio of energy intake to total energy expenditure requirements (EI:TEE) was used to categorize respondents as under-reporters (EI:TEE < 0.70), over-reporters (EI:TEE > 1.42) or plausible reporters (EI:TEE = 0.70 to 1.42). Descriptive analyses by category of respondent were conducted for respondents aged 2 or older who participated in the measured height and weight component. The main caloric sources that contributed to the difference in estimated energy requirements were used to show the impact of misreporting on the analysis. Results: The prevalence of under-reporters was 7.5% higher in 2015 compared with 2004, while the prevalence of over-reporters was 7.4% lower. There was no change in the prevalence of plausible reporters. Estimated energy intake from participants categorized as plausible reporters showed a difference of 84 kcal from 2004 to 2015, compared with a difference of 250 kcal for the entire sample. Estimated energy intake was lower in 2015 compared with 2004 across all categories of respondents for many foods, including sugar-sweetened beverages and milk, and was higher for only pastries and nuts. Interpretation: Misreporting changes will affect analysis and should, at a minimum, be acknowledged when comparing 2015 with 2004. Using a comparable category of plausible reporters or adjusting for reporting status are options that will allow a better comparison of these two datasets. [ABSTRACT FROM AUTHOR]

Background Nutritional risk screening is typically done in clinical settings to identify individuals at risk of malnourishment. This article presents the first population-level assessment of nutritional risk based on a large national sample representative of Canadian householders aged 65 or older. Data sources and methods Data from the 2008/2009 Canadian Community Health Survey--Healthy Aging were used to estimate the prevalence of nutritional risk by selected characteristics. Factors associated with nutritional risk were examined with restricted and full logistic models. The distribution of responses on the SCREEN II-AB nutritional risk instrument is reported. Results Based on the results of the 2008/2009 survey, 34% of Canadians aged 65 or older were at nutritional risk. Women were more likely than men to be at risk. Among people with depression, 62% were at nutritional risk, compared with 33% of people without depression. Level of disability, poor oral health, and medication use were associated with nutritional risk, as were living alone, low social support, infrequent social participation, and not driving on a regular basis. Lower income and education were also associated with nutritional risk. Interpretation Nutritional risk is common among seniors living in private households in Canada. The characteristics of people most likely to be at nutritional risk provide evidence for targeted screening and assessment. [ABSTRACT FROM AUTHOR]

According to the 2004 Canadian Community Health Survey--Nutrition, Canadians consumed an average of 110 grams (26 teaspoons) of sugar a day, approximately 20% of their total energy intake. While over 30% of this sugar came from vegetables and fruit, 35% came from the "other" foods category, which consists of items such as soft drinks, salad dressings and candy. The top ten sources of sugar accounted for approximately 85% of daily sugar intake. Beverages (milk, fruit juice, fruit drinks and regular soft drinks) represented 44% of the sugar consumed by children and adolescents, and 35% of that consumed by adults. Diabetics' average sugar intake was less than that of non-diabetics, but at 17%, exceeded the recommended 10% cut-off of total daily calories. [ABSTRACT FROM AUTHOR]

According to results from the 2004 Canadian Community Health Survey--Nutrition, Canadians get an average of 132 milligrams of vitamin C a day from food. About one adult in five has inadequate dietary intake of vitamin C. A third of Canadians take vitamin C supplements, which add 100 milligrams to total average daily intake. Supplement use lowers the overall percentage of adults with inadequate intake by 5 percentage points to 17%. Smokers, people who eat fruit and vegetables infrequently, and members of households with low income and low educational attainment tend to have relatively low vitamin C intake. [ABSTRACT FROM AUTHOR]

Background Under-reporting of food consumption is a recurrent challenge for nutrition surveys. Past research suggests that under-reporting tends to be most pronounced among overweight and obese people. Data and methods Data from 16,190 respondents to the 2004 Canadian Community Health Survey (CCHS 2.2)--Nutrition were used to estimate underreporting of food intake for the population aged 12 or older in the 10 provinces. Multiple linear regression models were used to assess the impact of different characteristics on underreporting. Results Average under-reporting of energy intake was estimated at 10%. Under-reporting was greater among people who were overweight or obese, those who were physically active, adults compared with teenagers, and women compared with men. Interpretation Under-reporting of energy intake is not random and varies by key health determinants. Awareness of the characteristics associated with under-reporting is important for users of nutrition data from the CCHS 2.2. [ABSTRACT FROM AUTHOR]

Background Under-reporting is common in nutrition surveys. The identification of plausible respondents is a way of measuring the impact of under-reporting on the relationship between energy intake and body mass index (BMI). Data and methods A 24-hour dietary recall from 16,190 respondents aged 12 or older to the Canadian Community Health Survey (CCHS)--Nutrition was used to determine energy and nutrient intake. To identify plausible respondents, a confidence interval was applied to total energy expenditure derived from equations developed by the Institute of Medicine. Estimates of energy and nutrient intake for plausible respondents were compared with estimates for all respondents. Linear regression was used to demonstrate the impact of under-reporting on the relationship between reported energy intake and weight. Logistic regression was used to determine the impact of under-reporting on modelling the characteristics of obese people. Results With a confidence interval of 70% to 142% around energy expenditure, 57% of CCHS respondents were identified as "plausible respondents." Nutrient under-reporting varied between 1% and 10%. Analysis based only on plausible respondents re-establishes the theoretical relationship between energy intake and body weight, a relationship that is lost when analysis is based on the full sample. Interpretation Identifying plausible respondents is an effective way of measuring the impact of under-reporting food intake. Conclusions based on plausible respondents, rather than on all respondents, are more in line with theoretical expectations, such as a positive association between high energy intake and obesity. [ABSTRACT FROM AUTHOR]

The article focuses on sodium consumption at all ages in Canada. The Institute of Medicine (IOM) recommends sodium intake of 1,000 milligrams for children aged 1 to 3, 1,200 milligrams for ages 4 to 8 and 1,500 for ages 9 to 50. Based on the 2004 Canadian Community Health Survey (CCHS)-Nutrition 24-hour dietary recall, Canadians exceeded the average daily intake of sodium at all ages. The survey also revealed the link between high sodium intake and hypertension.

Objectives This report is an overview of Canadians' eating habits: total calories consumed and the number of servings from the various food groups, as well as the percentage of total calories from fat, protein and carbohydrates. Data sources The data are from the 2004 Canadian Community Health Survey (CCHS) - Nutrition. Published results from the 1970-1972 Nutrition Canada Survey were used for comparisons over time. Analytical techniques An initial 24-hour dietary recall was completed by 35,107 people. A subsample of 10,786 completed a second recall 3 to 10 days later. Data collected in the first interview day were used to estimate, by selected characteristics, average calorie intake and average percentages of calories from fat, protein and carbohydrates. Usual intake of macronutrients was estimated with the Software for Intake Distribution Estimation (SIDE) program, using data from both interview days. Main results Although a minimum of five daily servings of vegetables and fruit is recommended, 7 out of 10 children aged 4 to 8 and half of adults did not meet this minimum in 2004. More than a third of 4- to 9-year-olds did not have the recommended two daily servings of milk products. Over a quarter of Canadians aged 3t to 50 obtained more than 35% of their total calories from fat. Snacks account for more calories than breakfast, and about the same number of calories as lunch. [ABSTRACT FROM AUTHOR]