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Objective: Limitations of traditional geospatial measures, like the modified Retail Food Environment Index (mRFEI), are well documented. In response, we aimed to: (1) extend existing food environment measures by inductively developing subcategories to increase the granularity of healthy v. less healthy food retailers; (2) establish replicable coding processes and procedures; and (3) demonstrate how a food retailer codebook and database can be used in healthy public policy advocacy. Design: We expanded the mRFEI measure such that 'healthy' food retailers included grocery stores, supermarkets, hypermarkets, wholesalers, bulk food stores, produce outlets, butchers, delis, fish and seafood shops, juice/smoothie bars, and fresh and healthy quick-service retailers; and 'less healthy' food retailers included fast-food restaurants, convenience stores, coffee shops, dollar stores, pharmacies, bubble tea restaurants, candy stores, frozen dessert restaurants, bakeries, and food trucks. Based on 2021 government food premise licences, we used geographic information systems software to evaluate spatial accessibility of healthy and less healthy food retailers across census tracts and in proximity to schools, calculating differences between the traditional v. expanded mRFEI. Setting: Calgary and Edmonton, Canada. Participants: N/A. Results: Of the 10 828 food retailers geocoded, 26 % were included using traditional mRFEI measures, while 53 % were included using our expanded categorisation. Changes in mean mRFEI across census tracts were minimal, but the healthfulness of food environments surrounding schools significantly decreased. Conclusions: Overall, we show how our mRFEI adaptation, and transparent reporting on its use, can promote more nuanced and comprehensive food environment assessments to better support local research, policy and practice innovations. [ABSTRACT FROM AUTHOR]

As providers of community-based physical activity programs, recreation and sports facilities serve as an important resource for health promotion. Unfortunately, the food environments within these settings often do not reflect healthy eating guidelines. This study sought to describe facilitators and barriers to implementing provincial nutrition guidelines in recreation and sports facilities in three Canadian provinces with nutrition guidelines. Semi-structured interviews were analysed thematically to identify facilitators and barriers to implementing provincial nutrition guidelines. Facilitators and barriers were then categorised using a modified "inside out" socio-ecological model that places health-related and other social environments at the centre. A total of 32 semi-structured interviews were conducted at two time-points across the three guideline provinces. Interview participants included recreation staff managers, facility committee or board members and recreation volunteers. Eight facilitators and barriers were identified across five levels of the inside out socio-ecological model. Facilitators included provincial or municipal expectations of guideline implementation, clear communication to staff around guideline directives and the presence of a champion within the community or facility who supported guideline implementation. Barriers included unhealthy food culture within community, competition from other food providers and issues within food service contracts that undermined healthy food provision. Findings reinforce the importance of top down (clear expectations regarding guideline implementation at the time of approval) and bottom up (need for buy-in from multiple stakeholders) approaches to ensure successful implementation of nutrition guidelines. The application of a modified socio-ecological model allowed for a more nuanced understanding of leverage points to support successful guideline implementation. Lay summary Healthy eating is an important behaviour for preventing chronic diseases. Supporting people to access healthy foods in places where they live, learn, work or play is a public health priority. Recreation and sports facilities are a setting where people can be physically active. Unfortunately, the food environment in these settings may not reflect nutrition guidelines. In this study, we interviewed key stakeholders from recreation and sports facilities in three Canadian provinces who had put guidelines for healthy eating in place. We used a specific framework to do this called the inside out socio-ecological model. Eight facilitators and barriers were identified using this model. Facilitators included provincial or municipal expectations of guideline implementation, clear communication to staff around guideline directives and the presence of a champion within the community or facility who supported guideline implementation. Barriers included unhealthy food culture within community, competition from other food providers and issues within food service contracts that undermined healthy food provision. Our findings can help people working in recreation and sports facilities to identify issues that may help or hinder healthy food provision in these settings. [ABSTRACT FROM AUTHOR]

Objective: In 2014, a Nutrition Report Card (NRC) was developed as a sustainable, low-cost framework to assess the healthfulness of children's food environments and highlight action to support healthy eating. We summarise our experiences in producing, disseminating, evaluating and refining an annual NRC in a Canadian province from 2015 to 2019.Design: To produce the NRC, children's food environment indicator data are collected, analyzed and compiled for consensus grading by an Expert Working Group of researchers and practitioners. Knowledge translation activities are tailored annually to the needs of target audiences: researchers, practitioners, policymakers and the public. Evaluation of reach is conducted through diverse strategies, including tracking media coverage and website traffic. Assessment of impact on diets and health outcomes is planned.Setting: Alberta, Canada.Participants: Not applicable.Discussion: The grading process has facilitated refining the NRC to enhance its relevance and utility as a tool for its target audiences. Its public release consistently captures media interest and policymakers' attention. The importance of partnerships in revealing data sources and in strategising to enhance policy approaches to improve food environments is apparent. The NRC has benchmarked progress and stimulated dialogue regarding healthy food environments for children.Conclusions: The NRC may help to foster a supportive climate for improving the quality of children's food environments. As an engaging and accessible document, the NRC represents a key mechanism for collating data related to children's food environments and ensuring it reaches the audiences best positioned to use it. Efforts are underway to expand the NRC across Canada. [ABSTRACT FROM AUTHOR]

To achieve food security in Canada, comprehensive approaches are required, which involve action at the public policy level. This qualitative study explored the experiences of 14 stakeholders engaging in a 9-month participatory public policy advocacy project to promote community food security in the province of Alberta through the initiation of a campaign to develop a Universal School Food Strategy. Through this exploration, four main themes were identified; a positive and open space to contribute ideas, diversity and common ground, confidence and capacity, and uncertainty. Findings from this study suggest that the participatory advocacy project provided a positive and open space for stakeholders to contribute ideas, through which the group was able to narrow its focus and establish a goal for advocacy. The project also seems to have contributed to the group’s confidence and capacity to engage in advocacy by creating a space for learning and knowledge sharing, though stakeholders expressed uncertainty regarding some aspects of the project. Findings from this study support the use of participatory approaches as a strategy for facilitating engagement in public policy advocacy and provide insight into one group’s advocacy experience, which may help to inform community-based researchers and advocates in the development of advocacy initiatives to promote community food security elsewhere. [ABSTRACT FROM AUTHOR]

Few studies have assessed the construct validity of measures of neighborhood food environment, which remains a major challenge in accurately assessing food access. In this study, we adapted a psychometric tool to examine the construct validity of 4 such measures for 3 constructs. We used 4 food-environment measures to collect objective data from 422 Ontario, Canada, food stores in 2010. Residents' perceptions of their neighborhood food environment were collected from 2,397 households between 2009 and 2010. Objective and perceptual data were aggregated within buffer zones around respondents' homes (at 250 m, 500 m, 1,000 m, and 1,500 m). We constructed multitrait-multimethod matrices for each scale to examine construct validity for the constructs of food availability, food quality, and food affordability. Convergent validity between objective measures decreased with increasing geographic scale. Convergent validity between objective and subjective measures increased with increasing geographic scale. High discriminant validity coefficients existed between food availability and food quality, indicating that these two constructs may not be distinct in this setting. We conclude that the construct validity of food environment measures varies over geographic scales, which has implications for research, policy, and practice. [ABSTRACT FROM PUBLISHER]

Background: Pathways by which food environments affect residents’ diet-related outcomes are still unclear. Understanding pathways may help decision makers identify food environment strategies to promote healthy diets. Purpose: To examine the hypothesis that residents’ perceptions mediate the relationship between objective food environment and residents’ diet quality and weight status. Methods: In the Waterloo Region, Ontario, objective food environment data were collected from 422 food stores and 912 restaurants using the Nutrition Environment Measure Survey in Stores and Restaurants, a shelf-space measure of fruits and vegetables, and the Retail Food Environment Index. Waterloo Region households (n=2223) completed a subjective food environment perception survey; household members (n=4102) self-reported weight, height, and waist circumference. A subsample (1170 individuals within 690 households) completed diet records. Food environment data were collected in 2010; respondent data were collected from 2009–2010; and data were analyzed in 2012. A series of gender-specific models were conducted to test mediation, adjusting for household income, car ownership, age, and education level. Results: Residents’ perceptions did not mediate the relationship between objective measures and diet-related outcomes; instead, results revealed the direct effect of several objectively measured factors of the food environment (notably food access and relative food affordability) on outcomes. Perceptions generally were not associated with diet-related outcomes. Conclusions: These results reveal that in this setting, strategies aimed at improving residents’ perceptions may be less effective than those acting directly on food environments to improve food access and relative food affordability. [ABSTRACT FROM AUTHOR]

ObjectiveLittle is known about how public entities can partner with industry to achieve public health goals. We investigated industry's perspective of factors that influenced their adoption and implementation of voluntary, government-issued nutrition guidelines (Alberta Nutrition Guidelines for Children and Youth, ANGCY) in recreational facilities.DesignIn-depth semi-structured interviews were conducted. Data were analysed using directed content analysis.SettingFood services in recreational facilities.SubjectsSeven managers from industry participated; five from companies that had adopted and implemented the ANGCY (adopters) in recreational facilities and two from companies that had not (non-adopters).ResultsIndustry views nutrition guidelines through the lens of profitability. Non-adopters were unwilling to implement the ANGCY for fear of sacrificing short-term profitability, whereas adopters adhered to them in an attempt to position themselves for long-term profitability. Adopters faced barriers including few resources, no training, complex guidelines, low availability of and demand for ANGCY-compliant products, competitive pressures and substantial declines in revenue. Managers believed widespread voluntary adoption of the ANGCY was unlikely without government incentives and/or a mandate, as the environmental context for voluntary action was poor. All managers supported government-mandated implementation of the ANGCY to level the playing field upon which companies compete.ConclusionsPublic–private partnerships in recreational facilities can embrace public health goals in the short term, provided industry perceives potential for long-term financial gain. Widespread uptake of voluntary nutrition guidelines in this setting is unlikely, however, as market mechanisms do not encourage industry to sell and promote healthier options. Government legislation may therefore be warranted. [ABSTRACT FROM AUTHOR]

Objective: To assess the overall diet quality of a sample of adolescents living in Alberta, Canada, and evaluate whether diet quality, nutrient intakes, meal behaviours (i.e. meal skipping and consuming meals away from home) and physical activity are related. Design: A cross-sectional study design. Students completed the self-administered Web-Survey of Physical Activity and Nutrition (Web-SPAN). Students were classified as having poor, average or superior diet quality based on Canada's Food Guide to Healthy Eating (CFGHE). Setting: One hundred and thirty-six schools (37 %) within forty-four public and private school boards (75 %) in Alberta, Canada. Subjects: Grade 7 to 10 Alberta students (n 4936) participated in the school-based research. Results: On average, students met macronutrient requirements; however, micronutrient and fibre intakes were suboptimal. Median CFGHE food group intakes were below recommendations. Those with poor diet quality (42 %) had lower intakes of protein, fibre and low-calorie beverages; higher intakes of carbohydrates, fat and Other Foods (e.g. foods containing mostly sugar, high-salt/fat foods, high-calorie beverages, low-calorie beverages and high-sugar/fat foods); a lower frequency of consuming breakfast and a higher frequency of consuming meals away from home; and a lower level of physical activity when compared with students with either average or superior diet quality. Conclusions: Alberta adolescents were not meeting minimum CFGHE recommendations, and thus had suboptimal intakes and poor diet quality. Suboptimal nutritional intakes, meal behaviours and physical inactivity were all related to poor diet quality and reflect the need to target these health behaviours in order to improve diet quality and overall health and wellness. [ABSTRACT FROM AUTHOR]

Objective: To explore the relationship among children's diet quality, weight status and food environment in subarctic Canada.Design: In the cross-sectional study, children's BMI was calculated, diet quality was assessed using three 24 h dietary recalls and children were asked about their home food environment and source of meals.Setting: Two Aboriginal Cree communities in northern Québec.Subjects: Two hundred and one children in grades 4-6.Results: The majority (64.2%) of children were overweight (29.9%) or obese (34.3%). Weight status was not associated with reported restaurant meal frequency or the home food environment. The 18% of children who consumed three or more restaurant meals in the three days of recall consumed, on average, 2004 kJ (479 kcal) more energy daily than children consuming no restaurant meals and had higher intakes of fat, saturated fat, Ca and soda. Most foods contributing to energy and dietary fat were energy-dense market foods of low nutritional value such as sweetened beverages and snack foods. Only 68% of children reported often having fruits and vegetables in the home and 98.5% of children consumed less than 5 fruits and vegetables daily. Many children (42.8%) were at risk of Zn inadequacy. Only 19% of children consumed 2 or more servings of milk daily, and the mean intakes of Ca and vitamin D were below the recommended adequate intake. Traditional game meat was consumed infrequently, but contributed significantly to Fe and Zn intake.Conclusions: Childhood obesity in subarctic communities prevailed in a food environment typified by high-energy-density commercial foods of low nutritional value. [ABSTRACT FROM AUTHOR]

Objective: Canada's Aboriginal population is vulnerable to food insecurity and increasingly lives off-reserve. The Canadian Community Health Survey, Cycle 2.2 Nutrition, was used to compare the prevalence and sociodemographic correlates of food insecurity between non-Aboriginal and off-reserve Aboriginal households. Design: Food insecurity status was based on Health Canada's revised interpretation of responses to the US Household Food Security Survey Module. Logistic regression was used to assess if Aboriginal households were at higher risk for food insecurity than non-Aboriginal households, adjusting for household sociodemographic factors. Setting: Canada. Subjects: Households (n 35,107), 1528 Aboriginal and 33 579 non-Aboriginal. Results: Thirty-three per cent of Aboriginal households were food insecure as compared with 9% of non-Aboriginal households (univariate OR 5.2, 95% CI 4.2, 6.3). Whereas 14% of Aboriginal households had severe food insecurity, 3% of non-Aboriginal households did. The prevalence of sociodemographic risk factors for household food insecurity was higher for Aboriginal households. Aboriginal households were more likely to have three or more children (14% v. 5 %), be lone-parent households (2 1% v. 5 %), not have home ownership (52% v. 31 %), have educational attainment of secondary school or less (43% v. 26 %), have income from sources other than wages or salaries (38% v. 29 %), and be in the lowest income adequacy category (33% v. 12 %). Adjusted for these sociodemographic factors, Aboriginal households retained a higher risk for food insecurity than non-Aboriginal households (OR 2.6, 95% CI 2.1, 3.2). Conclusions: Off-reserve Aboriginal households in Canada merit special attention for income security and poverty alleviation initiatives. [ABSTRACT FROM AUTHOR]

Copyright of Applied Physiology, Nutrition & Metabolism is the property of Canadian Science Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

For over two decades, digital food retail services have been emerging alongside advances in mobile technology and improved access to wi-fi. Digitalization has driven changes within the food environment, complicating an already complex system that influences food-related behaviors and eating practices. Digital food retail services support an infrastructure that enhances commercial food systems by extending access to and availability of highly processed foods, further escalating poor dietary intakes. However, digital food retail services are heterogeneous–food delivery apps, online groceries, and meal kits–and can be feasibly adapted to nutrition interventions and personalized to individual needs. Although sparse, new evidence indicates great potential for digital food retail services to address food insecurity in urban areas and to support healthy eating by making it easier to select, plan, and prepare meals. Digital food retail services are a product of the digital transformation that reflect consumers' constant need for convenience, which must be addressed in future research and interventions. This paper will discuss public health opportunities that are emerging from the global uptake of digital food retail services, with a focus on online groceries, food delivery apps, and meal kits. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Public Health is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

When people involved in children's feeding programs were asked to describe them, without exception they were described using phrases that reflected the perception of 'wonderfulness'. This paper critically analyses the 'wonderfulness' of children's feeding programs by examining the language used to describe these programs, and the features of a 'wonderful' program through an analysis of a multi-site, qualitative case study of nine diverse programs in Atlantic Canada. When participants justified their comments about the 'wonderfulness' of children's feeding programs, they did so based upon five perceptions of program strengths: enhanced family coping; providing good food and nutrition; socializing and making friends; behaving well in school; and volunteerism. We suggest that programs can be designed to be innately 'wonderful' if they are community- and charity-based, support a noble cause such as the elimination of child hunger,engage good people as donors and volunteers, and provide a direct service to children apart from their families. We challenge health promoters to beware of the 'wonderful' program; its 'wonderfulness' may actually be masking unintended negative irnpacts upon its participants. [ABSTRACT FROM AUTHOR]