Infant feeding practices and children's weight status.

PURPOSE: Feeding practices for young Canadian children from economically disadvantaged neighbourhoods were examined to determine adherence to infant feeding recommendations and factors associated with children's weight status. METHODS: Data for the study were collected from 1996 to 2003 as part of Better Beginnings, Better Futures, a longitudinal primary prevention initiative in Ontario. Study subjects were 546 children at age three months and 483 children at age 48 months. RESULTS: Mothers who had less than a high school education (odds ratio [OR] = 1.83, confidence interval [CI] = 1.01-3.29) and mothers who did not attend prenatal classes (OR = 2.37, CI = 1.33-4.24) were more likely to use formula. Mothers who were single parents were three times more likely to have an obese child (OR = 3.35, CI = 1.39-8.06) than were mothers who were married or with a partner. CONCLUSIONS: Targeted strategies are needed for families as single-parent households were predictive of obesity in young children. Innovative encouragement to participate in prenatal programming for pregnant women who have less than a high school education may improve breastfeeding rates.

Determinants of diet quality in pregnancy: sociodemographic, pregnancy-specific, and food environment influences.

OBJECTIVE: To advance the knowledge of determinants of diet quality in pregnancy by focusing on both personal characteristics and the food environment. DESIGN: Cross-sectional study in which participants from the Prenatal Health Project were linked to a geographic dataset by home address. Access to fast food, convenience stores, and grocery stores was measured using a geographic information system (ArcGIS9.3). SETTING: Pregnant women (n = 2,282) were recruited between 2002 and 2005 in London, Ontario, Canada. MAIN OUTCOME MEASURE: Dietary quality was measured using a validated food frequency questionnaire and the Canadian Diet Quality Index for Pregnancy. ANALYSIS: Univariate and multivariate linear regressions were calculated with the predictor variables on the Canadian Diet Quality Index for Pregnancy. RESULTS: Pregnant women who were born in Canada, common-law, nulliparous, less physically active, smokers, more anxious, or lacking family support had lower diet quality on average. Presence of fast-food restaurants, convenience stores, and grocery stores within 500 m of participants' homes was not associated with diet quality after controlling for personal variables. CONCLUSIONS AND IMPLICATIONS: The food environment does not seem to have a large influence on diet quality in pregnancy. Further research is needed to determine other potential reasons for low diet quality among pregnant women.

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 Canada's 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.

Inadequate dietary intakes among pregnant women.

PURPOSE: Eating behaviours were assessed among pregnant women in a mid-sized Canadian city. METHODS: As part of the Prenatal Health Project, we interviewed 2313 pregnant women in London, Ontario. Subjects also completed a food frequency questionnaire. Recruitment took place in ultrasound clinics at 10 to 22 weeks of gestation. The main outcome measures were number of daily servings for each food group, measured against the minimum number recommended by the 2007 Eating Well with Canada's Food Guide (CFG), the proportion of women consuming the recommended number of servings for each and all of the four food groups, and factors associated with adequate consumption. We also determined the number of servings of "other foods." Analysis included descriptive statistics and logistic regression, all at p<0.05. RESULTS: A total of 3.5% of women consumed the recommended number of servings for all four food groups; 15.3% did not consume the minimum number of servings of foods for any of the four food groups. Women for whom this was their first pregnancy were less likely to consume the recommended number of servings from all four food groups (odds ratio=0.41; confidence interval=0.23, 0.74). CONCLUSIONS: Very few pregnant women consumed food group servings consistent with the 2007 recommendations. Strategies to improve dietary behaviours must focus on the establishment of healthy eating behaviours among women of reproductive age.

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

Prenatal depression is a public health concern. This study's 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.

Depressive symptoms during pregnancy in relation to fish consumption and intake of n-3 polyunsaturated fatty acids.

An inverse association between depression and the n-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), primarily obtained from fish consumption, is observed in both observational and experimental research and is biologically plausible. Study objectives were to examine whether prenatal depressive symptoms were associated with lower intakes of fish or EPA+DHA. Pregnant women (n = 2394) completed a telephone interview between 10 and 22 weeks' gestation in London, Ontario, 2002-05. Depressive symptoms were measured using the Center for Epidemiologic Studies - Depression Scale (CES-D). Intakes of fish and EPA+DHA were measured using a validated food-frequency questionnaire. Sequential multiple regression was used to examine associations of depressive symptoms with intake of fish and EPA+DHA, respectively, while controlling for sociodemographic, health and lifestyle variables. The mean CES-D score was 9.9 (SD 8.0). Intake of EPA+DHA was dichotomised at the median value of 85 mg/day. Fish consumption and intake of EPA+DHA were not associated with prenatal depressive symptoms after adjustment for confounders; however, depressive symptoms were significantly higher for lower intakes of EPA+DHA among current smokers and women of single/separated/divorced marital status. The adjusted difference in CES-D scores between intake categories of EPA+DHA was -2.4 [95% CI -4.2, -0.4] for current smokers and -2.8 [95% CI -5.2, -0.4] for women of single marital status. Although pregnant women may be at risk for low concentrations of EPA and DHA, an association between low intakes of EPA+DHA and increased depressive symptoms was only observed among current smokers and women of single marital status.

Fish consumption among pregnant women in London, Ontario: associations with socio-demographic and health and lifestyle factors.

BACKGROUND: Intake of fish and omega-3 fatty acids is inversely related to adverse health outcomes; however, these relationships may be confounded by socio-economic status and health behaviours. This study's purpose was to describe the socio-demographic, health and lifestyle correlates of fish consumption among pregnant women. METHODS: Pregnant women (n=2394) completed a telephone interview between 10-22 weeks' gestation (London, Ontario, 2002-5) containing questions on socio-demographic, health and lifestyle variables; dietary intake was measured using a 106-item validated food-frequency questionnaire. Unadjusted and adjusted risk ratios were obtained using a modified Poisson regression model. RESULTS: Infrequent fish consumption, <1/week, was reported by 32% of women. After adjusting for age and education, infrequent fish consumption was associated with education

Adolescents' low-carbohydrate-density diets are related to poorer dietary intakes.

This study was undertaken to assess how low-carbohydrate-density diets below the acceptable macronutrient distribution range relate to food and micronutrient intake and sociodemographic and health-related characteristics. The multistage stratified cluster design in the 1990 Ontario Health Survey was used. There were 5,194 subjects, 12 to 18 years of age, in sampled households. Dietary data were collected via a food frequency questionnaire. Low-carbohydrate-density diets were consumed by 27.6% of males and 24.1% of females. Low-carbohydrate-density diets were related (P < .05) to reduced sufficiency of vegetables and fruit and higher consumption of meat and alternatives and added fats. The low-carbohydrate-density diet resulted in intakes lower in vitamin C and fiber and higher in cholesterol and total fat. The low-carbohydrate-density diet was directly associated with being Canadian-born (odds ratio [OR] = 1.78, 95% confidence interval [CI] = 1.27 to 2.50), overweight status (OR = 1.27, 95% CI = 1.02 to 1.57), smoking (OR = 1.53, 95% CI = 1.23 to 1.90), alcohol use (OR = 1.46, 95% CI = 1.21 to 1.75), and poorer self-rated health (OR = 1.47, 95% CI = 1.01 to 2.14). Use of the acceptable macronutrient distribution range identified adolescents with low-carbohydrate-density diets whose food choices and nutrient intake may impact negatively on short- and long-term health.

Dietary intake among young adolescents in Ontario: associations with vegetarian status and attitude toward health.

BACKGROUND: This study aimed to describe the dietary intakes of adolescent vegetarians and omnivores and determine if, and how, attitude toward personal health related to food consumption. METHODS: Among grade 9 students in Ontario, Canada (n = 630), vegetarian status and estimated consumption of foods and food groups were determined by food frequency questionnaire. Personal health was self-categorized as very important (the "health conscious") or somewhat/not important (the "non-health conscious"). RESULTS: The prevalence of vegetarianism was 6.5% (CI = 4.6-8.4%) among females and 1.0% (CI = 0.2-1.8%) among males. Health-conscious omnivores consumed more grain, vegetables and fruit, and milk product than non-health-conscious omnivores (P < 0.05). Health-conscious vegetarians ingested more grain products, vegetables and fruit, and meat and alternatives than non-health-conscious vegetarians (P < 0.05). Among non-health-conscious vegetarians, none consumed two daily servings of meat and alternatives compared to 60.5% of non-health-conscious omnivores (P < 0.001). Among health-conscious vegetarians, milk product consumption was lower than that of health-conscious omnivores (P = 0.015). CONCLUSIONS: Large proportions of both vegetarian and omnivore adolescents consumed suboptimal diets. Health consciousness had value as an indicator of dietary adequacy and may be useful as a rudimentary screen for problematic dietary consumption patterns.