Examining the associations between mothers' motivation to regulate their own eating behaviors, food parenting practices and perceptions of their child's food responsiveness.

Based on the Self-Determination Theory, this study examined: 1) how mothers' autonomous and controlled motivation to regulate their own eating behaviors relate to their food parenting practices, and 2) whether and how child food responsiveness (i.e., reactivity and attraction to food) interact with mothers' motivation to predict maternal food parenting practices. Participants were 296 French Canadian mothers of at least one child aged between 2 and 8 years old. Results of partial correlation analyses (controlling for demographics and controlled motivation) showed that maternal autonomous motivation to regulate their own eating behaviors was positively related to autonomy-promoting (i.e., child involvement) and structure-based (i.e., modeling, creating a healthy environment, monitoring) food parenting practices. In contrast, controlling for demographics and autonomous motivation, maternal controlled motivation was positively associated with food-related practices based on coercive control (i.e., the use of food to regulate the child's emotions, the use of food as a reward, pressure to eat, restriction for weight reasons, and restriction for health reasons). Furthermore, the child's food responsiveness was found to interact with mothers' motivation to regulate their own eating behaviors in the prediction of maternal food parenting practices such that mothers with high autonomous motivation or low controlled motivation were found to react with more structure-based (i.e., creating a healthy environment) and autonomy-based (i.e., child involvement) practices, as well as less controlling practices (i.e., the use of food to regulate the child's emotions), to a child who is highly responsive to food. In conclusion, findings suggest that guiding mothers toward developing a more autonomous and less controlled motivation to regulate their own eating behaviors might help them adopt more autonomy-promoting and structure-based and less controlling feeding practices, especially with children who are highly responsive to food.

Associations between mind-body practice engagement and diet quality: Exploring the mediating roles of eating behaviour traits and regulation styles for eating behaviours in the PREDISE study.

While engaging in Mind-Body Practices (MBPs) may be related to better diet quality, its association with eating behaviours is unclear. This cross-sectional study explores whether eating behaviour traits and regulation style of eating behaviours mediate the association between MBP engagement and diet quality. A total of 418 women and 482 men, aged between 18 and 65 years and recruited as part of the PREDISE study cohort, reported whether they currently practice one or more MBP (e.g., yoga or meditation). Canadian Healthy Eating Index (C-HEI) was calculated from three 24h dietary recalls. Intuitive Eating Scale (IES-2), and Regulation of Eating Behaviour Scale were completed online. Mann-Whitney tests were conducted to compare C-HEI scores of individuals who currently engage in MBPs (practitioners) to those who do not (non-practitioners). Multiple regression analyses and bootstrapping were performed to test whether eating behaviours and regulation style of eating behaviours mediate the association between MBPs and diet quality. Overall, 88 women and 43 men were practitioners. They had higher C-HEI scores than non-practitioners (62.9 ± 13.0 vs. 55.6 ± 14.3; p = 0.001). Parallel mediation model showed significant indirect effects of the IES-2 subscale relating to Body-Food Choice Congruence (ß = 1.57, SE = 0.41, 95% CI: 0.86, 2.43), self-determined motivation (ß = 1.51, SE = 0.39, 95% CI:0.81, 2.32) and non-self-determined motivation (ß = 0.39, SE = 0.21, 95% CI: 0.03, 0.85) on the association between practitioner status and C-HEI. These findings suggest that the current practice of MBPs is associated with better diet quality, mainly through practitioners' higher intuitive eating skills and more self-determined regulation of eating behaviours. Further studies should investigate the potential impacts of MBPs on the development and maintenance of positive eating habits.

Individuals with self-determined motivation for eating have better overall diet quality: Results from the PREDISE study.

The study aimed at documenting motivational orientations for the regulation of eating as defined by self-determination theory and their association with sociodemographic characteristics and overall diet quality. As part of the PREDISE study, French-speaking women (n = 550) and men (n = 547), aged 18-65 years, living in the Province of Québec, Canada, completed online validated questionnaires. The Regulation of Eating Behavior Scale, based on the self-determination theory, assessed self-determined and non-self-determined motivation to regulate one's eating behavior. Three web-based 24-h food recalls were completed and used to compute the Canadian Healthy Eating Index 2007 (C-HEI), an indicator of the overall adherence to Canadian guidelines for healthy eating. Multiple linear regressions were performed to assess how regulation styles are associated with the C-HEI. Model 1 included no covariate, model 2 included sociodemographic covariates, and fully adjusted model 3 included as covariates sociodemographic variables as well as variables that were previously associated with diet quality, namely nutrition knowledge and social support for healthy eating. Women (p < 0.0001), older individuals (p = 0.0002), those with a higher education level (p < 0.0001), and non-smokers (p < 0.0001) reported higher self-determined motivation score than their counterparts. Self-determined motivation was positively (model 1: B = 4.67, p < 0.0001; model 2: B = 3.82, p < 0.0001; model 3: B = 3.61, p < 0.0001) and non-self-determined motivation was negatively (model 1: B = -1.62, p = 0.0009; model 2: B = -1.63, p = 0.0006; model 2: B = -1.49, p = 0.0022) associated with C-HEI. The present study suggests that some subgroups of the general adult population show more self-determined motivation for eating, which is associated with a better diet quality independently of individual characteristics and other individual and social determinants of healthy eating. Strategies to help individuals internalize the regulation of eating should be further investigated.

Do pregnant women eat healthier than non-pregnant women of childbearing age?

We aimed to compare the dietary quality and intake of pregnant women, women planning to conceive and women of childbearing age. Fifty-five pregnant women were matched for age and pre-pregnancy body mass index with 55 women planning to conceive and 55 women of childbearing age. Three Web-based 24-h recalls were completed, from which the Canadian Healthy Eating Index was calculated. Pregnant women had greater overall diet quality scores (66.8 ± 10.7, 60.3 ± 14.1 and 61.4 ± 12.8, in pregnant vs. planning to conceive and childbearing age women, p = .009), explained by a higher intake in fruits, vegetables and grain products and lower intake of foods that are high in fat, sugar or salt. Energy intake was significantly higher in pregnant versus planning to conceive women only (2283 ± 518 vs. 2062 ± 430 kcal, p = .03). Diet quality was greater among pregnant women, but diet quality scores were low in all groups, indicating that healthier dietary behaviours should be encouraged for all childbearing age women.

Does HealthAtEvery Size® fit all? A group-based trajectory modeling of a non-diet intervention.

OBJECTIVE: Health At Every Size® (HAES®) interventions have been increasingly recognized as a sustainable strategy in obesity management. Nevertheless, heterogeneity among obese individuals leads to challenges as it translates in mixed responses to treatment. In this context, our objective was to identify trajectories of responses to a non-diet intervention for adult overweight/obese women to highlight profiles of responders. METHOD: Based on data from a multicentric quasi-experimental study, a latent class growth modeling (LCGM) was performed. Two hundred and ten women with high body mass index (BMI ≥ 25, MBMI = 36.53) who followed a non-diet intervention offered in Health and Social Services Centres completed questionnaires at T = 0, 4 and 16 months. Outcomes used in the LCGM were intuitive eating and body esteem, two central components in HAES® interventions. Types of responders were then profiled on sociodemographic, weight, lifestyle, psychological and eating variables. RESULTS: The LCGM revealed a 4-trajectory model (p < .001), comprising non-responders (14.67%), moderate improvement with low maintenance responders (49.89%), moderate improvement with high maintenance responders (29.28%) and high functioning partial responders (6.56%). Analysis of variances showed significant differences between all types of responders with medium to large effect sizes on depressive symptoms, self-esteem and disinhibited eating (p < .001; η2 = .23, 0.30 and 0.16 respectively). Fewer differences were found on sociodemographic, lifestyle, health and weight variables. Overall, non-responders (14.67%) had a distinctive profile compared to the other groups by consistently expressing poorer psychological functioning, less adapted eating behaviors and reaching more frequently the clinical cutoff for severe depression (p = .001). CONCLUSIONS: Findings strongly support the relevance of considering psychological characteristics to move towards personalized healthcare in obesity management.

Social support for healthy eating: development and validation of a questionnaire for the French-Canadian population.

OBJECTIVE: The present study aimed to develop and validate a questionnaire assessing social support for healthy eating in a French-Canadian population. DESIGN: A twenty-one-item questionnaire was developed. For each item, participants were asked to rate the frequency, in the past month, with which the actions described had been done by family and friends in two different environments: (i) at home and (ii) outside of home. The content was evaluated by an expert panel. A validation study sample was recruited and completed the questionnaire twice. Exploratory factor analysis was performed on items to assess the number of subscales. Internal consistency reliability was assessed using Cronbach's ɑ. Test-retest reliability was evaluated with intraclass correlations between scores of the two completions. SETTING: Online survey. SUBJECTS: Men and women from the Québec City area (n 150). RESULTS: The content validity assessment led to a few changes, resulting in a twenty-two-item questionnaire. Exploratory factor analysis revealed a two-factor structure for both environments, resulting in four subscales: supportive actions at home; non-supportive actions at home; supportive actions outside of home; and non-supportive actions outside of home. Two items were removed from the questionnaire due to low loadings. The four subscales were found to be reliable (Cronbach's ɑ=0·82-0·94; test-retest intraclass correlation=0·51-0·70). CONCLUSIONS: The Social Support for Healthy Eating Questionnaire was developed for a French-Canadian population and demonstrated good psychometric properties. This questionnaire will be useful to explore the role of social support and its interactions with other factors in predicting eating behaviours.

Development and validation of the Perceived Food Environment Questionnaire in a French-Canadian population.

OBJECTIVE: The present study aimed to develop and validate a questionnaire assessing perceived food environment in a French-Canadian population. DESIGN: A questionnaire, the Perceived Food Environment Questionnaire, was developed assessing perceived accessibility to healthy (nine items) and unhealthy foods (three items). A pre-test sample was recruited for a pilot testing of the questionnaire. For the validation study, another sample was recruited and completed the questionnaire twice. Exploratory factor analysis was performed on the items to assess the number of factors (subscales). Cronbach's α was used to measure internal consistency reliability. Test-retest reliability was assessed with Pearson correlations. SETTING: Online survey. SUBJECTS: Men and women from the Québec City area (n 31 in the pre-test sample; n 150 in the validation study sample). RESULTS: The pilot testing did not lead to any change in the questionnaire. The exploratory factor analysis revealed a two-subscale structure. The first subscale is composed of six items assessing accessibility to healthy foods and the second includes three items related to accessibility to unhealthy foods. Three items were removed from the questionnaire due to low loading on the two subscales. The subscales demonstrated adequate internal consistency (Cronbach's α=0·77 for healthy foods and 0·62 for unhealthy foods) and test-retest reliability (r=0·59 and 0·60, respectively; both P<0·0001). CONCLUSIONS: The Perceived Food Environment Questionnaire was developed for a French-Canadian population and demonstrated good psychometric properties. Further validation is recommended if the questionnaire is to be used in other populations.

Development and validation of a nutrition knowledge questionnaire for a Canadian population.

OBJECTIVE: The present study aimed to develop and validate a nutrition knowledge questionnaire in a sample of French Canadians from the province of Quebec, taking into account dietary guidelines. DESIGN: A thirty-eight-item questionnaire was developed by the research team and evaluated for content validity by an expert panel, and then administered to respondents. Face validity and construct validity were measured in a pre-test. Exploratory factor analysis and covariance structure analysis were performed to verify the structure of the questionnaire and identify problematic items. Internal consistency and test-retest reliability were evaluated through a validation study. SETTING: Online survey. SUBJECTS: Six nutrition and psychology experts, fifteen registered dietitians (RD) and 180 lay people participated. RESULTS: Content validity evaluation resulted in the removal of two items and reformulation of one item. Following face validity, one item was reformulated. Construct validity was found to be adequate, with higher scores for RD v. non-RD (21·5 (sd 2·1) v. 15·7 (sd 3·0) out of 24, P<0·001). Exploratory factor analysis revealed that the questionnaire contained only one factor. Covariance structure analysis led to removal of sixteen items. Internal consistency for the overall questionnaire was adequate (Cronbach's α=0·73). Assessment of test-retest reliability resulted in significant associations for the total knowledge score (r=0·59, P<0·001). CONCLUSIONS: This nutrition knowledge questionnaire was found to be a suitable instrument which can be used to measure levels of nutrition knowledge in a Canadian population. It could also serve as a model for the development of similar instruments in other populations.

Validation of a French-Canadian adaptation of the Intuitive Eating Scale-2 for the adult population.

Intuitive eating is an adaptive eating style based on the reliance on physiological cues to determine when, what, and how much to eat. The Intuitive Eating Scale-2 (IES-2) is a validated four-subscale tool measuring the degree of adherence to intuitive eating principles. The present series of studies aimed at evaluating the psychometric properties of a French-Canadian adaptation of the IES-2 for the adult population. The factor structure, the reliability (internal consistency and test-retest), the construct validity, and the discriminant validity were evaluated in 334 women and 75 men from the Province of Québec, Canada, across two studies. A confirmatory factor analysis upheld that the four-factor structure of the original IES-2 was adequate for the present sample of French-Canadians. The scale demonstrated adequate internal consistency and test-retest reliability. Construct validity evidence was obtained with the significant associations between intuitive eating and psychological and eating-related variables. Intuitive eating was negatively associated with eating disorder symptomatology and with food- and weight-preoccupation, and positively associated with body-esteem and well-being. The French-Canadian IES-2 was also able to discriminate between genders and body mass index categories. The properties of this new version of the IES-2 are demonstrative of a reliable and valid tool to assess intuitive eating in the French-Canadian adult population of the Province of Québec.

Impact of nutritional labelling on 10-d energy intake, appetite perceptions and attitudes towards food.

The purpose of this study was to investigate the impact of nutritional labelling on energy intake, appetite perceptions and attitudes towards food. During a 10-d period, seventy normal-weight (BMI<25 kg/m2) and seventy-one obese women (BMI≥30 kg/m2) were given three meals per d under ad libitum conditions. Participants were randomly assigned to one of three experimental labelling groups in which the only difference was the label posted on lunch meal entrée: (1) low-fat label, (2) energy label (energy content of the entrée and average daily needs) and (3) no label (control). Average energy intake was calculated by weighing all foods before v. after daily consumption. Hunger and fullness perceptions were rated on visual analogue scales immediately before and after each meal. Satiety efficiency was assessed through the calculation of the satiety quotient (SQ). The appreciation and perceived healthiness of the lunch entrées were rated on eight-point Likert scales. There was no difference in energy intake, SQ and attitudes towards food between the three labelling groups. Fasting hunger perception was higher in the low-fat label group compared with the two others groups (P=0·0037). No interactions between labelling groups and BMI categories were observed. In conclusion, although labelling does not seem to influence energy intake, a low-fat label may increase women's fasting hunger perceptions compared with an energy label or no label.

Examining women's perceptions of their mother's and romantic partner's interpersonal styles for a better understanding of their eating regulation and intuitive eating.

Intuitive eating is a positive approach to weight and eating management characterized by a strong reliance on internal physiological hunger and satiety cues rather than emotional and external cues (e.g., Tylka, 2006). Using a Self-Determination Theory framework (Deci & Ryan, 1985), the main purpose of this research was to examine the role played by both the mother and the romantic partner in predicting women's intuitive eating. Participants were 272 women (mean age: 29.9 years) currently involved in a heterosexual romantic relationship. Mothers and romantic partners were both found to have a role to play in predicting women's intuitive eating via their influence on women's motivation for regulating eating behaviors. Specifically, both the mother's and partner's controlling styles were found to predict women's controlled eating regulation, which was negatively related to their intuitive eating. In addition, autonomy support from the partner (but not from the mother) was found to positively predict intuitive eating, and this relationship was mediated by women's more autonomous regulation toward eating. These results were uncovered while controlling for women's body mass index, which is likely to affect women's eating attitudes and behaviors. Overall, these results attest to the importance of considering women's social environment (i.e., mother and romantic partner) for a better understanding of their eating regulation and ability to eat intuitively.

Validation of the French-Canadian Translation of the ecSatter Inventory 2.0 in an Adult Sample.

OBJECTIVE: Evaluate the psychometric proprieties of the French-Canadian translation of the Satter Eating Competence Inventory (FrCanada ecSI 2.0). DESIGN: Cross-sectional validation study. PARTICIPANTS AND SETTING: 424 French-Canadian adult Facebook users (61.8% women, 96.0% White). VARIABLES MEASURED: Eating competence and variables related to eating or body image. ANALYSIS: Factor analyses to assess the structural validity. Cronbach α and intraclass correlation coefficient to estimate reliability. Chi-square test of independence, Student t test, and Pearson's correlations to assess construct validity. RESULTS: The mean eating competence score was 33.0 ± 7.8; 62.0% of participants were considered competent eaters (total score ≥ 32/48). The original 4-factor structure was not reproduced (unsatisfactory fit indices and/or factor loadings). Therefore, it is recommended to use the global score-but not the subscale scores-of the FrCanada ecSI 2.0. The questionnaire showed good internal consistency (Cronbach α = 0.86) and test-retest reliability (intraclass correlation = 0.81). Competent and noncompetent eaters differed according to gender (39.5% vs 27.3% male; P = 0.03), age (49.3 ± 13.6 vs 42.7 ± 14.2 years; P < 0.01), education (62.3% vs 50.6% with a university degree; P = 0.03), intuitive eating (3.6 ± 0.5 vs 3.1 ± 0.6; P < 0.001), cognitive restraint (12.3 ± 3.3 vs 13.8 ± 3.7; P < 0.001), and body esteem (3.3 ± 0.8 vs 2.5 ± 0.8; P < 0.001). CONCLUSION AND IMPLICATIONS: Results suggest that the FrCanada ecSI 2.0 is a valid and reliable tool to measure eating competence in French-Canadian adults.

A perinatal social nutrition approach to improve breastfeeding in a culturally diverse group of low-income women.

Alima, Perinatal Social Nutrition Centre, is an established community organization that adopts a perinatal social nutrition approach to provide multidimensional support to women living in vulnerable conditions, particularly those with a precarious migratory status. This study aims to (i) determine which maternal characteristics, pregnancy-related variables, and structural features of the Alima intervention are associated with breastfeeding; and (ii) examine whether the association between attending breastfeeding workshops and breastfeeding characteristics differ according to maternal factors. The Alima digital database was used to analyze data from women who received the perinatal intervention between 2013 and 2020. Infant feeding data were retrieved at 2 weeks postpartum (T0, n = 2925), 2 months postpartum (T2, n = 1475), and 4 months postpartum (T4, n = 890). Logistic regressions were used to estimate the odds of overall and exclusive breastfeeding depending on sociodemographic characteristics, pregnancy-related variables, and features of the intervention. The prevalence of overall and exclusive breastfeeding was, respectively, 96.1% and 60.7% at T0; 93.0% and 58.5% at T2; 83.0% and 48.4% at T4. Higher education, previous breastfeeding experience, and recent immigration were associated with a higher likelihood of breastfeeding at each time point. Breastfeeding workshop attendance was associated with a greater likelihood of overall and exclusive breastfeeding at T2 and T4, with a stronger effect among women aged 35 or less, those with lower education, and those with excessive gestational weight gain. In conclusion, the Alima intervention is associated with positive breastfeeding outcomes, especially among vulnerable women living with precarious migratory status in Canada.

Social desirability, dietary intakes, and variables related to attitudes and behaviours towards eating among French-speaking adults from Quebec, Canada: The PREDISE study.

The primary objective of this study was to examine how social desirability is associated with self-reported measures of dietary intakes and variables related to attitudes and behaviours towards eating. This analysis was conducted in 1083 adults (50.0% women) from the PREDISE study. Social desirability was assessed using the Balanced Inventory of Desirable Responding (BIDR) questionnaire, which includes two subscales: (1) self-deceptive enhancement (SDE), i.e., having an overly positive self-image and (2) impression management (IM), i.e., intentional response distortion to please. BIDR total score and IM subscore were positively associated with the Canadian Healthy Eating Index (C-HEI) (ß = 0.24 and ß = 0.50; p ≤ 0.0003), calculated using data from three self-administered 24 h food recalls. All BIDR scores were positively associated with self-determined motivation for eating regulation (0.03 ≤ ß ≤ 0.06; p < 0.0001), measured by the Regulation of Eating Behavior Scale, and with the intuitive eating score (0.02 ≤ ß ≤ 0.05; p < 0.0001). Also, all BIDR scores were negatively associated with hunger and disinhibition scores measured by the Three-Factor Eating Questionnaire (-0.17 ≤ ß ≤ -0.09; p < 0.0001). All these associations were adjusted for age, sex, BMI, and the education level. Furthermore, controlling for both dimensions of social desirability did not impact the magnitude of the association between self-determined motivation (the strongest predictor of healthy eating in the PREDISE study) and C-HEI. According to our results, associations are observed with diet quality, as well as with attitudes and behaviours towards eating; therefore, a measurement of social desirability responding would be pertinent in studies using those or related variables.

A latent profile analysis based on diet quality and eating behaviours in participants of the PREDISE study characterized by a higher BMI.

The aim of this study was to identify eating-related latent profiles based on diet quality and eating behaviours within a population characterized by a body mass index (BMI) of at least 25 kg/m2, and to compare metabolic variables between profiles. This analysis was conducted in a sample of 614 adults (45.6% women; 44.8 ± 12.9 years) from the cross-sectional PREDISE study. Participants completed the Three-Factor Eating Questionnaire, the Intuitive Eating Scale-2, the Regulation of Eating Behavior Scale, and three self-administered 24 h food recalls. Waist circumference, blood lipids, blood pressure, and fasting glucose were measured to identify carriers of the metabolic syndrome. A latent profile analysis was performed, and cases of metabolic syndrome were compared between profiles. A three-profile solution was found. Profile 1 (22.8%) was characterized by lower diet quality, lower self-determined motivation for eating, lower restraint, and higher intuitive eating. Profile 2 (44.5%) was characterized by higher diet quality, higher self-determined motivation for eating, higher restraint, lower disinhibition, and higher intuitive eating. Profile 3 (32.7%) was characterized by intermediate diet quality, higher non-self-determined motivation for eating, higher restraint and disinhibition, and lower intuitive eating. We found fewer cases of metabolic syndrome among participants in profile 2 than in the other profiles (p = 0.0001). This study suggests that a profile characterized by a lower disinhibition and higher levels of restraint, intuitive eating, self-determined motivation, and diet quality is associated with a better metabolic health among individuals with a higher BMI.

A Community Prenatal Intervention in Social Nutrition: Evaluating the Impact on Pregnancy and Birthweight Outcomes.

This study aims to assess the associations between structural features of the Montreal Diet Dispensary's social nutrition intervention and pregnancy (i.e., anemia, gestational diabetes mellitus (GDM), gestational weight gain (GWG), hypertension) and birthweight outcomes (i.e., small- or large-for-gestational-age) among pregnant women, most of them recent immigrants. The study consists of a secondary analysis of the digital client database of the Montreal Diet Dispensary (n = 2925). Logistic regressions were used to estimate the odds of pregnancy and birthweight outcomes, depending on structural features of the intervention. Pregnant women who attended a welcoming group session presented lower odds of GDM and anemia compared to those who did not attend. A longer duration of intervention was also associated with lower odds of GDM and anemia. Each additional appointment with a dietitian was associated with higher odds of excessive GWG and lower odds of insufficient GWG only among women with a pre-pregnancy BMI lower than 25 kg/m2. This study emphasizes the importance of providing nutritional services early in pregnancy to reduce the risk of GDM and anemia. It also stresses the importance of using appropriate nutritional guidelines to avoid increasing the risk of excessive GWG.

Are Machine Learning Algorithms More Accurate in Predicting Vegetable and Fruit Consumption Than Traditional Statistical Models? An Exploratory Analysis.

Machine learning (ML) algorithms may help better understand the complex interactions among factors that influence dietary choices and behaviors. The aim of this study was to explore whether ML algorithms are more accurate than traditional statistical models in predicting vegetable and fruit (VF) consumption. A large array of features (2,452 features from 525 variables) encompassing individual and environmental information related to dietary habits and food choices in a sample of 1,147 French-speaking adult men and women was used for the purpose of this study. Adequate VF consumption, which was defined as 5 servings/d or more, was measured by averaging data from three web-based 24 h recalls and used as the outcome to predict. Nine classification ML algorithms were compared to two traditional statistical predictive models, logistic regression and penalized regression (Lasso). The performance of the predictive ML algorithms was tested after the implementation of adjustments, including normalizing the data, as well as in a series of sensitivity analyses such as using VF consumption obtained from a web-based food frequency questionnaire (wFFQ) and applying a feature selection algorithm in an attempt to reduce overfitting. Logistic regression and Lasso predicted adequate VF consumption with an accuracy of 0.64 (95% confidence interval [CI]: 0.58-0.70) and 0.64 (95%CI: 0.60-0.68) respectively. Among the ML algorithms tested, the most accurate algorithms to predict adequate VF consumption were the support vector machine (SVM) with either a radial basis kernel or a sigmoid kernel, both with an accuracy of 0.65 (95%CI: 0.59-0.71). The least accurate ML algorithm was the SVM with a linear kernel with an accuracy of 0.55 (95%CI: 0.49-0.61). Using dietary intake data from the wFFQ and applying a feature selection algorithm had little to no impact on the performance of the algorithms. In summary, ML algorithms and traditional statistical models predicted adequate VF consumption with similar accuracies among adults. These results suggest that additional research is needed to explore further the true potential of ML in predicting dietary behaviours that are determined by complex interactions among several individual, social and environmental factors.

Associations Between Nutrition Knowledge and Overall Diet Quality: The Moderating Role of Sociodemographic Characteristics-Results From the PREDISE Study.

PURPOSE: To assess how nutrition knowledge is associated with global diet quality and to investigate whether sociodemographic characteristics (ie, sex, age, education, income, marital status, and living with children or not) moderate this association. DESIGN: Cross-sectional web-based study. PARTICIPANTS: The PREDISE study aims at identifying correlates of adherence to healthy eating guidelines in French-speaking adults from the Province of Quebec, Canada. SUBJECTS: A probability sample of 1092 participants (50% female). MEASURES: The Nutrition Knowledge Questionnaire and 24-hour food recalls from which the Canadian Healthy Eating Index (C-HEI) was calculated. ANALYSIS: Multiple linear regressions performed to assess how nutrition knowledge is associated with the C-HEI. Interaction terms tested to evaluate whether sociodemographic characteristics moderate the association between nutrition knowledge and the C-HEI. RESULTS: Nutrition knowledge (B = 0.141 [95% CI: 0.075-0.208], P < .0001) was identified as a significant correlate of the C-HEI. Education significantly moderated the association between nutrition knowledge and the C-HEI (P interaction = .0038), with a significative association among participants with a lower education level (B = 0.295 [95% CI: 0.170-0.421], P < .0001) but not among participants with a higher education level (B = 0.077 [95% CI: -0.004 to 0.157], P = .06). Whether participants lived with or without children also significantly moderated the association (P interaction = 0.0043); nutrition knowledge was associated with the C-HEI only in participants who were not living with children (B = 0.261 [95% CI: 0.167 to 0.355], P < .0001). CONCLUSION: This study suggests that the association between nutrition knowledge and adherence to healthy eating guidelines is not the same in different subgroups of the population. Interventions aiming at increasing nutrition knowledge may be a promising approach to improve diet quality, especially among individuals with a lower education.

Are French Canadians able to accurately self-rate the quality of their diet? Insights from the PREDISE study.

The main objective of this study was to compare self-rated diet quality with a more comprehensive score of diet quality and to assess the ability of self-rated diet quality to predict adherence to healthy eating guidelines. This study also aimed to evaluate the influence of individual characteristics on the association between self-rated diet quality and the overall diet quality score. As part of the PRédicteurs Individuels, Sociaux et Environnementaux (PREDISE) study, 1045 participants (51% women) from the Province of Québec, Canada, self-rated their diet quality ("In general, would you say that your dietary habits are excellent, very good, good, fair, or poor?"). Three Web-based 24-h food recalls were completed, generating data for the calculation of the Canadian Healthy Eating Index (C-HEI) score, an overall diet quality indicator. Participants rated their diet quality as excellent (2.4%), very good (22.7%), good (49.5%), fair (20.3%), or poor (5.1%). C-HEI scores differed significantly between diet ratings, in the expected direction (p < 0.0001). Self-rated diet quality predicted adherence to healthy eating guidelines (i.e., C-HEI > 68) with a sensitivity of 44.5% and a specificity of 81.5% (C-statistic = 0.63). Sex significantly modified the association between self-rated diet quality and C-HEI score (p interaction = 0.0131); women had higher C-HEI scores than did men in the "good" and "fair" ratings. Self-rated diet quality can be useful in obtaining an overview of the diet quality of a population, but the results of this study suggest that such data should be used with caution given their poor ability to predict adherence to healthy eating guidelines. Individual characteristics may influence one's ability to appropriately self-evaluate diet quality.

Is the Canadian Healthy Eating Index 2007 an Appropriate Diet Indicator of Metabolic Health? Insights from Dietary Pattern Analysis in the PREDISE Study.

The objective of this study was to identify key elements from the 2007 Canada's Food Guide that should be included in a diet quality score aiming to reflect the risk of metabolic syndrome (MetS). Dietary intakes of 998 adults (mean age: 43.2 years, 50% women) were used to obtain the Canadian Healthy Eating Index 2007 (C-HEI 2007) and Alternative Healthy Eating Index 2010 (AHEI) scores, as well as a dietary pattern (DP) generated by the reduced rank regression (RRR) method. Based on these three scores, a modified version of the C-HEI 2007 (Modified C-HEI) was then proposed. The prevalence ratio (PR) of MetS was examined across diet quality scores using multivariate binomial regression analysis. A higher AHEI, Modified C-HEI, and a lower score for DP were all associated with a significantly lower prevalence of MetS (PR = 0.42; 95% confidence interval (CI) 0.28, 0.64; PR = 0.39; 95% CI 0.23, 0.63; and PR = 0.48; 95% CI 0.31, 0.74, respectively), whereas C-HEI 2007 was not (PR = 0.68; 95% CI 0.47, 1.00). Results suggest that a Modified C-HEI that considers key elements from the C-HEI 2007 and the AHEI, as well the DP, shows that participants with a higher score are less likely to have MetS.