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Many youth in Manitoba are not food secure. Newcomer youth may be more vulnerable to food insecurity. Further, it has been suggested that being food secure does not ensure a nutritionally adequate diet. This study examined survey data from 1,347 grade nine students to describe and compare food security by newcomer status. Survey data were also used to compare the dietary intakes, eating behaviors, and self-reported health of newcomer youth by food security status. Food security status between newcomer and non-newcomer youth was not significantly different, however, being food secure was not enough to have optimal nutritional health and well-being.

The release of Canada’s Food Guide (CFG) in 2019 by Health Canada prompted the development of indices to measure adherence to these updated dietary recommendations for Canadians. This study describes the development and scoring standards of the Healthy Eating Food Index (HEFI-2019), which is intended to measure alignment of eating patterns with CFG-2019 recommendations on food choices among Canadians aged 2 years and older. Alignment with the intent of each key recommendation in the CFG-2019 was the primary principle guiding the development of the HEFI-2019. Additional considerations included previously published indices, data on Canadians’ dietary intakes from the 2015 Canadian Community Health Survey-Nutrition, and expert judgement. The HEFI-2019 includes 10 components: Vegetables and fruits (20 points), Whole-grain foods (5 points), Grain foods ratio (5 points), Protein foods (5 points), Plant-based protein foods (5 points), Beverages (10 points), Fatty acids ratio (5 points), Saturated fats (5 points), Free sugars (10 points), and Sodium (10 points). All components are expressed as ratios (e.g., proportions of total foods, total beverages, or total energy). The HEFI-2019 score has a maximum of 80 points. Potential uses of the HEFI-2019 include research as well as monitoring and surveillance of food choices in population-based surveys. Novelty: The Healthy Eating Food Index-2019 was developed to measure adherence to the 2019 Canada's Food Guide recommendations on healthy food choices. The HEFI-2019 includes 10 components, of which 5 are based on foods, 1 on beverages and 4 on nutrients, for a total of 80 points.

Culinary education programs are generally designed to improve participants’ food and cooking skills, with or without consideration to influencing diet quality or health. No published methods exist to guide food and cooking skills’ content priorities within culinary education programs that target improved diet quality and health. To address this gap, an international team of cooking and nutrition education experts developed the Cooking Education (Cook-EdTM) matrix. International food-based dietary guidelines were reviewed to determine common food groups. A six-section matrix was drafted including skill focus points for: (1) Kitchen safety, (2) Food safety, (3) General food skills, (4) Food group specific food skills, (5) General cooking skills, (6) Food group specific cooking skills. A modified e-Delphi method with three consultation rounds was used to reach consensus on the Cook-EdTM matrix structure, skill focus points included, and their order. The final Cook-EdTM matrix includes 117 skill focus points. The matrix guides program providers in selecting the most suitable skills to consider for their programs to improve dietary and health outcomes, while considering available resources, participant needs, and sustainable nutrition principles. Users can adapt the Cook-EdTM matrix to regional food-based dietary guidelines and food cultures.

Adherence to a gluten-free diet (GFD) is the only available treatment for gluten-related disorders, although a GFD may also be followed for discretionary reasons. The main objectives of the present study were to (1) describe and test for differences in key nutrient intakes among Canadians who follow a GFD compared with Canadians with no dietary exclusions and (2) describe additional dietary avoidances adhered to by Canadians who avoid gluten. We conducted a secondary analysis of the cross-sectional 2015 Canadian Community Health Survey-Nutrition Survey, which included a general health survey and 24-h dietary recall (n20 487). Participants were categorised as those who avoid dietary gluten and those who reported no avoidances. Key nutrient intakes were assessed, as a percentage of Dietary Recommended Intakes, including fibre, B vitamins, vitamin D, Ca, Fe, Na and Zn, and compared between the two groups usingttests. Canadians who avoided gluten had significantly lower intakes of folate, vitamin B12, vitamin D, Fe, Na and Ca compared with those who did not avoid any food groups. However, Canadians who reported following a GFD were significantly more likely to use vitamin or mineral supplements in the past 30 d. More than 20 % of those who avoided gluten also avoided dairy products. Findings suggest that following a GFD places Canadians at risk for nutrient inadequacies, particularly folate, Ca and vitamin D. Further research is required to further examine how multiple dietary avoidances among those who avoid gluten may contribute to dietary inadequacies.

Many newcomers to Canada struggle with food insecurity and the health impacts of dietary acculturation. "Growing Roots" is a newcomer nutrition program designed through a community development approach to help immigrants and refugees adapt positively to the Canadian food environment. This qualitative action research project documented the development, implementation and impacts of the program in an inner city neighbourhood of Winnipeg, Manitoba, Canada. Data was collected through oral questionnaires and interviews. Impacts included: 1) Healthy adaptation to the Canadian foodscape; 2) Enhanced nutrition knowledge and behaviours; 3) Improvements to food security status; and 4) Enhanced social networks.

In Canada, Métis cultural restoration continues to advance. Food practices and protocols, from the vantage point of Métis women who were traditionally responsible for domestic work, qualify as important subjects worthy of study because food and food work are integral components of family health and well-being. This qualitative grounded theory study explored Métis cultural food in Manitoba, Canada, with the intent to honour Métis women. In-depth interviews were conducted with Métis residents of urban Winnipeg and southern rural Manitoba. Results indicate that women were traditionally the keepers of culinary knowledge and practices in Métis families, and were highly resourceful in feeding large families and often other community members. Traditional foods were often land-based (wild and cultivated) and frequently enhanced with market foods. There is a strong sense of history, pride, identity, and desire for revitalization through cultural activities such as food practices; however, disrupted cultural knowledge translation around food and the nutrition transition to unhealthy Western diets present challenges. Results of this research will provide Manitoba Métis people with opportunities for critical reflection on food and their identity as Métis; food origins; the role of food in our lives; and how ecological and political structures affect the production and consumption of food. In addition, this research will provide an alternative discourse as it relates to Métis food, supporting a holistic approach to overall health and well-being that is self-affirming and strength-based.

Purpose: Postsecondary students who move to a new country to continue their education experience a drastic shift in food landscape, often resulting in unhealthy dietary adaptations. Methods: This mixed-method study explored the eating experiences and dietary patterns of 30 international students attending a Canadian university. Data were collected through focus groups that were analyzed thematically and dietary records analyzed for compliance with Canada’s Food Guide for Healthy Living (2007). Results: Results showed that many participants want to maintain home country food traditions, yet their new independent living status and novel food environments led to changes in dietary habits. Limited food skills, busy schedules, reduced access to familiar foods, and fast-food environments contributed to unhealthy eating patterns. These perceptions were reflected in the high consumption of “other”, less nutritious foods and low servings of fruits and vegetables, milk products and alternatives, and grain products. Conclusions: These findings show that international university students face dual challenges of transitioning into independent living without sufficient food skills and family supports, and exposure to unfamiliar and unhealthy food environments. Resources need to be developed for newly enrolled international students that emphasize food awareness, food skills, and healthy eating habits.

Background A gluten-free diet (GFD) is required for the management of some conditions, whereas some Canadians may follow a GFD for discretionary reasons. We sought to estimate the prevalence of Canadians who adhere to a GFD, identify factors associated with adherence to a GFD, and describe and compare the location of food preparation and consumption for those who follow a GFD, those who report no dietary avoidances and those reporting other dietary avoidances. Methods We used cross-sectional data from the 2015 Canadian Community Health Survey - Nutrition (n = 20 487). Demographic variables included sex, age group, ethnicity, highest level of household education and income adequacy. The relations between respondent characteristics and report of a GFD were estimated using logistic regression. Respondents were further categorized as avoiding dietary gluten, other dietary avoidances and no dietary avoidances. Results An estimated 1.9% of Canadians follow a GFD. Women had 2 times higher odds (odds ratio [OR] 2.08, 95% confidence interval [CI] 1.32 to 3.27) of reporting a GFD than men. After adjustment for income adequacy, household education, sex, age group and ethnicity, residents of Ontario and Quebec had about half the odds (OR 0.52, 95% CI 0.31 to 0.87, and OR 0.55, 95% CI 0.32 to 0.94, respectively) of reporting a GFD compared with residents of Atlantic Canada. Canadians who followed a GFD consumed significantly fewer calories from foods prepared at restaurants than both Canadians who reported no dietary avoidances and those who reported dietary avoidances other than gluten. Canadians following a GFD reported that 2.0% (95% CI 1.1% to 2.9%) of their daily kilocalories were from foods prepared at restaurants, compared with 6.7% (95% CI 5.4% to 7.9%) for Canadians reporting 1 or more dietary avoidances other than gluten, and 6.4% (95% CI 6.0% to 6.9%) for those reporting no avoidances. Interpretation The estimated 1.9% prevalence of dietary gluten avoidance likely includes individuals with celiac disease, wheat allergies and nonceliac gluten sensitivity, as well as individuals excluding gluten in the management of irritable bowel syndrome or for reasons related to dietary trends. Canadians eating GFDs consume fewer daily calories from restaurant-prepared foods than other Canadians, which may have social implications.

To assess whether the current food security measurement tool used in Canada, the Canadian Community Health Survey, is appropriate for use with homeless adults.The Household Food Security Survey Module (HFSSM), a validated measurement tool utilized for determining the food security status of Canadian households, was used with a group of homeless men (n = 40). In-depth interviews were also conducted with participants to obtain particulars about their food acquisition strategies. Data were analyzed by comparing the results of the HFSSM with qualitative data.The HFSSM measurement tool found that 90% (n = 36) of the study participants experienced food insecurity with 67.5% (n = 27) experiencing severe food insecurity and 22.5% (n = 9) experiencing moderate food insecurity. The qualitative data, however, suggested that all participants (n = 40) were food insecure based on food acquisition practices, food accessibility, and diet quality.The HFSSM has validity concerns when applied to homeless populations. Nutrition professionals and other key stakeholders should work to develop valid tools for measuring the food security status of homeless individuals who are highly vulnerable to food insecurity.

While rates of food insecurity among various sectors of Canadian population are well documented, food security among post-secondary students as a particularly vulnerable population has emerged in recent years as an area of research. Based on a survey of 548 students in the 2015/16 school year, this article examines the extent of food insecurity among a population of undergraduate and graduate students at the University of Manitoba. Our study reveals that 35.3% of survey respondents face food insecurity. 23.5% of these students experience moderate food insecurity, while 11.8% are severely food insecurity. Using chi-square tests and regression analysis, we compare these rates with various demographic indicators to assess which students are at greater risk of food insecurity, factors contributing to food insecurity, and its effect on their student experience, their health and their lives in general. In contemplating funding for post-secondary institutions and increases in tuition fees, provincial governments need to consider how this will affect student food security

Purpose The purpose of this paper is to explore the challenges and opportunities associated with attempting to maintain a healthy traditional diet for newcomers living in the North End neighbourhood of Winnipeg, Canada. Design/methodology/approach In this mixed-methods photovoice study the researcher used food photographs taken by participants to facilitate in-depth, semi-structured interviews with newcomers living in the area of interest. Community workers involved in food and newcomer programming were also interviewed. Qualitative data from the interviews were analysed using thematic analysis. Food security status of newcomer participants was also determined using The Household Food Security Survey Module. Findings Newcomer participants reported many struggles, including low incomes, gardening challenges and little access to culturally acceptable foods. Community worker interviews, field notes and an environmental scan of community resources also revealed a lack of social inclusion/support and few food and nutrition resources for newcomers. Originality/value Newcomers to Canada experience high rates of food insecurity and diminishing health status associated with length of time in Canada. This study demonstrates an imminent need for additional resources and programmes in this inner city community in order to decrease food security rates and help newcomers in Winnipeg to eat healthy traditional diets and avoid a decline in health.

Introduction Les « déserts alimentaires » ont vu le jour dans les 20 dernières années et forment des secteurs préoccupants pour les collectivités, les autorités en santé publique et les chercheurs en raison de leur effet négatif possible sur la qualité de l’alimentation et en raison de leurs conséquences sur la santé. Ce sont des espaces résidentiels, habituellement en milieu urbain, où les résidents à faible revenu n’ont que peu ou pas accès à des établissements de vente au détail d'aliments qui offrent suffisamment de variété à un prix abordable. La recherche sur les déserts alimentaires présente des défis méthodologiques, notamment la façon de repérer et de classer les magasins d’alimentation au détail, la définition de la population à faible revenu ainsi que les paramètres concernant le transport et la proximité. De plus, les méthodes complexes qui sont souvent employées dans la recherche sur les déserts alimentaires peuvent être difficiles à reproduire et à communiquer aux principaux intervenants. Pour surmonter ces difficultés, nous avons voulu montrer qu’on pouvait concevoir une méthode simple et reproductible pour repérer les déserts alimentaires, à l’aide de données facilement accessibles en contexte canadien. Méthodologie Cette étude a été menée à Winnipeg (Canada) en 2014. Les établissements de vente au détail des aliments ont été trouvés à l’aide des Pages Jaunes et vérifiés par des diététistes en santé publique. Nous avons créé deux scénarios sur les déserts alimentaires en fonction de l’emplacement de la population à quintile de revenu le plus faible : a) celle qui habitait à 500 m ou plus d’une épicerie appartenant à une chaîne nationale et b) celle qui habitait à 500 m ou plus d’une épicerie appartenant à une chaîne nationale ou d’une épicerie à service complet. Résultats En fonction du scénario utilisé, 64 574 ou 104 335 résidents à faible revenu vivaient dans un désert alimentaire. Conclusion Les déserts alimentaires touchent une proportion importante de la population de Winnipeg et, même s’ils sont concentrés en centre-ville, ils sont présents également en banlieue. La méthodologie employée pour repérer les déserts alimentaires est accessible, claire et reproductible. Elle est utilisable pour exercer une surveillance périodique à faible coût, ainsi que pour favoriser un engagement significatif de la part des collectivités, des magasins de détail et des responsables des politiques.

Purpose: Food knowledge and skills appear to have declined in the general population over recent decades and may be contributing to negative outcomes and poor nutritional health. It is pertinent to observe the food skills and habits of Canadians, particularly Canadian youth. Methods: Data from the Canadian Community Health Survey 2013 Rapid Response on Food Skills (n = 10 098) were used to examine the involvement of children in food preparation processes by identifying and describing the role of children in meal preparation as well as the practice of family meals. Variables were examined to assess differentiations between socio-demographic groupings (marital status, education, and income). Results: Results indicate a moderate to high level of child participation in Canadian household food-related activities, with two-thirds of households with children having children involved in choosing meals and grocery shopping and one-third of children helping with meal preparation. Some differences were observed between region, education level, and Aboriginal and immigration status. Seventy-five percent of respondents participated in family meals. Conclusions: Data from this study contribute to the current discussion regarding loss of food skills and the significance of family meals on social and health indicators. Results suggest a range of interventions for dietitians including improving the quality of foods prepared at home and campaigns to promote family meals.

The purpose of this qualitative, grounded theory study was to explore the concept of food literacy from the perspective of young Canadian adults who recently transitioned to independent living. Seventeen individual, in-depth interviews were conducted with Canadian university students who recently transitioned to independent living. Results suggest that young adults face significant challenges with regard to healthy eating and acquiring and utilizing food literacy. The main reasons for these challenges were due to a lack of food and nutrition education prior to independent living through home and school environments, time-constraints, and complex food relationships. This study will add to the existing body of literature by exploring the food experiences of young adults and the concept of food literacy from their perceptions, thereby strengthening theoretical foundations and developing practical recommendations moving forward.

Homelessness, Aboriginal ethnicity, and nutritional vulnerability are key determinants of health. Substance abuse further compounds health risk. This study explored the nutritional vulnerability of homeless men, some of who were solvent-users, to assess nutrition-related chronic disease risk factors. Anthropometric data were used to calculate disease risk using body mass index. Diet was assessed using a 24-hr food recall and data were compared to Canada’s Food Guide recommendations. A significant proportion of participants had low intakes of vegetables and fruit and milk and alternatives. More than half of the participants met the intake recommendations for grain servings and meat and alternatives. Solvent-using participants consumed significantly higher intakes of vegetables and fruit, grain products, and other foods and beverages, than non-solvent using men. More than half of the participants were classified as overweight or obese. Healthy food consumption was influenced by lack of stable housin...

Although there has been much discussion about distinctions between quantitative and qualitative research, our purpose here is not to revive those conversations, but instead to attempt to explore and articulate our identities as researchers who practice in the qualitative tradition. Using autoethnography as our methodology, we as six researchers from various social science disciplines and at various career stages engaged in focused introspection by responding individually to two questions: who am I as a qualitative researcher; and how did I come to that understanding? This reflection led to discussions of those elements and experiences that have shaped the way we see ourselves in the context of our research. The question of “identity” evolved into a discussion about “what we do.” During our data analysis, six themes emerged, representing our group’s responses: (a) building epistemology, (b) making/doing good research, (c) as an art or craft, (d) why does qualitative research need legitimating? (e) qualitative research as a social bridge, and (f) stewards of people’s lived experience. We conclude by reflecting on the value of building a community of practice among qualitative researchers.

Current definitions of food insecurity center around the dominant themes of (1) individual and household food insecurity, stemming from a lack of access to resources needed to obtain adequate food; and (2) community food insecurity, which occurs when dominant food systems falls short in terms of social, economic, and environmental sustainability. These definitions do not sufficiently incorporate the concept of nutrition security or adequate nutritional status in terms of macro- and micronutrients, a state not achieved by most Canadians. We propose the Sustainable Livelihoods for Food and Nutrition Security Framework, which integrates food security and nutrition security to achieve public health nutrition goals.

Background Canada’s Food Guide (CFG) has been an important health promotion tool for over seventy years. The most recent version was released in 2007. This study examined Canadians’ exposure to, knowledge, and use of CFG. Methods Data came from the Canadian Community Health Survey’s Rapid Response on the Awareness and Usage of Canada’s Food Guide, which included 10,098 Canadians ≥12 y in all ten provinces. Questions were asked on familiarity, awareness and usage of CFG and Canada’s Food Guide for First Nations, Inuit and Métis, as well as healthy eating principles and behaviours. Descriptive statistics and logistic regression were used to observe counts and differences among key demographic variables. Results More than 80% of Canadians have heard of CFG however significantly more women than men were aware of the Guide. Most knew that ‘Vegetables and Fruit’ had the most recommended servings and that dark green vegetables should be consumed daily; however fewer than half knew this of orange vegetables. Just under one third had a copy in their homes, and the most common sources for obtaining CFG were child’s school and health professional/trainer. Those who consulted CFG recently were more likely to consume the recommended servings of vegetables and fruits, and to state that their eating habits were ‘much better’ than one year previously. Conclusions CFG has “brand recognition” among Canadians however there are gaps between awareness and eating behaviours. The new Food Guide could consider additional dissemination tools including social media, videos and workbooks tailored to various age groups, demographic groups and settings.

High population rates of obesity and nutrition-related chronic diseases warrant an examination of the role of food and nutrition education in health promotion. Using a mixed-methods approach, this study explored student enrolment trends in, and perceptions of, Home Economics Food and Nutrition education in a Canadian province. Enrolment in Home Economics Food and Nutrition courses for grades 7–12 was examined from 2000 to 2010 using administrative data. Perceptions of Home Economics Food and Nutrition education by home economics teachers and superintendents were investigated through in-depth interviews using a grounded theory approach. Results revealed that, although enrolment, including boys, increased slightly over the study period, the majority of children do not take Home Economics Food and Nutrition classes. Further, enrolment decreased significantly from grades 7 (45.77%) to 12 (7.61%). Home Economics Food and Nutrition education faces significant challenges to its future viability. These include: many school administrators, non-home economics teachers and some parents do not value Home Economics Food and Nutrition education; Home Economics Food and Nutrition education is seen as less valuable than math and science for future career planning; outdated curriculum and teaching infrastructure; reduced numbers of new home economics teachers; decreasing student food knowledge and skills; and changing social norms regarding food and eating (increased use of convenience foods across population groups, a youth ‘fast food culture’ and fewer family meals). Results also indicated that Home Economics Food and Nutrition education is seen as critically important for youth, given that one third of Canadian children are now overweight or obese, fast and highly processed foods make up an increasing proportion of Canadians' diets, and there are increasing dilemmas being faced with food production and food safety. These results signal a growing tension between societal trends towards technological solutions in education and everyday living, and the growing acknowledgement of the externalities associated with these trends including poor health and environmental impacts. Consequently, evidence-based food and nutrition education that is relevant for today's food environment and busy lifestyles is warranted to improve the health of current and future generations. This should be based on a comprehensive food and nutrition framework including functional, interactive and critical ‘food literacy’. Policy measures are urgently required to ensure all youth have access to food literacy education.

This research examined the aetiology of employed mothers' food choice and food provisioning decisions using a qualitative, grounded theory methodology. Semi-structured interviews using the Food Choice Map were conducted with eleven middle-income employed mothers of elementary school-age children. Results demonstrated that the women exhibited conflicting identities with respect to food choice and provisioning. As 'good mothers' they were the primary food and nutrition caregivers for the family, desiring to provide healthy, homemade foods their families preferred at shared family meals. They also sought to be independent selves, working outside the home, within the context of a busy modern family. Increased food autonomy of children, and lack of time due to working outside the home and children's involvement in extracurricular activities, were significant influences on their food choice and provisioning. This resulted in frequently being unable to live up to their expectations of consistently providing healthy homemade foods and having shared family meals. To cope, the women frequently relied on processed convenience and fast foods despite their acknowledged inferior nutritional status. Using Giddens' structuration theory, the dynamic relationships between the women's food choice and provisioning actions, their identities and larger structures including socio-cultural norms, conditions of work and the industrial food system were explored. The ensuing dietary pattern of the women and their families increases the risk of poor health outcomes, including obesity. These results have implications for public health responses to improve population health by shifting the focus from individual-level maternal influences to structural influences on diet.

Résumé La présente étude, qui repose sur l’Enquête sur la santé dans les collectivités canadiennes de 2005, porte sur la répartition des cas d’embonpoint et d’obésité chez les adultes canadiens parmi les groupes sociodémographiques et géographiques. Les taux de prévalence d’embonpoint et d’obésité ont été calculés en fonction de certains indicateurs sociodémographiques établis à l’aide du modèle de régression de Poisson et ils ont été répartis géographiquement à l’aide de cartes choroplèthes. Le coefficient de Gini a été utilisé pour déterminer la répartition de la prévalence parmi les groupes à risque. Les conséquences possibles des stratégies de prévention axées sur la population à risque élevé par rapport aux stratégies axées sur la population générale sur la prévalence de l’obésité ont aussi été examinées. Parmi les adultes âgées de 25 à 64 ans, 17 % étaient obèses et 53 % faisaient de l’embonpoint ou étaient obèses, les taux les plus élevés ayant été observés chez les groupes d’âge plus vieux ainsi que chez les personnes qui ne font pas d’activité physique, qui sont de race blanche, qui ont le statut de non-immigrant, qui ont un faible niveau de scolarité et qui vivent dans les régions des Prairies et de la côte est. En recalculant les taux d’obésité selon différents scénarios de prévention, nous avons constaté que les stratégies axées sur la population générale pouvaient permettre de réduire quatre fois plus les cas d’obésité que les stratégies axées sur la population à risque élevé, ce qui montre la nécessité d’adopter des stratégies axées sur une plus vaste population pour prévenir l’obésité au Canada.

Objective This study identified and described Canadians' self-perceived eating habits and food skills through the use of population-based data. Design Data from the Canadian Community Health Survey 2013 Rapid Response on Food Skills was used to examine the eating quality and patterns of Canadians. Data were collected from all provinces in January and February 2013. Main Outcome Measures Respondent variables (sex, age, Aboriginal/immigrant status) were examined to assess differentiations between socio-demographic groupings (family structure, marital status, education, and income). Analysis Logistic regression was used to determine whether demographic variables increased the likelihood of certain responses. Results Forty-six percent of Canadians believe they have excellent/very good eating habits, with 51% categorizing their habits as good or fair. Similarly, the majority report having good food skills. Sex and age were significantly associated with food skills, with women rating their cooking skill proficiency higher than men (72% vs 55%), and older Canadians reporting higher food skill knowledge than their younger counterparts. Conclusions and Implications Results indicate that while portions of the Canadian population have adequate food skills, others are lacking, which may negatively impact their diet. Findings from this study have implications for education and health promotion programs focusing on foods skills, particularly among vulnerable target groups.

To assess the status of food and nutrition programming in community-based HIV organizations in Canada.A telephone survey was administered to 80 community-based HIV organizations asking about characteristics of food and nutrition programs and the perceived program gaps.The majority of organizations had programs directed at improving food access through meals, food banks, community kitchens or cooking classes, food vouchers, gardens, and street vans. Almost half of the organizations (n = 39) provided nutrition counselling by a registered dietitian or nurse, and the majority also provided referrals to other food and nutrition services in the community. Most organizations would like to have more food-related programming, including: more frequent provision of nutritious and fresh food options, methods to make better use of available food, transportation and grocery vouchers, more staff dedicated to food programs, and improved food preparation and storage infrastructure.Although community-based HIV organizations provide a range of food and nutrition programs, they face challenges due to inadequate resources. Decision makers should provide more funding for these programs; however, they must be augmented with other supports such as adequate housing, income, and addiction counselling. Dietitians can help organizations maximize the impact of their limited resources and can advocate for systemic changes to enhance determinants of health for people living with HIV.

Background. Increased awareness of the wide spectrum of activity of vitamin D has focused interest on its role in the health of Canada’s Aboriginal peoples, who bear a high burden of both infectious and chronic disease. Cutaneous vitamin D synthesis is limited at northern latitudes, and the transition from nutrient-dense traditional to nutrient-poor market foods has left many Canadian Aboriginal populations food insecure and nutritionally vulnerable. Objective. The study was undertaken to determine the level of dietary vitamin D in a northern Canadian Aboriginal (Dene´) community and to determine the primary food sources of vitamin D. Design. Cross-sectional study. Methods. Dietary vitamin D intakes of 46 adult Dene´ men and women were assessed using a food frequency questionnaire and compared across age, gender, season and body mass index. The adequacy of dietary vitamin D intake was assessed using the 2007 Adequate Intake (AI) and the 2011 Recommended Dietary Allowance (RDA) values for Dietary Reference Intake (DRI). Results. Mean daily vitamin D intake was 271.4 IU in winter and 298.3 IU in summer. Forty percent and 47.8% of participants met the vitamin D 1997 AI values in winter and summer, respectively; this dropped to 11.1 and 13.0% in winter and summer using 2011 RDA values. Supplements, milk, and local fish were positively associated with adequate vitamin D intake. Milk and local fish were the major dietary sources of vitamin D. Conclusions. Dietary intake of vitamin D in the study population was low. Only 2 food sources, fluid milk and fish, provided the majority of dietary vitamin D. Addressing low vitamin D intake in this population requires action aimed at food insecurity present in northern Aboriginal populations. Keywords: vitamin D; First Nations; indigenous; Aboriginal; diet; nutrition; food security (Published: 5 August 2013) This paper is part of Supplement 1, 2013, ICCH15 Proceedings . More papers from this Supplement can be found here . Citation: Int J Circumpolar Health 2013, 72 : 20723 - http://dx.doi.org/10.3402/ijch.v72i0.20723

The wide spectrum of vitamin D activity has focused attention on its potential role in the elevated burden of disease in a northern Canadian First Nations (Dené) cohort. Vitamin D insufficiency, and gene polymorphisms in the vitamin D receptor (VDR) and vitamin D binding protein (VDBP) have been implicated in susceptibility to infectious and chronic diseases. The objectives of this study were to determine the contribution of vitamin D from food, and measure the serum concentrations of 25-hydroxyvitamin D(3) (25-OHD(3)) and VDBP in Dené participants. Single nucleotide polymorphisms (SNPs) associated with the dysregulation of the innate immune response were typed and counted. Potential correlations between the SNPs and serum concentrations of 25-OHD(3) and VDBP were evaluated. Venous blood was collected in summer and winter over a one-year period and analyzed for 25-OHD(3) and VDBP concentrations (N = 46). A questionnaire was administered to determine the amount of dietary vitamin D consumed. Sixty-one percent and 30% of the participants had 25-OHD(3) serum concentrations

ObjectiveThe present study describes the trajectory of the energy gap (energy imbalance) in the Canadian population from 1976 to 2003, its temporal relationship to adult obesity, and estimates the relative contribution of energy availability and expenditure to the energy gap. It also assesses which foods contributed the most to changes in available energy over the study period.DesignAnnual estimates of the energy gap were derived by subtracting population-adjusted per capita daily estimated energy requirements (derived from Dietary Reference Intakes) from per capita daily estimated energy available (obtained from food balance sheets). Food balance sheets were used to assess which foods contributed to changes in energy availability. Adult obesity rates were derived from six national surveys. The relationship to the energy gap was assessed through regression analysis.ResultsBetween 1976 and 2003, per capita daily estimated energy availability increased by 18 % (1744 kJ), and increased energy availability was the major driver of the increased energy gap. Salad oils, wheat flour, soft drinks and shortening accounted for the majority of the net increase in energy availability. Adult obesity was significantly correlated with the energy gap over the study period.ConclusionsThe widening energy gap is being driven primarily by increased energy availability. The food commodities driving the widening energy gap are major ingredients in many energy-dense convenience foods, which are being consumed with increasing frequency in Canada. Policies to address population obesity must have a strong nutritional focus with the objective of decreasing energy consumption at the population level.

Little is known about the determinants of pandemic H1N1 (pH1N1) infection in Canada among low-income, inner city populations. To inform future influenza planning, the seroprevalence of pH1N1 antibodies among inner city clinic attendees in Winnipeg (Manitoba) according to sociodemographic and risk factor characteristics were estimated and vaccination rates were explored.Adults presenting to three inner city community clinics in Winnipeg from October 2009 to December 2009 were recruited as study participants (n=458). A questionnaire was administered to collect demographic, risk factor and symptom information, and a venous blood sample was collected for hemagglutination inhibition assay testing to detect the presence of antibodies against pH1N1.Approximately one-half (53%) of the study participants reported an annual household income of$10,000/year, and 65% identified as Aboriginal. pH1N1 positivity was 5.7% among those enrolled early in the study and 15.5% among those enrolled later in the study. Positivity was higher among participants who were female, Aboriginal and in contact with children ≤5 years of age. The overall pH1N1 vaccination rate was 28%.pH1N1 positivity was high among low-income adults accessing clinics in Winnipeg's inner city compared with the general population. Of further concern were the low rates of uptake of both seasonal and pH1N1 influenza vaccinations. When planning for future influenza outbreaks, it is important to incorporate strategies for the prevention, control, and care of influenza among low-income and inner city adults.On ne sait pas grand-chose des déterminants de l’infection par la grippe pandémique H1N1 (pH1N1) dans les quartiers centraux du Canada. Pour étayer la future planification de la grippe, les chercheurs ont estimé la séroprévalence des anticorps du virus pH1N1 chez les personnes qui fréquentent une clinique des quartiers centraux de Winnipeg, au Manitoba, d’après les caractéristiques sociodémographiques et sur le plan des facteurs de risque, et ils ont examiné les taux de vaccination.Les chercheurs ont recruté les adultes qui se sont présentés à trois cliniques communautaires des quartiers centraux de Winnipeg entre octobre et décembre 2009 à titre de participants à l’étude (n=458). Ils ont utilisé un questionnaire pour colliger de l’information sur la démographie, les facteurs de risque et les symptômes et prélevé un échantillon de sang veineux pour procéder à un test d’inhibition de l’hémagglutination afin de déceler la présence d’anticorps contre le virus pH1N1.Environ la moitié (53 %) des participants à l’étude, dont 65 % étaient Autochtones, ont déclaré avoir un revenu familial annuel inférieur à 10 000 $. La positivité au virus pH1N1 était de 5,7 % chez les participants en début d’étude et de 15,5 % chez les personnes qui y ont participé plus tard. La positivité était plus élevée chez les participants de sexe féminin, autochtones ou en contact avec des enfants de cinq ans et moins. Le taux de vaccination global contre le virus pH1N1 s’élevait à 28 %.La positivité au virus pH1N1 était élevée chez les adultes à faible revenu qui fréquentaient des cliniques des quartiers centraux de Winnipeg par rapport à la population générale. Par ailleurs, le faible taux de vaccination contre l’influenza saisonnière et contre la grippe pH1N1 était inquiétant. Dans le cadre de la planification de futures éclosions d’influenza, il sera important d’intégrer des stratégies de prévention, de contrôle et de soins de l’influenza chez les adultes à faible revenu des quartiers centraux.

Background . Canadian First Nation populations have experienced endemic and epidemic tuberculosis (TB) for decades. Vitamin D–mediated induction of the host defence peptide LL-37 is known to enhance control of pathogens such as Mycobacterium tuberculosis . Objective . Evaluate associations between serum levels of 25-hydroxy vitamin D (25(OH)D) and LL-37, in adult Dene First Nation participants (N = 34) and assess correlations with single nucleotide polymorphisms (SNPs) in the vitamin D receptor (VDR) and vitamin D binding protein (VDBP). Design . Venous blood was collected from all participants at baseline (winter and summer) and in conjunction with taking vitamin D supplements (1,000 IU/day) (winter and summer). Samples were analysed using ELISA for concentrations of vitamin D and LL-37, and SNPs in the VDR and VDBP regions were genotyped. Results . Circulating levels of 25(OH)D were not altered by vitamin D supplementation, but LL-37 levels were significantly decreased. VDBP and VDR SNPs did not correlate with serum concentrations of 25(OH)D, but LL-37 levels significantly decreased in individuals with VDBP D432E T/G and T/T, and with VDR SNP Bsm1 T/T genotypes. Conclusions . Our findings suggest that vitamin D supplementation may not be beneficial as an intervention to boost innate immune resistance to M. tuberculosis in the Dene population. Keywords: vitamin D; indigenous; genetics; cathelicidin (LL-37); tuberculosis (Published: 19 August 2015) Citation: Int J Circumpolar Health 2015, 74: 28952 - http://dx.doi.org/10.3402/ijch.v74.28952