Susan Evers

Smoking, Physical Activity and Breakfast Consumption Among Secondary School Students in a Southwestern Ontario Community

OBJECTIVES To determine the prevalence of smoking, low levels of physical activity, and missing breakfast among students (n=318) in grades 9 through 12 in three schools in southwestern Ontario; to see if these behaviours were associated; and, whether there were gender differences. METHODS A self-administered survey was conducted in grade 10 English classes. RESULTS The response rate was 87.1%. The prevalence of smoking was 36.2%; there was no gender difference. Only 42.8% of students ate breakfast daily; 48.8% of boys and 36.1% of girls (chi2 = 5.2; p<0.05). A higher proportion of boys (77.1%) were active for at least 30 minutes > or = 3 times/week compared to girls (66.0%) (chi2 = 4.8; p<0.05). Students who were active > or = 3 times/week were more likely to eat breakfast daily and, among boys, 60.4% of non-smokers ate breakfast daily compared to 31.9% of those currently smoking (chi2 = 13.3; p<0.001). There were no differences among girls. More girls (63.9%) were concerned about gaining weight compared to boys (36.1%) (chi2 = 37.7; p<0.001). Among girls, a higher proportion of those who were concerned about gaining weight were less likely to engage in physical activity or smoke, and more likely to skip breakfast compared to those who were not concerned. DISCUSSION Weight concern was not associated with frequency of physical activity, smoking, or breakfast consumption among boys. The high prevalence rates for these behaviours suggests that interventions in high schools should include daily physical activity, promotion of breakfast eating (either at home or in the school), and encouragement to quit smoking.

GEOGRAPHICAL DISTRIBUTION OF DIABETES AMONG THE NATIVE POPULATION OF CANADA: A NATIONAL SURVEY

The prevalence of diagnosed diabetes was determined for 76% of the registered Indian and Inuit (Eskimo) population of Canada from case registers maintained by the federal agency responsible for Indian health services. A total of 5324 cases were ascertained. The age-sex adjusted rate varied among the Indians from a low of 0.8% in the Northwest Territories to a high of 8.7% in the Atlantic region. Among Inuit, the prevalence was 0.4%. Most cases occur in middle-aged or older individuals, with a higher prevalence among Indian (but not Inuit) females. An ecologic analysis was performed with the crude prevalence of individual communities regressed upon independent variables that included longitude, latitude, geographic isolation, culture area, and language family. Stepwise regressions were also carried out within the Algonkian, Athapaskan, and Eskimoan language families. For the national sample, composite language phylum-culture area predictors were used. The results in the national sample confirmed most findings in the individual language family analysis. Six predictors: latitude, Northeast-Algonkian, Northeast-Iroquoian, Subarctic-Algonkian, Plains-Siouan, and Plains-Algonkian, ranked here in decreasing order of importance, explained 48.4% of the variation in diabetes prevalence. All the named groups had rates significantly greater than found in the reference group of Arctic-Eskimoans. We conclude that the distribution of diabetes among Canadian natives is determined by both genetic and environmental factors.

Higher zinc intake buffers the impact of stress on depressive symptoms in pregnancy.

Prenatal depression is a public health concern. This studys objectives are to model associations involving dietary zinc intake, psychosocial stress, and sociodemographic factors as they interrelate in the development of depressive symptoms in a cohort of pregnant women from London, Ontario (Prenatal Health Project). We hypothesized that (1) psychosocial stress is intermediate in the causal pathway between sociodemographic factors and zinc intake and that (2) zinc intake serves as a partial mediator between sociodemographic factors, psychosocial stress, and the development of depressive symptoms. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale (CES-D). Psychosocial stress was measured by validated scales and summarized into a composite score. Zinc intake was quantified from food frequency questionnaire and nutrient supplement data. Regression methods were used. The Baron and Kenny method was applied to test mediation hypotheses. Stress-zinc interaction terms were added to the regression model predicting CES-D score to test a possible moderating role for zinc. Our analyses showed that social disadvantage, higher stress, and lower zinc intake were associated with higher CES-D score. Every 1-point increase in stress score was associated with a 1-point increase in CES-D score. Being in the lowest quintile of zinc intake was associated with a 1-point increase in CES-D score; although not clinically meaningful, the association was robust. Evidence was not in favor of the mediation hypotheses, but showed instead that zinc intake moderated the association between stress and depressive symptoms; being in the highest zinc quintile appeared to buffer the impact of stress.

Energy and Nutrient Inadequacies in the Diets of Low-Income Women who Breast-Feed

OBJECTIVE To assess the energy and nutrient intakes of women who are breast-feeding in relation to the Recommended Dietary Allowances (RDAs) for energy and nutrients during lactation. DESIGN Survey using a interviewer-administered questionnaire and a 24 dietary recall. SUBJECTS The subjects were 183 women breast-feeding at 3 months postpartum. All were living in low-income communities in Ontario, Canada, that were participating in the longitudinal prevention initiative, Better Beginnings, Better Futures. STATISTICAL ANALYSES Mann-Whitney U test to compare energy and nutrient intakes of women with incomes above and below the Statistics Canada poverty line. RESULTS Median intake of energy (2,148 kcal) was below the RDA of 2,700 kcal. Compared with the RDAs, intakes of calcium (928 vs 1,200 mg), folate (222 vs 280 microns), iron (13 vs 15 mg), thiamin (1.4 vs 1.6 mg), vitamin A (846 vs 1,300 retinol equivalents), and zinc (10 vs 19 mg) were below recommended values for women who are lactating. Although household income for 70% of the women was below the poverty line, differences in energy and nutrient intakes according to income group were not statistically significant. APPLICATIONS Lactating women are at high risk of energy and nutrient inadequacies. Programs to increase breast-feeding rates, particularly among low-income communities, must include strategies to ensure adequate diets during lactation.

Feeding patterns and weight among First Nations children.

Purpose: Little information is available on the growth and feeding patterns of First Nations children. Our goal was to assess the anthropometric status, feeding practices, and dietary intake of children born in 1994 or 1995 (n=102) and living in Walpole Island First Nation. Methods: Information on demographic characteristics and infant feeding practices was obtained through parent interviews conducted between 1994 and 1999. Parents also completed a 24-hour dietary recall for their children when they were 48 months old. Head circumference was measured at three and 18 months, and weight and length/height at three, 18, 33, and 48 months. Results: Most infants (75%) were breastfed at birth; however, by the time infants were three months old, 39.7% of the mothers had stopped breastfeeding. Over half (57.1%) of the infants were fed solids before age three months, 11.6% were given whole milk before age nine months, and 59.4% had low fat milk before age two years. Body mass index (kg/m2) (BMI) was above the 85th ...PURPOSE Little information is available on the growth and feeding patterns of First Nations children. Our goal was to assess the anthropometric status, feeding practices, and dietary intake of children born in 1994 or 1995 (n=102) and living in Walpole Island First Nation. METHODS Information on demographic characteristics and infant feeding practices was obtained through parent interviews conducted between 1994 and 1999. Parents also completed a 24-hour dietary recall for their children when they were 48 months old. Head circumference was measured at three and 18 months, and weight and length/height at three, 18, 33, and 48 months. RESULTS Most infants (75%) were breastfed at birth; however, by the time infants were three months old, 39.7% of the mothers had stopped breastfeeding. Over half (57.1%) of the infants were fed solids before age three months, 11.6% were given whole milk before age nine months, and 59.4% had low fat milk before age two years. Body mass index (kg/m2) (BMI) was above the 85th percentile for 27.8% at the 48-month interview, and was associated with a maternal BMI above 25 (OR=7.8, CI=1.1-41.9). CONCLUSIONS Mothers need to be encouraged to follow current infant feeding recommendations. Strategies should be developed to reduce the prevalence of overweight among adults and children in First Nations communities.Purpose: Little information is available on the growth and feeding patterns of First Nations children. Our goal was to assess the anthropometric status, feeding practices, and dietary intake of children born in 1994 or 1995 (n=102) and living in Walpole Island First Nation. Methods: Information on demographic characteristics and infant feeding practices was obtained through parent interviews conducted between 1994 and 1999. Parents also completed a 24-hour dietary recall for their children when they were 48 months old. Head circumference was measured at three and 18 months, and weight and length/height at three, 18, 33, and 48 months. Results: Most infants (75%) were breastfed at birth; however, by the time infants were three months old, 39.7% of the mothers had stopped breastfeeding. Over half (57.1%) of the infants were fed solids before age three months, 11.6% were given whole milk before age nine months, and 59.4% had low fat milk before age two years. Body mass index (kg/m2) (BMI) was above the 85th ...

Adolescents' diets do not comply with 2007 Canada's food guide recommendations.

This study evaluated the eating behaviours of students in grade six and, three years later when they were in grade nine, relative to the recommendations of Canadas 2007 Food Guide. Students completed a self-administered questionnaire on eating behaviours in 2002 (n=647) and again in 2005 (n=520) as part of Better Beginnings, Better Futures, a primary prevention initiative among economically disadvantaged communities. McNemar analysis and X(2) analysis were used to assess differences in compliance with the recommendations of the Food Guide. Differences in the mean number of servings of the four food groups and the Other Foods group were examined using independent sample t-tests and paired t tests. In grade six, 5% of males and 7% of females met the minimum number of recommended servings for all four food groups. By grade nine this had dropped to 0.4% and 2% respectively. Among males who completed the questionnaire in both grade six and grade nine there was a decline in the mean number of daily servings for all four food groups. For females a similar trend was observed. The likelihood of adolescents meeting all Food Guide recommendations decreased from grade six to grade nine.

Persistence of Overweight among Young Children Living in Low Income Communities in Ontario

Objective: the rise in the prevalence of overweight in pediatric populations is a major health concern. Little is known however, about the prevalence of overweight in younger children. Our objectives were to determine the annual prevalence of overweight in children from junior kindergarten (JK) to grade 3; to assess the persistence of overweight over this time period; and, to identify factors associated with overweight in this group. Methods: annual interviews were completed with parents (primarily the mother) living in economically disadvantaged communities in Ontario who are participating in the Better Beginnings, Better Futures project. Weight and height were measured annually for the children (n=760) beginning in JK. Risk of overweight was defined as body mass index (BMI) ≥ 85th to < 95th percentile; overweight was BMI ≥ 95th percentile. Parents’ height and weight were self-reported; BMI ≥ 25 was considered overweight. Results: the risk of overweight among children ranged from 14.1% to 17.5%; the prevalence of overweight increased from 9.9% to 15.2%; 68.2% (15/22) of the children who were overweight in JK were >95th percentile in grade 3. BMI ≥ 85th to < 95th percentile or ≥ 95th percentile in JK were strongly predictive of overweight in grade 3. Almost 50% of the mothers were overweight. Conclusions: A high prevalence of overweight was found in young children; and, for a large proportion, their early weight status persisted. Strategies promoting healthy eating and physical activity for both children and parents are essential.

Attitudes and health behaviours of young adolescent omnivores and vegetarians: A school-based study

This study aimed to identify attitudes, health behaviours, social adjustment and self-reported health of vegetarian and omnivore teenagers and determine characteristics independently related to vegetarian status. Participants were 630 Grade 9 students, ages 13-15 years, in seven schools in Ontario, Canada. Vegetarian status was determined using a 19-item food inventory. The vegetarian group included lacto, ovo and/or lacto-ovo and semi-vegetarians. Omnivores consumed red meat at least monthly. Social adjustment factors included school misbehaviour, low academic performance, authority-defying risks and unsafe/illegal risks. Logistic regression estimated the relationship of characteristics to vegetarian status. The sample comprised 25 vegetarians (4%) and 605 omnivores. Analyses focussed mainly on females; 22 vegetarians and 315 omnivores. Dieting behaviours (current, frequent and past year), alcohol use, poorer social adjustment and poorer self-rated health were positively related to vegetarian eating (p<.05). Among females (using logistic regression), past year dieting (OR 9.88; 95% CI 2.19-44.47) and alcohol use (OR 2.91; 95% CI 1.02-8.32) predominated in the presence of attitudes that personal health and animal rights are very important. The model predicted 79.9% of cases. Teenage vegetarians were distinctive in health behaviours. The independent, positive association of alcohol use with vegetarian eating is a unique and concerning finding. Dieting behaviours were strongly, independently and positively linked to female vegetarian eating. Further studies with a greater range of behaviours would be useful to more fully characterize teenage vegetarians and explore subgroups.

Eat smart! Workplace Cafeteria Program evaluation of the nutrition component.

Purpose: The nutrition component of the Eat Smart! Workplace Cafeteria Program (ESWCP) in a hospital was evaluated. We assessed staff’s frequency of visits to and purchases in the hospital cafeteria, attitudes about the program, short-term eating behaviour change, and suggestions to improve the ESWCP. Methods: Questionnaires were sent to hospital staff members who were not on leave (n=504). Dillman’s Tailored Design Method was used to design and implement the survey. Four mail-outs were used and yielded a 51% response rate. Results: Eighty-seven percent of respondents visited the hospital cafeteria at least once a week in an average seven-day week, and 69% purchased one to five meals or snacks there each week. Eighty-six percent of respondents said that they were aware of the hospital’s program. Notices on cafeteria tables were the primary method of learning about the program (67%). Reported program benefits included increased knowledge about healthy eating, convenience of having healthy foods in the cafe...

Anthropometric status and diet of 4 to 5 year old low income children

Abstract As part of the longitudinal, multidisciplinary prevention project, Better Beginnings, Better Futures, we assessed the dietary and anthropometric status of 4 and 5 year old children (n = 325) in four economically disadvantaged urban communities in Ontario. Anthropometric measurements included height, weight, triceps skinfolds, mid-arm circumference and indices of body composition. Information on demographic characteristics was collected through a parent interview. We obtained a 24 hour dietary recall for each child from the respondent parent and, where appropriate, any caregivers. Height-for-age was similar to the NCHS distribution. The proportion with weight-for-height Z scores >1.645 exceeded NCHS reference data for both boys (x 2 = 25.2, p 2 = 21.5, p