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Objectives: The COVID-19 pandemic has impacted all aspects of the food system, including the retail grocery sector. We sought to (objective 1) document and (objective 2) analyze the policies implemented in the grocery sector during the first wave of the pandemic in Manitoba, Canada.Methods: Our qualitative policy analysis draws from organizational communications (websites and social media) (n = 79), news media articles (n = 95), and key informant interviews with individuals (n = 8) working within the grocery sector in urban and rural, Manitoba. Media and communications were extracted between March 9-May 8, 2020 and interviews were conducted in July-August, 2020.Results: Newly implemented policies due to the pandemic fell under four inter-related themes: Employee health and wellbeing, Safety measures, Operational measures, and Community support. Employee health and wellbeing included sub-themes of financial and social support, health recommendations and protocols, and new employee guidelines. Safety measures encompassed numerous policies pertaining to sanitation, personal protection, transmission prevention, physical distancing, and limiting access. Overall, new policies were discussed as effective in making grocery shopping as safe as possible given the situation. Compliance and enforcement, employee teamwork, and support for employees were key themes related to perceptions of policy success in a challenging and inequitable context. Nevertheless, government support and communication was needed as well to ensure safety within the grocery sector.Conclusions: The grocery sector reacted to the pandemic with the swift implementation of policies to address food supply issues, prevent transmission of the virus, support their employees as essential workers, and better serve high-risk populations. [ABSTRACT FROM AUTHOR]

Historically, the constructs of inclusion, diversity, equity, and access (IDEA) have not been sufficiently considered or included in population health nutrition research and practice. Consequently, current nutrition assessment benchmarks and knowledge translation tools may not accurately or adequately reflect diversity in the Canadian population or produce meaningful dietary guidance. The purpose of this current opinion paper is to introduce the population health nutrition research and practice framework and explore the current application of IDEA within this framework. Recommendations are offered to incorporate the constructs of IDEA along the continuum of future nutrition research and services to improve population nutritional health. [ABSTRACT FROM AUTHOR]

Home Economics Food and Nutrition (HEFN) courses offered through schools have the potential to provide youth with food literacy (knowledge, attitudes and skills) to manage in the contemporary food environment. Little is known, however, about the capacity of current HEFN programs to foster food literacy. While the existence of such courses varies between schools, regions and countries, many students in the province of Manitoba, Canada and the state of Victoria, Australia are enrolled in HEFN programs in grades 7 and 8 (students aged 11-13 years). This study sought to explore the feasibility of HEFN programs to support the development of food literacy competencies in Manitoba and Victoria through curricula document reviews and qualitative interviews with home economics teachers. Curricular mapping compared the Manitoban Specific Learning Outcomes (SLOs) and Victorian Content Description Codes (CDCs) from curricula documents with a framework of food literacy competencies for youth (Slater, Falkenberg, Rutherford, & Colatruglio, 2018). Semi-structured interviews were conducted with eight teachers. Curriculum mapping revealed that not all food literacy competencies were present in curricular documents. The interviews showed that teachers mainly focused on developing functional food literacy competencies, while higher-ordered competencies, such as the relational and systems competencies, were less obvious. The discussion considers four areas in which to improve the development of food literacy competencies: (1) curricular structure and content; (2) teacher pedagogy and training; (3) teacher resources for supporting programming; and (4) time allocated to HEFN programs. Unless students receive HEFN in higher years, their food literacy competencies established in grades 7 and 8 may not be sufficient for healthy living in adulthood. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Introduction: "Food deserts" have emerged over the past 20 years as spaces of concern for communities, public health authorities and researchers because of their potential negative impact on dietary quality and subsequent health outcomes. Food deserts are residential geographic spaces, typically in urban settings, where low-income residents have limited or no access to retail food establishments with sufficient variety at affordable cost. Research on food deserts presents methodological challenges including retail food store identification and classification, identification of low-income populations, and transportation and proximity metrics. Furthermore, the complex methods often used in food desert research can be difficult to reproduce and communicate to key stakeholders. To address these challenges, this study sought to demonstrate the feasibility of implementing a simple and reproducible method of identifying food deserts using data easily available in the Canadian context. Methods: This study was conducted in Winnipeg, Canada in 2014. Food retail establishments were identified from Yellow Pages and verified by public health dietitians. We calculated two scenarios of food deserts based on location of the lowest-income quintile population: (a) living = 500 m from a national chain grocery store, or (b) living = 500 m from a national chain grocery store or a full-service grocery store. Results: The number of low-income residents living in a food desert ranged from 64 574 to 104 335, depending on the scenario used. Conclusion: This study shows that food deserts affect a significant proportion of the Winnipeg population, and while concentrated in the urban core, exist in suburban neighbourhoods also. The methods utilized represent an accessible and transparent, reproducible process for identifying food deserts. These methods can be used for costeffective, periodic surveillance and meaningful engagement with communities, retailers and policy makers. [ABSTRACT FROM AUTHOR]

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. Results suggest that while young adults value "healthy" eating, they are at risk for leaving their family homes lacking the necessary food literacy required to make healthy food choices, sustain healthy food relationships, and be well within complex food environments. Findings indicate that young adults could potentially benefit from expanding their views on food and health. This paper adds value to the existing literature by exploring the components of food literacy and connections to well-being from the perceptions of young Canadian adults. [ABSTRACT FROM AUTHOR]

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 (Dené) community and to determine the primary food sources of vitamin D. Design. Cross-sectional study. Methods. Dietary vitamin D intakes of 46 adult Dené 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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Objective: The 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. Design: Annual 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. Results: Between 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. Conclusions: The 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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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 D3 (25-OHD3) 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-OHD3 and VDBP were evaluated. Venous blood was collected in summer and winter over a one-year period and analyzed for 25-OHD3 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-OHD3 serum concentrations <75 nmol/L in the winter and summer respectively. Mean vitamin D binding protein concentrations were within the normal range in the winter but below normal in the summer. VDBP and VDR gene polymorphisms affect the bioavailability and regulation of 25-OHD3. The Dené had a high frequency of the VDBP D432E-G allele (71%) and the Gc1 genotype (90%), associated with high concentrations of VDBP and a high binding affinity to 25-OHD3. The Dené had a high frequency of VDR Fok1-f allele (82%), which has been associated with a down-regulated Th1 immune response. VDBP and VDR polymorphisms, and low winter 25-OHD3 serum concentrations may be risk factors for infectious diseases and chronic conditions related to the dysregulation of the vitamin D pathway. [ABSTRACT FROM AUTHOR]

Healthy eating is challenging within a food environment that constantly exposes the public to unhealthy processed foods that are appealing and convenient. Food environments are becoming more complex with technological advances that further increase the availability and marketing of processed foods. At the same time, widespread food and nutrition misinformation and "diet culture" are contributing to negative associations with food, negatively impacting well-being. Food literacy presents an opportunity to negate some of these influences, by assisting individuals in developing the knowledge, skills, attitudes, and self-efficacy needed to make healthy dietary decisions within different contexts. Further work is required to translate a more holistic concept of food literacy into interventions rather than single aspects of it such as nutrition education, which tends to be focused on dietary standards, nutrients, and food groups. This manuscript summarizes a colloquium given at the International Food Studies Conference in 2018, where the authors presented a narrative review of the state of food literacy in Canada and chronicled four examples of initiatives that have been undertaken in various settings. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Objective: The 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.Design: Annual 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.Results: Between 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.Conclusions: The 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. [ABSTRACT FROM AUTHOR]