The mediation effect of breastfeeding duration on the relationship between maternal preconception BMI and childhood nutritional risk.

BACKGROUND: Higher maternal preconception body mass index (BMI) is associated with lower breastfeeding duration, which may contribute to the development of poor child eating behaviours and dietary intake patterns (components of nutritional risk). A higher maternal preconception BMI has been found to be associated with higher child nutritional risk. This study aimed to determine whether breastfeeding duration mediated the association between maternal preconception BMI and child nutritional risk. METHODS: In this longitudinal cohort study, children ages 18 months to 5 years were recruited from The Applied Research Group for Kids (TARGet Kids!) in Canada. The primary outcome was child nutritional risk, using The NutriSTEP®, a validated, parent-reported questionnaire. Statistical mediation analysis was performed to assess whether total duration of any breastfeeding mediated the association between maternal preconception BMI and child nutritional risk. RESULTS: This study included 4733 children with 8611 NutriSTEP® observations. The mean (SD) maternal preconception BMI was 23.6 (4.4) and the mean (SD) breastfeeding duration was 12.4 (8.0) months. Each 1-unit higher maternal preconception BMI was associated with a 0.081 unit higher nutritional risk (95% CI (0.051, 0.112); p < 0.001) (total effect), where 0.011(95% CI (0.006, 0.016); p < 0.001) of that total effect or 13.18% (95% CI: 7.13, 21.25) was mediated through breastfeeding duration. CONCLUSION: Total breastfeeding duration showed to mediate part of the association between maternal preconception BMI and child nutritional risk. Interventions to support breastfeeding in those with higher maternal preconception BMI should be evaluated for their potential effect in reducing nutritional risk in young children.

Body Weight at Age Four Years and Readiness to Start School: A Prospective Cohort Study.

Background: Adolescents with obesity have lower academic performance, but little is known about the association between body weight in early childhood and school readiness. The objective was to examine the association between age- and sex-standardized body mass index (zBMI) and body weight status and school readiness in young children. Methods: A prospective cohort study in Toronto, Canada, was conducted in young children enrolled in TARGet Kids!. Children's weight and height were measured before the start of kindergarten. Children's school readiness was measured by the Early Development Instrument (EDI), a validated teacher-completed instrument that assesses children's skills and behaviors in five developmental domains in kindergarten. Generalized estimating equations, adjusted for relevant confounders, were used in the analysis. Results: The study included 1015 children (1217 observations): 52% were male and mean age at zBMI was 4.2 years [50 months (SD 12.1)] and school readiness was 5.2 years [62.7 months (SD 6.9)]. There was no evidence found that zBMI was associated with school readiness. However, in a post hoc analysis, being classified as overweight or with obesity in kindergarten was associated with twofold higher odds of vulnerability in school readiness and a lower social competence score compared with their normal weight peers. Conclusions: Being classified as overweight or with obesity was associated with poor school readiness in year 2 of kindergarten. Early interventions to promote healthy growth before school entry may help promote development and school readiness in young children. www.clinicaltrials.gov (NCT01869530).

Nutritional Risk in Early Childhood and School Readiness.

BACKGROUND: Nutrition in early childhood is important for healthy growth and development. Achieving school readiness is considered one of the most important developmental milestones for young children. OBJECTIVES: The purpose of this study is to determine if nutritional risk in early childhood is associated with school readiness in kindergarten. METHODS: A prospective cohort study was conducted through The Applied Research Group for Kids (TARGet Kids!) primary care research network in Toronto, Canada, 2015-2020. Nutritional risk was measured (18 mo to 5 y) using validated parent-completed questionnaires called Nutrition Screening for Toddlers and Preschoolers (NutriSTEP). High nutritional risk was categorized as scores ≥21. School readiness was measured using the validated teacher-completed Early Developmental Instrument (EDI), which measures 5 developmental domains in kindergarten (2 y of schooling, ages 4-6 y, before they enter grade 1). Vulnerability indicates scores lower than a population-based cutoff at the 10th percentile on at least 1 domain. Multiple logistic and linear regression models were conducted adjusting for relevant confounders. RESULTS: The study included 896 children: 53% were male, 9% had high nutritional risk, and 17% were vulnerable on the EDI. A 1-SD increase in NutriSTEP total score was associated with 1.54 times increased odds of being vulnerable on the EDI among children in year 2 of kindergarten (P = 0.001). High nutritional risk cutoff was associated with 4.28 times increased odds of being vulnerable on the EDI among children in year 2 of kindergarten (P < 0.001). NutriSTEP total score and high nutritional risk were associated with lower scores on all 5 EDI domains, with the strongest association observed for the domains of language and cognitive development and communication skills and general knowledge. CONCLUSIONS: Higher nutritional risk in early childhood is associated with lower school readiness in year 2 of kindergarten. Nutritional interventions early in life may offer opportunities to enhance school readiness. This trial was registered www.clinicaltrials.gov as NCT01869530.

Nutritional risk in early childhood and parent-reported school concerns.

OBJECTIVE: To determine if nutritional risk in early childhood is associated with parent-reported school concerns. DESIGN: A prospective cohort study conducted through the TARGet Kids! primary care research network (2011-2018). Nutritional risk was measured between 18 months and 5 years of age using validated parent-completed NutriSTEP® questionnaires with eating behaviour and dietary intake subscores (0 = lowest and 68 = highest total nutritional risk score). Parent-reported school concerns were measured at school age (4-10 years of age) and included: speech and language; learning; attention; behaviour; social relationships; physical coordination; fine motor coordination and self-help skills and independence. The primary outcome was any parent-reported school concerns, and individual school concerns were used as secondary outcomes. Multiple logistic regression models were conducted adjusting for clinically relevant confounders to assess the relationship between nutritional risk and school concerns. SETTING: Toronto, Canada. PARTICIPANTS: Children aged 18 months to 10 years. RESULTS: The study included 3655 children, 52 % were male, mean NutriSTEP® score was 14·4 (sd 6·4). Each 1 sd increase in NutriSTEP® total score was associated with a 1·18 times increased odds of school concerns (adj OR: 1·18, 95 % CI 1·07, 1·28, P = 0·0004), and high nutritional risk was associated with a 1·42 times increased odds of school concerns (adj OR: 1·42, 95 % CI 1·13, 1·78, P = 0·002). CONCLUSIONS: Nutritional risk in early childhood was associated with school concerns. Nutritional interventions in early childhood may reveal opportunities to enhance school outcomes.

Screening for marginal food security in young children in primary care.

BACKGROUND: Household food insecurity (FI), even at marginal levels, is associated with poor child health outcomes. The Nutrition Screening Tool for Every Preschooler (NutriSTEP®) is a valid and reliable 17-item parent-completed measure of nutrition risk and includes a single item addressing FI which may be a useful child-specific screening tool. We evaluated the diagnostic test properties of the single NutriSTEP® FI question using the 2-item Hunger Vital Sign™ as the criterion measure in a primary care population of healthy children ages 18 months to 5 years. RESULTS: The sample included 1174 families, 53 (4.5%) of which were marginally food secure. An affirmative response to the single NutriSTEP® question "I have difficulty buying food I want to feed my child because food is expensive" had a sensitivity of 85% and specificity of 91% and demonstrated good construct validity when compared with the Hunger Vital Sign™. CONCLUSION: The single NutriSTEP® question may be an effective screening tool in clinical practice to identify marginal food security in families with young children and to link families with community-based services or financial assistance programs including tax benefits. TRIAL REGISTRATION: TARGet Kids! practice-based research network (Registered June 5, 2013 at www.clinicaltrials.gov ; NCT01869530); www.targetkids.ca.

Beyond BMI: a feasibility study implementing NutriSTEP in primary care practices using electronic medical records (EMRs). / Au-delà de l'IMC : étude de faisabilité de la mise en oeuvre de NutriSTEP dans les établissements de soins primaires au moyen des dossiers médicaux électroniques (DME).

INTRODUCTION: Primary care providers have a role to play in supporting the development of healthy eating habits, particularly in a child's early years. This study examined the feasibility of implementing the NutriSTEP® screen-a 17-item nutrition risk screening tool validated for use with both toddler and preschooler populations-integrated with an electronic medical record (EMR) in primary care practices in Ontario, Canada, to inform primary care decision-making and public health surveillance. METHODS: Five primary care practices implemented the NutriSTEP screen as a standardized form into their EMRs. To understand practitioners' experiences with delivery and assess factors associated with successful implementation, we conducted semi-structured qualitative interviews with primary care providers who were most knowledgeable about NutriSTEP implementation at their site. We assessed the quality of the extracted patient EMR data by determining the number of fully completed NutriSTEP screens and documented growth measurements of children. RESULTS: Primary care practices implemented the NutriSTEP screen as part of a variety of routine clinical contacts; specific data collection processes varied by site. Valid NutriSTEP screen data were captured in the EMRs of 80% of primary care practices. Approximately 90% of records had valid NutriSTEP screen completions and 70% of records had both valid NutriSTEP screen completions and valid growth measurements. CONCLUSION: Integration of NutriSTEP as a standardized EMR form is feasible in primary care practices, although implementation varied in our study. The application of EMR-integrated NutriSTEP screening as part of a comprehensive childhood healthy weights surveillance system warrants further exploration.

Fit for School Study protocol: early child growth, health behaviours, nutrition, cardiometabolic risk and developmental determinants of a child's school readiness, a prospective cohort.

INTRODUCTION: School readiness is a multidimensional construct that includes cognitive, behavioural and emotional aspects of a child's development. School readiness is strongly associated with a child's future school success and well-being. The Early Development Instrument (EDI) is a reliable and valid teacher-completed tool for assessing school readiness in children at kindergarten age. A substantial knowledge gap exists in understanding how early child growth, health behaviours, nutrition, cardiometabolic risk and development impact school readiness. The primary objective was to determine if growth patterns, measured by body mass index trajectories in healthy children aged 0-5 years, are associated with school readiness at ages 4-6 years (kindergarten age). Secondary objectives were to determine if other health trajectories, including health behaviours, nutrition, cardiometabolic risk and development, are associated with school readiness at ages 4-6 years. This paper presents the Fit for School Study protocol. METHODS AND ANALYSIS: This is an ongoing prospective cohort study. Parents of children enrolled in the The Applied Health Research Group for Kids (TARGet Kids!) practice-based research network are invited to participate in the Fit for School Study. Child growth, health behaviours, nutrition, cardiometabolic risk and development data are collected annually at health supervision visits and linked to EDI data collected by schools. The primary and secondary analyses will use a two-stage process: (1) latent class growth models will be used to first determine trajectory groups, and (2) generalised linear mixed models will be used to examine the relationship between exposures and EDI results. ETHICS AND DISSEMINATION: The research ethics boards at The Hospital for Sick Children, Unity Health Toronto and McMaster University approved this study, and research ethics approval was obtained from each school board with a student participating in the study. The findings will be presented locally, nationally and internationally and will be published in peer-reviewed journals. TRIAL REGISTRATION NUMBER: NCT01869530.

The Family Mealtime Observation Study (FaMOS): Exploring the Role of Family Functioning in the Association between Mothers' and Fathers' Food Parenting Practices and Children's Nutrition Risk.

This cross-sectional study explores associations between mothers' and fathers' food parenting practices and children's nutrition risk, while examining whether family functioning modifies or confounds the association. Home observations assessed parents' food parenting practices during dinnertime (n = 73 families with preschoolers). Children's nutrition risk was calculated using NutriSTEP®. Linear regression models examined associations between food parenting practices and NutriSTEP® scores. An interaction term (family functioning × food parenting practice) explored effect modification; models were adjusted for family functioning to explore confounding. Among mothers, more frequent physical food restriction was associated with higher nutrition risk in their children (ß = 0.40 NutriSTEP® points, 95% Confidence Interval (CI) = 2.30, 7.58) and among both mothers and fathers, positive comments about the target child's food were associated with lower nutrition risk (mothers: ß = -0.31 NutriSTEP® points, 95% CI = -0.54, -0.08; fathers: ß = -0.27 NutriSTEP® points, 95% CI = -0.75, -0.01) in models adjusted for parent education and child Body Mass Index (BMI) z-score. Family functioning did not modify these associations and they remained significant after adjustment for family functioning. Helping parents to use positive encouragement rather than restriction may help to reduce their children's nutrition risk.

A Canadian University "Understanding Foods" Course Improves Confidence in Food Skills and Food Safety Knowledge.

The impact of a hands-on foods course on undergraduate students' food skills was examined at the University of Guelph. For a convenience sample, first- and second-year students (n = 47, 87% female) registered in the "Understanding Foods" course were recruited to participate in a survey administered on Qualtrics at the beginning of the semester and again at the end of the semester. Participants were asked questions related to demographics and food habits; additional questions on food skills, in Likert-scale format, included confidence in food preparation, food safety knowledge, and grocery shopping habits. Subscales were combined for an overall Food Skills Questions (FSQ) score and differences were determined by paired t tests. Overall, significant (P < 0.05) improvements were observed related to students' confidence and food safety knowledge scores as well as the overall FSQ score. Students, however, rated their personal eating habits more poorly (P < 0.05) at the end of the semester. As a lack of food skills is often considered a barrier for healthy eating among students, these results signify the importance of a hands-on introductory cooking course at the undergraduate level.

Food parenting practices and their association with child nutrition risk status: comparing mothers and fathers.

In Canada, little is known about how food parenting practices are associated with young children's dietary intakes and no studies have examined food parenting practices of Canadian fathers. This study aimed to examine associations between food parenting practices and preschool-age children's nutrition risk. We conducted a cross-sectional analysis of thirty-one 2-parent families; 31 mothers, 31 fathers, and 40 preschool-age children. Parents completed an adapted version of the Comprehensive Feeding Practices Questionnaire. We calculated children's nutrition risk using their NutriSTEP score. To account for sibling association, we used generalized estimating equations, adjusting for child age, sex, household income, and parental body mass index. Both mothers' and fathers' involvement of children in meal preparation were associated with lower child nutrition risk (mother [Formula: see text] = -3.45, p = 0.02; father [Formula: see text] = -1.74, p = 0.01), as were their healthy home environment scores (mother [Formula: see text] = -8.36, p < 0.001; father [Formula: see text] = -2.69, p = 0.04). Mothers' encouragement of balance and variety was associated with lower nutrition risk ([Formula: see text] = -8.88, p = 0.01), whereas mothers' use of food as a reward was associated with higher nutrition risk ([Formula: see text] = 4.67, p < 0.001). Fathers' modelling of healthy behaviours was associated with lower nutrition risk ([Formula: see text] = -2.21, p = 0.01), whereas fathers' restriction for health ([Formula: see text] = 2.21, p = 0.03) and pressure-to-eat scores ([Formula: see text] = 3.26, p = <0.001) were associated with higher nutrition risk. No associations were found between child nutrition status and parental emotion regulation, control, monitoring, or restriction for weight. In conclusion, both mothers' and fathers' food parenting practices are associated with their children's nutrition status. Fathers should be included in food parenting practices interventions.

Young Adults' Perceptions of Calcium Intake and Health: A Qualitative Study.

Many young Canadian adults are not meeting dietary calcium recommendations. This is concerning as adequate calcium is important throughout young adulthood to maximize peak bone mass for osteoporosis prevention. There are limited studies that have explored young adults' perceptions toward calcium and health. Our objectives were to determine young adults' (18-34 years) knowledge of calcium in relation to health, facilitators and barriers to adequate calcium intake, and to explore both their suggestions for individual strategies to increase calcium intake and ways to communicate calcium-related messaging to this population. Eight gender-specific focus groups (18 men; 35 women) were conducted using a semistructured interview guide, guided by social cognitive theory. Deductive thematic analysis was used to generate themes. Participants perceived adequate calcium intake to be important for children and older adults but were uncertain of the benefits for their own age group. Perceived positive outcomes (e.g., aesthetics such as strong nails) associated with adequate calcium intake were cited as a motivator to increase intake. Perceived barriers to achieving increased calcium intake included the high cost and inconvenience of milk products and negative practices of dairy farmers. Participants suggested planning healthy well-balanced meals and forming a habit of consuming calcium-rich foods as individual strategies to increase calcium intake. Strategies to convey calcium-related information to young adults included increasing awareness of the importance of calcium via credible sources of information and developing nutrition education curricula. Social media and advertising were perceived as ineffective. Our findings provide key information for nutrition education initiatives.

Parents and Tots Together: Pilot randomized controlled trial of a family-based obesity prevention intervention in Canada.

OBJECTIVE: To test the feasibility, acceptability and preliminary impact of Parents and Tots Together (PTT), a family-based obesity prevention intervention, in Canada. PARTICIPANTS: Canadian parents of preschoolers (aged 2-5 years). SETTING: Ontario Early Years centres in southwestern Ontario. INTERVENTION: A pilot randomized controlled trial involving 48 parents who received either the PTT intervention (n = 27) or an attention-matched control home safety intervention (n = 21). To evaluate the feasibility of PTT, we assessed participant retention and outcome evaluation completion rates. To evaluate acceptability, we assessed program attendance and parents' responses to program satisfaction surveys. To evaluate preliminary impact, we assessed children's body mass index (BMI) at baseline, after intervention (end of 9-week intervention) and at 9-month follow-up. As well, at each time point, parents completed surveys assessing stress and self-efficacy related to parenting, children's sleep, activity, TV viewing and diet. OUTCOMES: Retention rates were high in the intervention (93%) and control (84%) study arms, and 87% of parents reported that they would highly recommend PTT to a friend. At 9-month follow-up, intervention parents reported lower parenting stress (ßï¼¾ = 15.83, 95% confidence interval [CI] -29.57, -2.07, p = 0.02) and greater self-efficacy in managing their child's behaviour (ßï¼¾ = 0.16, 95% CI 0.002, 0.33, p = 0.05) than control parents. PTT had minimal influence on children's weight-related behaviours and BMI. CONCLUSIONS: The results suggest that PTT can feasibly be implemented and tested in the Canadian context. Preliminary impact results suggest that the program may be effective in changing general parenting; however, program content should be modified to adequately address children's weight-related behaviours.

Development, reliability, and validity testing of Toddler NutriSTEP: a nutrition risk screening questionnaire for children 18-35 months of age.

Nutrition is vital for optimal growth and development of young children. Nutrition risk screening can facilitate early intervention when followed by nutritional assessment and treatment. NutriSTEP (Nutrition Screening Tool for Every Preschooler) is a valid and reliable nutrition risk screening questionnaire for preschoolers (aged 3-5 years). A need was identified for a similar questionnaire for toddlers (aged 18-35 months). The purpose was to develop a reliable and valid Toddler NutriSTEP. Toddler NutriSTEP was developed in 4 phases. Content and face validity were determined with a literature review, parent focus groups (n = 6; 48 participants), and experts (n = 13) (phase A). A draft questionnaire was refined with key intercept interviews of 107 parents/caregivers (phase B). Test-retest reliability (phase C), based on intra-class correlations (ICC), Kappa (κ) statistics, and Wilcoxon tests was assessed with 133 parents/caregivers. Criterion validity (phase D) was assessed using Receiver Operating Characteristic (ROC) curves by comparing scores on the Toddler NutriSTEP to a comprehensive nutritional assessment of 200 toddlers with a registered dietitian (RD). The Toddler NutriSTEP was reliable between 2 administrations (ICC = 0.951, F = 20.53, p < 0.001); most questions had moderate (κ ≥ 0.6) or excellent (κ ≥ 0.8) agreement. Scores on the RD nutrition risk rating and the Toddler NutriSTEP were correlated (r = 0.67, p < 0.000). The area under the ROC curve for moderate and high RD risk ratings were 84.6% and 82.7%, respectively. Cut-points of ≥21 (sensitivity 86%; specificity 61%) (moderate risk) and ≥26 (sensitivity 95%; specificity 63%) (high risk) were determined. The Toddler NutriSTEP questionnaire is both reliable and valid for screening for nutritional risk in toddlers.

Vitamin D intake among young Canadian adults: validation of a mobile vitamin D calculator app.

OBJECTIVE: To establish the validity and reproducibility of the dietary component of a mobile vitamin D calculator app. METHODS: Participants entered their dietary intake into the Vitamin D Calculator app on 3 recording days over 1 month and underwent subsequent 24-hour dietary recalls. RESULTS: There were 50 adults (25 female), aged 18-25 years (mean, 22 ± 2 years). Paired-samples t tests tested for significant differences (P < .05) in mean vitamin D and calcium intake between the app and dietary recalls; Bland-Altman plots assessed agreement between the 2 measures. Intra-class correlations and Wilcoxon signed-rank tests assessed reproducibility of intakes estimated by the app. Mean vitamin D (n = 50) and calcium (n = 48) intakes and risk classifications did not differ significantly between the 2 measures (P > .05). CONCLUSIONS AND IMPLICATIONS: The Vitamin D Calculator app is a valid classification measure for dietary vitamin D and calcium intake. This tool could be used by the general public to increase awareness and intake of these nutrients.

Association between serum cholesterol and eating behaviours during early childhood: a cross-sectional study.

BACKGROUND: Modifiable behaviours during early childhood may provide opportunities to prevent disease processes before adverse outcomes occur. Our objective was to determine whether young children's eating behaviours were associated with increased risk of cardiovascular disease in later life. METHODS: In this cross-sectional study involving children aged 3-5 years recruited from 7 primary care practices in Toronto, Ontario, we assessed the relation between eating behaviours as assessed by the NutriSTEP (Nutritional Screening Tool for Every Preschooler) questionnaire (completed by parents) and serum levels of non-high-density lipoprotein (HDL) cholesterol, a surrogate marker of cardiovascular risk. We also assessed the relation between dietary intake and serum non-HDL cholesterol, and between eating behaviours and other laboratory indices of cardiovascular risk (low-density lipoprotein [LDL] cholesterol, apolipoprotein B, HDL cholesterol and apoliprotein A1). RESULTS: A total of 1856 children were recruited from primary care practices in Toronto. Of these children, we included 1076 in our study for whom complete data and blood samples were available for analysis. The eating behaviours subscore of the NutriSTEP tool was significantly associated with serum non-HDL cholesterol (p = 0.03); for each unit increase in the eating behaviours subscore suggesting greater nutritional risk, we saw an increase of 0.02 mmol/L (95% confidence interval [CI] 0.002 to 0.05) in serum non-HDL cholesterol. The eating behaviours subscore was also associated with LDL cholesterol and apolipoprotein B, but not with HDL cholesterol or apolipoprotein A1. The dietary intake subscore was not associated with non-HDL cholesterol. INTERPRETATION: Eating behaviours in preschool-aged children are important potentially modifiable determinants of cardiovascular risk and should be a focus for future studies of screening and behavioural interventions.

Predictors of bone mineral density in a convenience sample of young Caucasian adults living in southern Ontario.

Osteoporosis is a major public health concern in Canada and worldwide. Although much is known about bone health in older adults, little is known about bone health in young, healthy Canadian men and women. The objectives of this research were to describe bone mineral density (BMD) of young, healthy adults living in southern Ontario, Canada, and to identify predictors of BMD in this population. Two-hundred and fifty-eight Caucasian men and women aged 18-33 years completed health and physical activity questionnaires along with a calcium and vitamin D specific food frequency questionnaire. Height and mass were measured. BMD of the total hip, femoral neck, spine, and total body was measured using dual energy X-ray absorptiometry. Among men, body mass, weight-bearing physical activity, and calcium intake were significant predictors of BMD. Among women, body mass, calcium intake, and family history of osteoporosis significantly predicted log BMD. The predictors of BMD in young Canadian men and women identified in this study may inform the development of longitudinal studies designed to examine the influence of lifestyle factors on BMD in young adults.

Air displacement plethysmography for fat-mass measurement in healthy young women.

PURPOSE: Dual energy X-ray absorptiometry (DXA) and air displacement plethysmography (ADP) are commonly used to assess body composition. Accurate body fat measures are valuable in a variety of populations. Because DXA, the reference standard, is expensive and labour-intensive, determining whether these two methods are interchangeable is important. METHODS: Forty-five female undergraduate students aged 21 to 33 with body mass indexes of 18.3 to 28.6 kg/m² were recruited from the University of Guelph. Each participant underwent one full-body DXA scan and one ADP assessment, to determine total percent fat mass (%FM). RESULTS: The Pearson's correlation between %FM(DXA) (27.1 ± 4.8) and %FM(ADP) (26.1 ± 5.5) indicated good association (r=0.88, p<0.01). While Bland-Altman analysis revealed no systematic bias between the two methods (R2=0.07, p=0.08), large intraindividual variation occurred (95% confidence interval: -5.86% to 4.11%); this was related to height, weight, body-surface area, and lung volume. CONCLUSIONS: The two methods were significantly correlated. Mean %FM was not significantly different and no systematic bias between methods was observed. These findings indicate that ADP and DXA may be used interchangeably for determining %FM at the group level in healthy young women; a large intraindividual variation between the methods precludes interchangeability at the individual level.

Effect of the transition from high school to university on anthropometric and lifestyle variables in males.

The obesity epidemic in North America has focused attention on the health risks of excess weight gain. The transition from high school to university is a critical period for weight gain, commonly referred to as the Freshman 15. The purpose of this study was to investigate the effect of the transition from high school to university on anthropometrics and physical and sedentary activities in males. A total of 108 males completed 3 study visits: the summer prior to first year university, and the ends of the first and second semesters. Outcome measures were body mass, height, body mass index (BMI), body fat, waist circumference, hip circumference, waist:hip ratio, dietary intake, and participation in physical and sedentary activities. Between the summer prior to and the end of first year university, male students experienced a significant weight gain, of 3.0 kg, with significant increases in BMI, body fat, waist circumference, hip circumference, and waist:hip ratio. Energy and nutrient intake did not change. Final body mass was significantly predicted by intention for body mass to stay the same, relative to weight loss intention. Fast aerobic physical activity significantly decreased between the summer prior to and the end of first year university, while slow aerobic physical activity, strength training, and flexibility training did not change. Computer and studying time significantly increased, while television time and hours of nightly sleep significantly decreased between the summer prior to and the end of first year university. Weekly alcoholic drinks and binge drinking frequency significantly increased over this time period. In conclusion, between the summer prior to and the end of first year university, male students gained an average of 3.0 kg, with increases in related anthropometrics. These changes may be due to body mass change intention and (or) the observed decreased physical and increased sedentary activities, but appear to be unrelated to dietary intake.

Folic acid food fortification prevents inadequate folate intake among preschoolers from Ontario.

OBJECTIVE: Folic acid food fortification has successfully reduced neural tube defect-affected pregnancies across Canada. The effect of this uncontrolled public health intervention on folate intake among Canadian children is, however, unknown. Our objectives were to determine folic acid intake from food fortification and whether fortification promoted adequate folate intakes, and to describe folic acid-fortified food usage among Ontario preschoolers. DESIGN: Cross-sectional data were used from the NutriSTEP validation project with preschoolers recruited using convenience sampling. Mean daily total folate and folic acid intakes were estimated from 3 d food records, which included multivitamin supplement use. Comparisons were made to Dietary Reference Intakes, accounting for and excluding fortificant folic acid, to determine the prevalence of inadequate and excessive intakes. SETTING: Canada. SUBJECTS: Two hundred and fifty-four preschoolers (aged 3-5 years). RESULTS: All participants (130 girls, 124 boys) ate folic acid-fortified foods and 30% (n 76) used folic acid-containing supplements. Mean (SE) fortificant folic acid intake was 83 (2) microg/d, which contributed 30% and 50% to total folate intake for supplement users and non-users, respectively. The prevalence of total folate intakes below the Estimated Average Requirement was <1%; however, excluding fortificant folic acid, the prevalence was 32%, 54% and 47% for 3-, 4- and 5-year-olds, respectively. The overall prevalence of folic acid (fortificant and supplemental) intakes above the Tolerable Upper Intake Level was 2% (7% among supplement users). CONCLUSIONS: Folic acid food fortification promotes dietary folate adequacy and did not appear to result in excessive folic acid intake unless folic acid-containing supplements were consumed.

Body weight and percent body fat increase during the transition from high school to university in females.

A critical period for weight gain may occur during the transition from high school to university. This descriptive, noncontrolled cohort study of 116 healthy females examined the effect of this transition over three study visits in first year university. The main outcome measure was body weight; others were height, body composition, waist circumference, dietary intake, and participation in physical and sedentary activities. Difference among study visits was determined by repeated measures analysis of variance; multiple regression examined changes in energy intake and physical and sedentary activities as predictors of final weight. Weight increased (P<0.001) by 2.4 kg (61.4 to 63.8 kg) during the entire course of the study. Other increases (P<0.001) included: body mass index (calculated as kg/m(2)), 22.3 to 23.1; percent body fat, 23.8% to 25.6%; and waist circumference, 76.9 to 79.4 cm. Dietary energy intake did not increase; vigorous physical, but not strength building, activities increased; television use decreased; and computer use increased (P<0.03 for all): however, these changes were not predictive of final weight. A change (decrease) in moderate physical activity was, however, an important predictor of final weight. Females making the transition to university gained 2.4 kg; weight gain during this formative period may be modified by lifestyle activities.