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1.
Public Health Nutr ; 26(12): 2882-2890, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37927150

RESUMO

OBJECTIVE: Dual modality feeding (DMF) - feeding human milk interchangeably from the breast and from a bottle - comes with unique practical, emotional and relational challenges, as well as support needs. Yet, there is little research that explores the experiences of individuals who use DMF in the Canadian context. The aim of this study is to explore the practices, challenges, reasons and enablers of DMF. DESIGN: Repeat, semi-structured one-on-one interviews were conducted at 8 weeks and 22 weeks postpartum. Interview transcripts were thematically analysed using a critical feminist lens. SETTING: Nova Scotia, Canada. PARTICIPANTS: Ten DMF mothers. RESULTS: DMF practices were influenced by a mix of social and material circumstances, including breast-feeding challenges, the involvement of support persons, finances and access to lactation support. Individuals who predominantly fed at the breast expressed milk strategically to mitigate transitory breast-feeding challenges, for convenience under specific circumstances, and to share feeding responsibilities with other caregivers for personal and practical reasons. Individuals who mainly bottle-fed did so due to long-term breast-feeding challenges or a need to return to employment. Enablers of successful DMF were consistent between the two groups and included practical, personal and relational aspects. CONCLUSIONS: DMF is a unique practice compared to feeding human milk solely from the breast or bottle. Despite the potential growing prevalence of DMF, it is currently understudied and inadequately addressed in existing support programmes in Nova Scotia. Tailored programming and public messaging are needed to support DMF families.


Assuntos
Alimentação com Mamadeira , Leite Humano , Feminino , Humanos , Lactente , Aleitamento Materno/psicologia , Mães , Nova Escócia
2.
Inquiry ; 60: 469580231184326, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37366324

RESUMO

Framed by the socio-ecological model of well-being, we examined the relative importance of factors contributing to three dimensions of well-being (child, parent, and family) during the COVID-19 pandemic. A sample of 536 participants from the Atlantic provinces of Canada answered a cross-sectional survey in 2021, covering experiences during the pandemic (eg, changes in family life and well-being). Well-being was assessed with 3 single-item measures on positive change in the life of children, parents, and families during the pandemic. This study involved 21 predictor variables (eg, change in time spent on various family activities). Using multiple regression and measures of relative importance based on the Lindeman, Merenda and Gold (lmg) method, we identified the variables most important to predicting well-being. Twenty-one predictors accounted for 21% of the variance in child well-being, 25% in parent well-being, and 36% in family well-being. Well-being at all 3 levels (child, parent, and family) shared the same top predictor (family closeness). The top 6 predictors of well-being at each level were related to leisure (eg, play) and time-use (eg, to prepare meals, engage in self-care, and rest). The effect sizes were smaller for child well-being than at the parent or family level, suggesting there may be important predictors of child well-being not accounted for in these analyses. This study may inform family-level programing and policy that seeks to promote well-being for children and their families.


Assuntos
COVID-19 , Pandemias , Criança , Humanos , Estudos Transversais , Canadá , Pais
3.
Can J Diet Pract Res ; 84(2): 93-97, 2023 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-36866836

RESUMO

Purpose: This study investigated the potential influence of the 2019 Canada's Food Guide (CFG) on the eating environment and food provided in early learning and childcare centres across Canada.Methods: Directors of childcare centres were invited to complete an online survey about their awareness and adoption of the 2019 CFG and submit their menus for analysis.Results: Twenty-five directors completed the survey, and eighteen cycle menus were analyzed. Frequency and the types of foods offered in childcare centres were assessed. Ninety-two percent reported being aware of the changes in the food guide. Many challenges including the lack of support and resources, cost of food, and food reluctance could affect their ability to apply the changes, especially the incorporation of plant-based protein and the uncertainty around the amount of dairy products to provide. Menu analysis indicated frequency of offering items from the various food groups. Vegetables were mostly offered during lunchtime with an average offering rate of 4.83 ± 0.24 times per week.Conclusion: Representatives of early learning and childcare centres identified having difficulties in interpreting and applying the changes in the 2019 CFG. Dietitians have the knowledge and skills required to support childcare centres through training opportunities, workshops, toolkits, and advocacy.


Assuntos
Cuidado da Criança , Serviços de Alimentação , Humanos , Criança , Política Nutricional , Canadá , Verduras
4.
Artigo em Inglês | MEDLINE | ID: mdl-36231167

RESUMO

Children benefit from responsive feeding environments, where their internal signals of hunger and satiety are recognized and met with prompt, emotionally supportive and developmentally appropriate responses. Although there is existing research on responsive feeding environments in childcare, there is little synthesized literature on the implementation practices using a behavior change framework. This scoping review sought to explore the factors influencing the implementation and sustainability of responsive feeding interventions in the childcare environment, using the behavior change wheel (BCW). A total of 3197 articles were independently reviewed and 39 met the inclusion criteria. A thematic analysis identified the factors influencing the implementation and sustainability of responsive feeding, including the following: (1) pre-existing nutrition policies, (2) education and training, (3) provider beliefs and confidence, (4) partnership development and stakeholder engagement and (5) resource availability. The most common BCW intervention functions were education (n = 39), training (n = 38), environmental restructuring (n = 38) and enablement (n = 36). The most common policy categories included guidelines (n = 39), service provision (n = 38) and environmental/social planning (n = 38). The current literature suggests that broader policies are important for responsive feeding, along with local partnerships, training and resources, to increase confidence and efficacy among educators. Future research should consider how the use of a BCW framework may help to address the barriers to implementation and sustainability.


Assuntos
Cuidado da Criança , Saúde da Criança , Criança , Humanos , Política Nutricional , Participação dos Interessados
5.
Can J Diet Pract Res ; 83(4): 198-202, 2022 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-36004725

RESUMO

The home environment and parental influence are strong predictors of eating behaviours in young children and can influence healthy development. The objective of this study was to describe the feeding practices of a sample of families on Prince Edward Island. Eleven parent participants were recruited, one-on-one interviews were held, and a thematic analysis was conducted. Conversations with parents revealed that the family feeding environment is influenced by a multitude of factors that change daily and need to be navigated based on the age of the child. Parents saw family meals as time together and an opportunity to model healthy eating behaviours; however, they faced several challenges at mealtimes, including perceived picky eating. Parents recognized their children's hunger and satiety cues, although they respected satiety signals more often if children ate what they perceived as a lot of food. Many parents used food as a reward to encourage their children to eat more but recognized that it could lead to the development of undesirable habits. Despite the complex factors that influence feeding, dietitians can work with families to foster a responsive feeding environment by encouraging family meals, recognizing and respecting hunger and satiety cues, and understanding typical changes in eating behaviours as children age.


Assuntos
Comportamento Alimentar , Pais , Criança , Humanos , Pré-Escolar , Ilha do Príncipe Eduardo , Relações Pais-Filho , Refeições
6.
Can J Diet Pract Res ; 83(4): 168-174, 2022 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-36004728

RESUMO

Purpose: The values, beliefs and practices between the family home and child care environment can play a role in shaping a responsive food environment for young children, but few studies have explored the differences across these settings. The purpose of this study was to compare responsive feeding practices in child care and home environments through the framework of the 2019 Canada Food Guide healthy eating recommendations.Methods: Nova Scotia families and child care providers completed an online survey on responsive feeding. Independent-samples t-tests explored the differences between family and child care respondents on variables related to the 2019 Canada's Food Guide, including: food variety, mindfulness, eating with others, cooking more often, and enjoyment of food. A directed content analysis was used to code the open-ended qualitative questions.Results: Family respondents (n = 603) were more likely to report offering a variety of foods, repeated exposures to new foods, and asking children about fullness. Child care respondents (n = 253) were more likely to sit with children during meals and less likely to encourage children to finish their food.Conclusions: The results identify potential points of intervention, including the importance of increasing communication to ensure mutually supportive messages and environments for healthy eating.


Assuntos
Cuidado da Criança , Ambiente Domiciliar , Criança , Pré-Escolar , Humanos , Comportamento Alimentar , Refeições , Nova Escócia
7.
Child Care Health Dev ; 48(6): 1122-1133, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-35997511

RESUMO

OBJECTIVES: Changes to income and employment are key social determinants of health that have impacted many families during the COVID-19 pandemic. This research aimed to understand how changes to employment and income influenced family environments that contribute to early childhood development and health. METHODS: A concurrent triangulation mixed method design was used through a cross-sectional survey on early impacts of the COVID-19 pandemic involving families with young children in the Canadian Maritime provinces (n = 2158). Analyses included multivariate regression models to examine whether changes to employment and income predicted changes to Family access to resources and social support, parenting Abilities and self-care at home, and home Routines and Environments (FARE Change Scale). Content analysis was used to identify themes from the open-ended questions. RESULTS: Changes to employment and income early in the pandemic like no longer working but continued to receive salary, working fewer hours for the same salary earned before the pandemic, no longer working nor receiving salary, working fewer hours resulting in salary reduction, essential worker status and household income were significant predictors of FARE Change Scale when ethnicity/cultural background and province of residence are controlled (P < .05). Themes provided a description of family impacts, including shifting employment and income, finding time and capacity, feelings of guilt and the creation of new routines. CONCLUSION: Our study provides insight on the implications of public health restrictions, such as the importance of increased time for parents (through reduced work hours) and access to resources and social support to support child development and health.


Assuntos
COVID-19 , Pandemias , COVID-19/epidemiologia , Canadá/epidemiologia , Criança , Desenvolvimento Infantil , Pré-Escolar , Estudos Transversais , Humanos
8.
Appl Physiol Nutr Metab ; 47(5): 495-501, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35113682

RESUMO

Children benefit from responsive feeding practices where their internal signals of hunger and satiety are valued and met with prompt, emotionally supportive, and developmentally appropriate responses. Using an online survey, this study describes responsive feeding values and practices among parents of young children (0-5 years) (n = 1039) across 3 Canadian Maritime provinces. Independent-samples t-tests and 1-way ANOVA were performed to determine the differences in survey questions related to the responsive feeding practices and values. First-time parents and parents with younger children report implementing more consistently some of the challenging responsive feeding practices, such as avoiding pressuring their children to eat, compared with parents with multiple children and parents with children ages 3-5 years. Parents often have well-intended reasons to encourage their children to eat; however, these can coincide with non-responsive practices with food such as pressuring, rewarding, and restriction. These coercive practices may be ineffective and counterproductive as they reinforce reasons to eat unrelated to appetite and self-regulation. Preschool and early feeding interventions that support parents in understanding normal child development, including typical eating behaviours and self-regulation, could help to equip them for challenging feeding experiences and encourage long-term responsive feeding practices. Novelty: First-time parents and parents with younger children report more consistently avoiding pressuring their children to eat, compared with parents with multiple children and parents with children ages 3-5 years. Parents often have well-intended reasons to encourage their children to eat; however, these can coincide with non-responsive practices such as pressuring, rewarding, and restriction.


Assuntos
Relações Pais-Filho , Poder Familiar , Canadá , Comportamento Infantil , Pré-Escolar , Comportamento Alimentar/psicologia , Humanos , Poder Familiar/psicologia , Pais , Inquéritos e Questionários
9.
Can J Diet Pract Res ; 82(4): 176-182, 2021 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-34286630

RESUMO

Purpose: To describe the energy (E), sodium, saturated fat, sugar, and fibre intakes of a sample of children attending regulated childcare (RCC) in Nova Scotia.Methods: Nutrient analyses from 79 food records were compiled and grouped by intakes in and outside of RCC, age, sex, location of the RCC (urban or rural), and nutrient intake data. Descriptive statistics and independent t tests were conducted.Results: Mean E and macronutrients were within recommended ranges and, for days attending RCC, 45%E was consumed in RCC. Saturated fat intake was 12%E on average. Mean sodium intake exceeded or approached the tolerable upper limit for 3-year olds (1726 mg/day) and 4-5-year olds (1770 mg/day), respectively. Total sugar was 27%E intake and significantly more sugar was consumed outside RCC and by boys compared to girls. Mean daily dietary fibre intake was below recommended levels (15 g/day).Conclusions: On average dietary intakes of children exceeded recommendations for sodium, saturated fat, and sugar with higher intakes outside RCC. The foods provided by RCC have a positive influence on children's intakes, but given the pervasiveness of sugar and sodium in the food environment and the challenges of feeding children, support is needed for both RCC and families to encourage healthy eating behaviours for positive growth and development.


Assuntos
Cuidado da Criança , Dieta , Criança , Carboidratos da Dieta , Gorduras na Dieta , Ingestão de Alimentos , Ingestão de Energia , Comportamento Alimentar , Feminino , Humanos , Masculino
10.
Physiol Behav ; 222: 112931, 2020 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-32413534

RESUMO

OBJECTIVE: Sedentary video game playing (VGP) and caloric preloads in the pre-meal environment have been shown to influence short-term food intake (FI) regulation in children. Other factors that may affect FI control include physical activity and/or heightened emotion. Therefore, we examined the effects of a glucose preload and 30 min of active VGP (aVGP) on subjective appetite, short-term FI, and subjective emotions in 9-14 year-old children. METHODS: On four test mornings approximately one-week apart, twenty-seven children (sex: 15M, 12F; age: 11.3 ± 0.3 years; BMI percentile: 55.3 ± 6.1%) consumed a standardized breakfast two hours prior to consuming 250 mL of either a 50 g glucose preload or Sucralose® control. Following the preload, participants participated in 30 min of quiet sitting or aVGP. Energy expenditure was measured during aVGP via indirect calorimetry. FI from an ad libitum pizza meal was measured after each test condition. Subjective appetite and emotions were measured at baseline (0 min), during treatment (15min), and immediately before the test meal (30 min). RESULTS: aVGP did not affect FI, but the glucose preload decreased FI compared with the sucralose control (∆ = 157 kcal, <0.001). Although not statistically significant (p=0.12), caloric compensation was lower following the glucose preload in the aVGP condition. Subjective appetite increased with time, and was higher in the sucralose control + aVGP condition (p=0.05). Change from baseline subjective emotion scores of anger and excitement were higher (p=0.03) and lower (p=0.02) after aVGP, respectively. CONCLUSIONS: Neither short-term FI nor net energy balance were affected by low-intensity aVGP (energy expenditure of 34 kcal). These findings suggest that a short bout of low-intensity aVGP does not alter energy balance during the study measurement period, and may not support achieving or maintaining healthy weights in children. However, future longitudinal studies are needed to confirm such advice.


Assuntos
Apetite , Jogos de Vídeo , Adolescente , Regulação do Apetite , Glicemia , Criança , Ingestão de Alimentos , Ingestão de Energia , Feminino , Humanos , Masculino
11.
Can J Diet Pract Res ; 81(1): 15-20, 2020 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-31512496

RESUMO

Purpose: The vegetable/fruit intakes of a sample of children attending regulated childcare in Nova Scotia was assessed and compared by age groups (3 and 4-5 year olds) and by home and childcare environments. Methods: Seventy-nine children had 3-4-day food records and 58 had records from both environments. The data were coded by the 2007 Canada's Food Guide (CFG) recommendations and the 2014 Classification of Foods in the Canadian Nutrient File according to CFG (CNF/CFG) Tiers. Descriptive statistics and tests of significance were determined. Results: Overall, 56% of children met the CFG vegetable/fruit recommendations but the percentage of older children meeting recommendations was half that of the younger age group; a significant difference. Fruit and juice comprised 65% of vegetable/fruit intakes with more consumed at home. Vegetable/fruit items were mostly from the higher quality CNF/CFG Tiers but more of the lower quality items were consumed at home. Conclusions: The 4-5 year olds may not be increasing their vegetable/fruit intakes as the CFG recommends. While just over half of children met CFG vegetable/fruit recommendations, the vegetable/fruit items were mostly high quality; fruit and juice predominated. Identification of strategies to support increased vegetable/fruit intakes of children in both home and childcare environments is warranted.


Assuntos
Cuidado da Criança/estatística & dados numéricos , Dieta/estatística & dados numéricos , Frutas , Verduras , Pré-Escolar , Registros de Dieta , Ingestão de Alimentos , Humanos , Nova Escócia , Recomendações Nutricionais
12.
Appl Physiol Nutr Metab ; 44(3): 248-254, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30096245

RESUMO

Video game playing (VGP) is associated with overweight/obesity (OW/OB). VGP and caloric preloads in the pre-meal environment influence short-term food intake (FI) in healthy-weight children. Therefore, the purpose of the present study was to examine the effect of pre-meal VGP and a glucose preload on subjective emotions, subjective appetite, and FI in boys with OW/OB. On 4 separate mornings, boys with OW/OB (n = 22; mean ± SD: age = 11.9 ± 1.6 years; body mass index percentile = 94.3 ± 3.9) participated in 4 test conditions. Two hours after a standardized breakfast, boys consumed equally sweetened preloads (250 mL) of sucralose (0 kcal) or glucose (200 kcal), with or without 30 min of subsequent VGP. Immediately after each test condition, FI was evaluated during an ad libitum pizza meal. Subjective appetite was measured at 0 (baseline), 15, and 30 min. Subjective emotions (aggression, anger, excitement, disappointment, happiness, upset, and frustration) were measured at 0 and 30 min. VGP did not affect FI, but the glucose preload decreased FI compared with the sucralose control (Δ = -103 ± 48 kcal, p < 0.01). However, cumulative FI (preload kcal + meal kcal) was 9% higher after the glucose preload (p < 0.01). Subjective appetite increased with time (p < 0.05) but was not influenced by preload or VGP. Frustration was the only subjective emotion that increased following VGP (p < 0.01). A glucose preload, but not VGP, suppressed FI in boys with OW/OB, suggesting a primary role of physiological factors in short-term FI regulation.


Assuntos
Apetite , Ingestão de Alimentos , Emoções , Sobrepeso/psicologia , Obesidade Infantil/psicologia , Jogos de Vídeo , Criança , Comportamento Alimentar , Glucose/administração & dosagem , Humanos , Masculino , Sacarose/administração & dosagem , Sacarose/análogos & derivados , Edulcorantes/administração & dosagem
14.
Appetite ; 111: 32-37, 2017 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-28011003

RESUMO

PURPOSE: To determine the effect of pre-meal screen-time activities on subjective emotions, subjective appetite, and food intake (FI) in 9-14 year-old girls. METHODS: In this clinical study, 31 girls completed four 45-min treatment conditions of television viewing (TVV), video game playing (VGP), a challenging computer task (CT), and sitting without screen exposure (control) in a randomized order. Each treatment condition was followed immediately by an ad libitum pizza lunch, and FI was calculated from the weight of the consumed pizza. Subjective appetite was assessed at baseline, 15, 30, and 45 min during the treatment condition, and upon trial completion at 75 min. Subjective emotions were assessed at baseline and at 45 min. RESULTS: FI was not affected by screen type, but was positively correlated with body composition (fat mass [FM, kg], fat free mass [FFM, kg]) in all treatment conditions. Subjective appetite was not affected by screen type, but increased with time in all treatment conditions (p < 0.0001). Subjective emotions were affected by VGP only. Anger, excitement, frustration, and upset feelings were increased at 45 min following VGP. VGP led to increased frustration compared to control (p = 0.0003), CT (p = 0.007) and TVV (p = 0.0002). CONCLUSION: Exposure to TVV or CT before eating did not affect subjective emotions, subjective appetite, or FI, and no difference was found between screen activities and the control condition for average appetite or FI. Despite a change in subjective emotions during the VGP condition, there was no increase in subjective appetite or subsequent FI. These findings suggest that physiologic signals of satiation and satiety are not overridden by environmental stimuli of pre-meal screen-time exposure among young girls. (Clinical trial number NCT01750177).


Assuntos
Apetite , Ingestão de Alimentos/psicologia , Emoções , Fatores de Tempo , Jogos de Vídeo/psicologia , Adolescente , Composição Corporal , Criança , Computadores , Feminino , Humanos , Almoço , Distribuição Aleatória , Televisão
15.
J Obstet Gynaecol Can ; 38(6): 508-554.e18, 2016 06.
Artigo em Inglês | MEDLINE | ID: mdl-27368135

RESUMO

OBJECTIVES: To provide health care professionals in Canada with the basic knowledge and tools to provide nutrition guidance to women through their lifecycle. OUTCOMES: Optimal nutrition through the female lifecycle was evaluated, with specific focus on adolescence, pre-conception, pregnancy, postpartum, menopause, and beyond. The guideline begins with an overview of guidance for all women, followed by chapters that examine the evidence and provide recommendations for the promotion of healthy nutrition and body weight at each life stage. Nutrients of special concern and other considerations unique to each life stage are discussed in each chapter. EVIDENCE: Published literature, governmental and health agency reports, clinical practice guidelines, grey literature, and textbook sources were used in supporting the recommendations made in this document. VALUES: The quality of evidence was rated using the criteria described in the report of the Canadian Task Force on Preventive Health Care. CHAPTER 2: GENERAL FEMALE NUTRITION: Summary Statements Recommendations CHAPTER 3: ADOLESCENCE NUTRITION: Summary Statements Recommendations CHAPTER 4: PRE-CONCEPTUAL NUTRITION: Summary Statement Recommendations CHAPTER 5: NUTRITION IN PREGNANCY: Summary Statements Recommendations CHAPTER 6: POSTPARTUM NUTRITION AND LACTATION: Summary Statements Recommendations CHAPTER 7: NUTRITION DURING MENOPAUSE AND BEYOND: Summary Statement Recommendations.


Assuntos
Fenômenos Fisiológicos da Nutrição , Saúde da Mulher , Adolescente , Saúde do Adolescente , Feminino , Humanos , Lactação , Menopausa , Período Pós-Parto , Gravidez
16.
J Obstet Gynaecol Can ; 38(6): 555-609.e19, 2016 06.
Artigo em Inglês | MEDLINE | ID: mdl-27368136

RESUMO

OBJECTIFS: Doter les professionnels de la santé du Canada de connaissances et d'outils de base, afin qu'ils puissent prodiguer des conseils nutritionnels aux femmes tout au long de leur cycle de vie. RéSULTATS: L'alimentation optimale a fait l'objet d'une évaluation tout au long du cycle de vie de la femme. Elle a porté en particulier sur l'adolescence, la préconception, la grossesse, la période post-partum, la ménopause et au-delà. Le présent guide fournit d'abord des directives abrégées à l'intention de toutes les femmes. Elles sont suivies de chapitres proposant un examen des données probantes, ainsi que des recommandations sur la promotion d'une alimentation saine et d'un poids santé à chaque étape de la vie. Par ailleurs, tous les chapitres présentent une analyse de nutriments d'intérêt particulier, ainsi que d'autres aspects uniques à chaque étape de la vie. DONNéES PROBANTES: Des documents publiés, des rapports d'organismes gouvernementaux et de santé, des lignes directrices de pratique clinique, de la documentation parallèle et des extraits de manuels ont servi à étayer les recommandations formulées dans le présent document. VALEURS: L'évaluation de la qualité des données probantes repose sur les critères décrits dans le rapport du Groupe d'étude canadien sur les soins de santé préventifs. CHAPITRE 2 : CONSEILS GéNéRAUX SUR L'ALIMENTATION FéMININE: Déclarations Sommaires Recommandations CHAPITRE 3 : ALIMENTATION DE L'ADOLESCENTE: Déclarations Sommaires Recommandations CHAPITRE 4 : ALIMENTATION PRéCONCEPTIONNELLE: Déclarations Sommaires Recommandations CHAPITRE 5 : ALIMENTATION PENDANT LA GROSSESSE: Déclarations Sommaires Recommandations CHAPITRE 6 : ALIMENTATION ET LACTATION POST-PARTUM: Déclarations Sommaires Recommandations CHAPITRE 7 : ALIMENTATION PENDANT LA MéNOPAUSE ET AU-DELà: Déclarations Sommaires Recommandations.

17.
Can J Public Health ; 106(2): e43-51, 2015 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-25955671

RESUMO

OBJECTIVES: To assess what health promotion policies and practices were adopted by schools in Nova Scotia and the extent that these policies and practices affected the diet quality, physical activity (PA) and weight status of students. METHODS: We developed and administered a 'school practice assessment tool' to assess the presence of 72 different school-based health promotion policies and practices. Surveys were conducted in 2003 and 2011 to assess diet, PA and weight status in approximately 10,000 grade 5 students. We used multilevel regression methods to examine changes in these outcomes across schools with varying levels of health promotion policies and practices between the two time-points. RESULTS: Between 2003 and 2011 the diet quality of students improved, PA decreased and the prevalence of childhood obesity increased. Although we did not find consistent or significant favourable benefits resulting from higher implementation levels, we did observe fewer negative trends among schools at higher levels of implementation. CONCLUSION: Our results build on the current gap in knowledge on the impact of Health Promoting Schools (HPS) implementation through population health interventions, but there is a continued need for further evaluation and monitoring of school policies to understand how HPS practices are supporting healthier eating and PA for students.


Assuntos
Peso Corporal , Dieta/normas , Atividade Motora , Política Organizacional , Serviços de Saúde Escolar/organização & administração , Estudantes/psicologia , Criança , Feminino , Humanos , Masculino , Análise Multinível , Nova Escócia/epidemiologia , Obesidade Infantil/epidemiologia , Avaliação de Programas e Projetos de Saúde , Análise de Regressão , Estudantes/estatística & dados numéricos
18.
Matern Child Health J ; 19(9): 2048-56, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25656729

RESUMO

Breastfeeding has been rigorously studied in relation to childhood obesity prevention. Few studies have examined whether combination feeding­breast milk and formula­may also be protective against obesity. This study aimed to investigate the relationship between breastfeeding duration, combination feeding and overweight and obesity among Canadian school children. We analyzed data from a 2011 cross-sectional, population based survey (n = 5,560), which included self-reported infant feeding behaviours, a food frequency questionnaire and measured height and weight. Multilevel regression methods were used to examine the association between breastfeeding duration and overweight and obesity adjusting for socioeconomic status, diet quality and physical activity. Thirty-four percent of children were breastfed for <1 week or never while 32% were breastfed for at least 6 months. In the fully adjusted model, children who were only formula fed or who were combination fed for <6 months were more likely to be overweight or obese relative to children who were only breastfed (OR 1.29, 95% CI 1.04-1.60 and OR 1.35, 95% CI 1.09-1.69, respectively). When examining overweight and obese children separately, those who were only formula fed were more likely obese (OR 1.57, 95% CI 1.10-2.25) relative to their peers who were only breastfed. And those who were combination fed for <6 months relative to those only breastfed were more likely to be overweight (OR 1.29, 95% CI 1.01-1.66). Breastfeeding, in the absence of formula feeding, appears to have a protective effect on childhood obesity. While combination feeding confers less benefit than only breastfeeding, it is more desirable than formula feeding alone. Strategies and social policies are needed to promote exclusive and longer breastfeeding duration and should be integrated with comprehensive efforts to prevent childhood obesity and to reduce the burden of chronic diseases in the long term.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Comportamento Alimentar , Fórmulas Infantis/estatística & dados numéricos , Obesidade Infantil/epidemiologia , Índice de Massa Corporal , Criança , Estudos Transversais , Feminino , Humanos , Recém-Nascido , Masculino , Nova Escócia/epidemiologia , Autorrelato
19.
Public Health Nutr ; 18(16): 2943-51, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25075606

RESUMO

OBJECTIVE: Food security (FS) exists when all people, at all times, have physical and economic access to sufficient, safe and nutritious food to meet their needs. The present research sought to determine whether students from households experiencing moderate or severe food insecurity (FI) had poorer diet quality, higher body weights and poorer psychosocial outcomes than students from households classed as having high FS or marginal FI status. DESIGN: Population-based survey conducted in schools. Multiple regression analysis was used to explore associations between FS status (high FS; marginal, moderate, severe FI), dietary behaviours and intake, and health-related outcomes (body weight, quality of life, mood, peer relationships, externalizing problems). SETTING: Nova Scotia, Canada. SUBJECTS: Grade 5 students (n 5853), aged 10-11 years, with complete information on FS status and student outcomes. RESULTS: In this sample, rates of household FS were 73·5% (high FS), 8·3% (marginal FI) 10·2% (moderate FI) and 7·1% (severe FI status). Students living in households experiencing moderate or severe FI had poorer diet quality, higher BMI and poorer psychosocial outcomes than students classed as having high FS or marginal FI. CONCLUSIONS: These findings provide important evidence for policy makers on the prevalence of FI among families in Nova Scotia with grade 5 children and its relationship with childhood nutrition, psychosocial and quality of life factors, and weight status.


Assuntos
Dieta , Características da Família , Comportamento Alimentar , Abastecimento de Alimentos , Nível de Saúde , Pobreza , Qualidade de Vida , Afeto , Peso Corporal , Criança , Feminino , Abastecimento de Alimentos/estatística & dados numéricos , Saúde , Humanos , Relações Interpessoais , Masculino , Nova Escócia , Instituições Acadêmicas , Estudantes , Inquéritos e Questionários
20.
Appetite ; 83: 256-262, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25150911

RESUMO

Increased food intake (FI) during television viewing has been reported in children, but it is unknown if this occurs following pre-meal video game playing (VGP). The objective was to determine the effect of pre-meal VGP for 30 min on subjective appetite and emotions, and FI in normal weight (NW) boys after a glucose or control preload. On four test mornings, NW boys (n = 19) received equally sweetened preloads of a non-caloric sucralose control or 50 g glucose in 250 mL of water, with or without VGP for 30 min. Food intake from an ad libitum pizza meal was measured immediately after. Subjective appetite was measured at 0, 15, 30, and 60 min. Subjective emotions were determined by visual analog scale at baseline and immediately before lunch. Both VGP (p = 0.023) and glucose (p <0.001) suppressed FI. Pre-meal VGP compared with no-VGP, and glucose compared with the non-caloric control, decreased FI by 59 and 170 kcal, respectively. Subjective average appetite increased to 30 min (p = 0.003), but was lower after glucose (p = 0.01) in both the VGP and no-VGP conditions compared with the control. Frustration and aggression scores increased after VGP (p <0.05), but did not correlate with FI. However, baseline and pre-meal happiness and excitement scores were inversely associated with FI. In conclusion, both pre-meal VGP and the glucose preload suppressed FI, supporting the roles of both physiologic and environmental factors in the regulation of short-term FI in 9- to 14-year-old NW boys.


Assuntos
Regulação do Apetite , Comportamento Infantil , Fenômenos Fisiológicos da Nutrição Infantil , Glucose/administração & dosagem , Modelos Psicológicos , Lanches , Jogos de Vídeo/psicologia , Adolescente , Comportamento do Adolescente , Fenômenos Fisiológicos da Nutrição do Adolescente , Criança , Ingestão de Energia , Felicidade , Humanos , Almoço , Masculino , Adoçantes não Calóricos/administração & dosagem , Nova Escócia , Prazer , Sacarose/administração & dosagem , Sacarose/análogos & derivados
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