Geographic Comparison of Dietary Intake and Quality in Manitoba Adolescents.

Purpose: The Food and Nutrition for Manitoba Youth (FANS) study examined dietary intakes, food behaviours, food security status, health indicators, and body mass index of a cohort of grade 9 students. This paper describes regional differences and similarities in dietary intake (food and nutrients) and quality of youth participants in the FANS study.Methods: Grade 9 students completed a web-based survey on dietary intakes (24-hour recall), food behaviours, self-reported health indicators, and sociodemographic variables. Nutrient intakes were compared with national guidelines and diet quality was assessed using a modified Healthy Eating Index.Results: A total of 1587 students participated from northern, rural, and urban regions in Manitoba. Northern and rural students had higher intakes of sugar, sodium, and saturated fat compared with urban. Northern students consumed fewer grain products compared to urban, and more servings of "other" foods compared with rural and urban. While most participants were classified into the "needs improvement" or "poor" Healthy Eating Index categories, significantly more northern participants were in the "poor" category.Conclusions: Most adolescents in the study are at nutritional risk; however, there are additional vulnerabilities for those in rural and northern communities. Dietitians can use results to advocate for and plan interventions to improve adolescent nutrition.

Food Behaviours and Health Indicators in Manitoba Adolescents and Relation to the Healthy Eating Index.

Adolescence is a vital period of growth and development, both of which are dependent on adequate nutrition; however, concerns persist about poor nutrition and inappropriate food behaviours. In addition to nutrition assessment, the context of food and health behaviour is necessary to understand how dietary choices are shaped and related to diet quality. This study describes food-related behaviours and health indicators associated with dietary quality among adolescents in Manitoba, Canada. A stratified two-stage sampling method was used to collect data on the diet, food behaviours and health indicators of 1587 grade nine students. Diet quality was analysed using the Healthy Eating Index-Canada. Several food behaviours and health indicators varied by gender and school region (urban, rural, northern). The Independent Samples t-test and one-way ANOVA (analysis of variance) assessed differences between groups on the Healthy Eating Index-Canada. Higher Healthy Eating Index-Canada scores were found for those eating family dinners more frequently; consuming breakfast and lunch more frequently; consuming breakfast at home; eating lunch and morning snacks at school; purchasing fewer meals and snacks from cafeterias and vending machines; believing that food and nutrition education is important; not attempting to lose weight; being classified as 'healthy weight'; and getting more sleep. Many Manitoba youth are exhibiting food and health behaviours that increase their risk of having a poor diet.

Food insecurity, nutrition insecurity, and self-reported health among newcomer Manitoba youth: A cross-sectional study.

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 Food and Nutrition Security for Manitoba Youth (FANS) study: rationale, methods, dietary intakes and body mass index.

BACKGROUND: Good nutrition and access to healthy foods are essential for child growth and development. However, there are concerns that Canadian children do not have a healthy diet, which may be related to dietary choices as well as lack of access to healthy foods. The FANS (Food and Nutrition Security for Children and Youth) study examined the nutrition and food security status of youth in the province of Manitoba, Canada. This paper describes methods, dietary intakes, and body mass index for the FANS study.  METHODS: This cross-sectional study included 1587 Manitoba grade nine students who completed a self-administered web-based survey. Data was collected on demographic characteristics, dietary intake (24-h recall), food behaviors, food security, and self-report health indicators. Dietary data was compared to national dietary guidelines (Dietary Reference Intakes and Canada's Food Guide). Mean and median nutrient and food group intakes were calculated with corresponding measures of variability. Chi-square tests compared percentage of respondents not meeting key nutrients and food groups. Significant differences in percentage of total servings for each food group were determined by a Kruskal-Wallis test, and differences between different caloric groups were assessed using Dunn's test for post-hoc comparisons.  RESULTS: Half of study respondents were female (50.5%). Median energy intake was higher in males (2281 kcal) compared with females (1662 kcal), with macronutrient distribution of 52%, 16%, and 32% for carbohydrates, protein, and fats respectively. Most participants consumed inadequate fibre (94%), vitamin D (90%), and calcium (73%), while median sodium intakes exceeded recommendations for males but not females. A majority of participants did not meet Health Canada's recommendations for food group servings: Vegetables and Fruit (93%), Milk and Alternatives (74%), Meat and Alternatives (57%) and Grain Products (43%). Other Foods, including sugar sweetened beverages and juice, were consumed by most participants. Higher energy consumers had a greater proportion of food servings coming from Other Foods. 72.1% of students were classified as having a healthy weight and 25% were classified as overweight or obese. CONCLUSION: Poor dietary intakes and body mass index values indicate an urgent need for policy and program strategies to support healthy eating habits and food awareness in Manitoba youth.

Policy responses to the COVID-19 pandemic in the Manitoba grocery sector: a qualitative analysis of media, organizational communications, and key informant interviews.

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.

Food Experiences and Dietary Patterns of International Students at a Canadian University.

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.

Visualizing participant experiences in maternal and child nutrition studies using timeline mapping.

Iron and folic acid (IFA) supplementation is one of the most cost-effective interventions to prevent and treat anemia during pregnancy. Despite having the highest global burden of anemia among pregnant women, rates of IFA uptake in pregnancy in India are still very low, particularly in the state of Uttar Pradesh. Timeline maps were developed as a visual qualitative tool to explore the nuances of health behaviors among pregnant women with respect to antenatal care (ANC) services, including IFA consumption.  Timeline maps were used to elicit and visually document critical events pertaining to ANC services chronologically, including details on contact points with the health system and events specific to IFA distribution, consumption and counselling. The tool consists of a horizontal straight line with nine suspended boxes corresponding to each month of pregnancy, with legends on how to illustrate IFA receipt and consumption. In this instance, the woman's last menstrual period and expected date of delivery were used as a frame of reference for the duration of pregnancy.  Six research assistants (RAs) were trained on how to use timeline maps to elicit and record participant narratives. The RAs later participated in a focus group discussion to gain insight about their experiences using the tool. The timeline maps were easy-to-use and facilitated in-depth conversations with participants. RAs were able to actively engage the participants in co-creating the maps. The visual nature of the tool prompted participants' recall of key pregnancy events and reflexivity. Challenges reported with the tool/process included recollection of past events and potential misrepresentation of information. These highlight a need to restructure training processes. Our findings indicate that timeline maps have the potential to be used in a variety of other program contexts, and merit further exploration.