Knowledge and Perceptions of Carbohydrates among Nutrition-Major and Nutrition-Elective Undergraduate Students in Canada.

Objective: The purpose of the study was to assess knowledge and perceptions related to carbohydrates, including sugars, among Canadian nutrition-major undergraduates compared to those enrolled in elective nutrition courses (i.e., "nutrition-elective students").Methods: Cross-sectional surveys were distributed during class time at eight Canadian universities, which included 32 questions on demographics, knowledge and perceptions of carbohydrates and sugars. Descriptive analyses were performed. Differences between groups were tested by Chi-squared statistics.Results: A total of 1207 students (60% nutrition-majors) participated in the survey (January 2016-February 2017). Internet-based sources accounted for one-third of the sources where students obtained nutrition information. About 61% of internet-bases sources were "online" or "website" with no qualifiers, and about a quarter was from social media. A higher percentage of nutrition-majors correctly answered knowledge questions of carbohydrates compared with nutrition-elective students (p < 0.01); no difference was observed for sugars-related knowledge questions. The perceptions of sugars were generally negative and did not differ between groups.Conclusions: Several knowledge gaps and common perceptions on topics related to carbohydrates and sugars were identified; nutrition-major students performed better than nutrition-elective students on carbohydrate knowledge questions, but not sugars. These results highlight the importance of identifying methods to help students bridge knowledge gaps and develop skills to critically evaluate nutrition information from various resources and challenge personal biases.

Usual dietary fatty acid intakes and red-blood-cell membrane fatty acid composition in Inuit children attending child-care centres in Nunavik, northern Québec, Canada.

OBJECTIVES: To assess dietary fatty acid intakes and to examine the relationship between dietary sources of n-3 and n-6 PUFA and red-blood-cell (RBC) n-3 and n-6 PUFA composition. DESIGN: A cross-sectional study. Dietary intakes were assessed with a 24 h dietary recall. A second recall was performed for 44 % of the children. Usual dietary intakes were estimated with the Software for Intake Distribution Estimation (SIDE). The fatty acid composition was measured in RBC membranes. Multivariate linear regression analyses were performed to explain RBC n-3 and n-6 PUFA concentrations. SETTING: Child-care centres in Nunavik, northern Québec, Canada. SUBJECTS: One hundred and sixty-seven Inuit children aged 11-53 months. RESULTS: A high proportion of the participants had inadequate n-3 and n-6 PUFA intakes (47·9 % and 93·5 %, respectively). Breast-feeding status and consumption of traditional food during the first 24 h dietary recall were significantly associated with RBC n-3 PUFA levels. Older children also tended to have higher RBC n-3 PUFA levels (P = 0·0528), whereas sex, infant formula status and n-3 PUFA dietary intakes were not associated with RBC n-3 PUFA concentrations. RBC n-6 PUFA concentrations were positively associated with breast-feeding status and n-6 PUFA dietary intakes, whereas age, sex and infant formula status were not. CONCLUSIONS: The present findings highlight the fact that Inuit pre-school children are not consuming enough n-3 and n-6 PUFA for optimum health. These observations call for actions to increase traditional food intake among Inuit children and to help them and their parents make healthier store-bought food choices.

Impact of a childcare centre nutrition program on nutrient intakes in Nunavik Inuit children.

PURPOSE: We assessed the impact of a nutrition program implemented in Nunavik childcare centres on Inuit children's food and dietary intakes. METHODS: Two hundred and forty-five Inuit children (aged 25.0 ± 9.6 months) were recruited between 2006 and 2010 in Nunavik childcare centres. Dietary intakes were assessed using a single 24-hour dietary recall (n=217). We compared participants' energy and nutrient intakes, and the proportions who met iron requirements and Canada's Food Guide - First Nations, Inuit and Métis recommendations, depending on whether or not they attended a childcare centre during the 24-hour dietary reference period. RESULTS: Children who attended a childcare centre on the day of the recall had significantly higher intakes of omega-3 fatty acids, calcium, total iron, bioavailable iron, phosphorus, beta-carotene, folate, pantothenic acid, riboflavin, and vitamin K, while a higher proportion of them met the recommended intake for total and bioavailable iron. The proportion of children who met the recommended servings for vegetables and fruit, grain products, and milk and alternatives was also significantly higher among participants who attended a childcare centre. CONCLUSIONS: The nutrition program was effective at improving these Inuit preschoolers' diet.

Prevalence of anemia among Inuit women in Nunavik, Canada.

OBJECTIVES: To assess the prevalence and main types of anemia present among non-pregnant Inuit women of Nunavik using a representative sample. STUDY DESIGN: A cross-sectional population-based study. Methods. Iron status was assessed in 466 women aged 18-74 who participated in the 2004 Nunavik Inuit Health Survey. The presence of different types of anemia has been evaluated based on available biochemical indicators of vitamins and of iron status. The correlation between iron status indicators, vitamin status parameters, inflammation markers and heavy metal concentrations was also assessed. RESULTS: Anemia was present in 43% of the Inuit women in Nunavik and 21% suffered from iron deficiency anemia (IDA). The main type of anemia present among women 18-49 years old was IDA (61% of anemia cases) while anemic women 50 years and over suffered mainly from anemia related to chronic inflammation (ACI) (42%). Over 99% of women had normal values for vitamin A, vitamin B12 and folate. Of interest is that ferritin was positively correlated with blood mercury and lead levels. CONCLUSION: The prevalence of anemia in Nunavik women is similar to levels observed in non-industrialized countries and represents a severe public health problem that should be further investigated. The most prevalent type of anemia in these women shifted from IDA to ACI with age. Vitamin A, vitamin B12 and folate deficiencies do not constitute a widespread problem and their contribution to anemia is probably minimal. Sources of heavy metals are also major sources of iron in the diet of Nunavik women which could explain the positive association found between heavy metals and iron status.

Healthful eating: beyond food, a global concept.

Producing a definition of healthful eating that expresses adequately the richness and the complexity of the eating experience is challenging. Still, the effort is crucial if one wants to promote behavioural change in the population, as well as a transformation of interventional practices, programs, and policies, and even the agri-food system. We explain that the biological, social, and environmental dimensions of healthful eating, along with the interactions among them, must be addressed. Once these dimensions are considered as a whole, the definition of healthful eating allows the identification of a wide range of strategic interventions to implement such eating. We suggest a continuum of eating quality that could be used to identify, in general, the food habits of persons or groups.

Education and improved iron intakes for treatment of mild iron-deficiency anemia in adolescent girls in southern Benin.

BACKGROUND: To our knowledge, the impact of a nutrition education program combined with an increase in bioavailable dietary iron to treat iron-deficiency anemia has never been studied in adolescent girls. OBJECTIVE: To evaluate the impact of an intensive dietary program for the treatment of iron-deficiency anemia in 34 intervention and 34 control boarding-school girls aged 12 to 17 years from Benin. METHODS: A quasi-experimental design consisting of 4 weeks of nutrition education combined with an increase in the content and bioavailability of dietary iron for 22 weeks was implemented in the intervention school, but not in the control school. Data were obtained from both groups from a nutrition knowledge questionnaire, 24-hour dietary recalls, anthropometric measurements, measurement of iron status indices, and screening for malarial and intestinal parasitic infections. RESULTS: Nutrition knowledge scores and mean intakes of nutrients, including dietary iron, absorbable iron, and vitamin C, were significantly higher in the intervention group (p < .05) than in the control group after 26 weeks. Mean hemoglobin and serum ferritin values were also significantly higher in the intervention group than in the control group (122 vs. 112 g/L [p = .0002] and 32 vs. 19 microg/L [p = .04], respectively), whereas the prevalence of anemia (32% vs. 85% [p = .005] and iron-deficiency anemia (26% vs. 56% [p = .04]) was significantly lower in the intervention group than in the control group. No significant differences between the groups were observed in intestinal parasitic infections or malaria status postintervention. CONCLUSIONS: A multidietary strategy aiming to improve available dietary iron can reduce iron-deficiency anemia in adolescent girls.

Effect of a nutrition education program and diet modification in Beninese adolescent girls suffering from mild iron deficiency anemia.

A 26-week nutrition intervention, including 4 weeks of nutrition education, combined with an increase in the content and bioavailability of dietary iron for 22 weeks was carried out in 34 intervention and 34 control adolescent girls suffering from mild iron deficiency anemia (IDA). In post-intervention, hemoglobin and serum ferritin were significantly higher in the intervention group, whereas the incidence of IDA was significantly lower in the intervention group compared to the control group. Nutrition knowledge scores were significantly higher in intervention girls compared to control girls. Dietary changes to improve available dietary iron can reduce iron deficiency anemia.

Impact of socioeconomic and health related factors on the iron status of adolescent girls from two boarding schools in Southern Benin.

UNLABELLED: To our knowledge, the impact of socioeconomic and health related factors on the iron status of adolescent girls has never been studied in Benin. OBJECTIVE: These factors were studied in 180 girls aged 12 to 17 years living in two boarding schools from South Benin. METHODS: Iron deficiency (ID) was defined as either serum ferritin (SF) < 20 microg/L or SF between 20-50 microg/L plus two abnormal values in the three following parameters: serum iron < 11 micromol/L, total iron binding capacity > 73 micromol/L or transferrin saturation < 20%. Socioeconomic and health related factors were obtained from each participant by mean of an interview using a standardized and pre-tested questionnaire. RESULTS: Almost half the participants reported some health problems in the last four months before the study, whereas more than 75% auto-medicated before going to the hospital. The majority of the girls believed themselves to be in good health, although only 16% could define the term 'anemia'. Multivariate regression analysis indicated that girls whose mother was a manual worker (P = .002), who came from a larger family (P = .0001), and who auto-medicated (P = .014), had a lower hemoglobin level, whereas girls who had started their menstruation (P = .008) had a lower SF level. In a logistic regression analysis, girls from a large family size and whose mother was a manual worker showed a higher risk of IDA (OR = 3.5; 95% CI = 1.1-2.5; P = .04; OR = 3.0; 95% CI = 1.2-2.2; P = .04 respectively). CONCLUSION: The findings indicate that iron deficiency is related to the occupation of the mother, family size, auto-medication, and menstruation.

Intestinal parasitic infections in adolescent girls from two boarding schools in southern Benin.

Intestinal parasitic infections (IPI), especially helminths, represent a major public health problem that increase iron deficiency anaemia in developing countries. This study investigated the prevalence, risk factors and nutritional consequences of IPIs in 180 adolescent girls aged 12-17 years living in two boarding schools in southern Benin. Data were collected using a structured questionnaire and laboratory analysis of blood and faecal samples. The relationships between socioeconomic indicators, IPIs and iron status were analysed using logistic regression analysis. Fifty percent of the subjects were infected with at least one IPI: 2% with helminths, 41% with protozoa and 7% with two or more intestinal parasites. Adolescent girls from a large family and those whose mothers were manual workers showed a higher risk of intestinal parasitism (odds ratio (OR)=3.5, 95% CI 2.5-5.2 (P=0.02) and OR=2.4, 95% CI 2.0-3.0 (P=0.03), respectively). Likewise, drinking untreated water was also a high risk factor for infection (OR=2.3, 95% CI 1.5-2.4; P=0.03). No significant association was observed between IPIs and iron deficiency or iron deficiency anaemia, which can be explained by the low wormload observed. These findings reinforce the need to involve mothers in health initiatives to control intestinal parasitism in Benin.

Factors influencing the initiation and duration of breastfeeding among low-income women followed by the Canada prenatal nutrition program in 4 regions of quebec.

The factors that influence the actual initiation and duration of breastfeeding were studied among low-income women followed by the Canada Prenatal Nutrition Program (CPNP). A group of 196 pregnant women were selected at random from a sample of 6223 pregnant women who registered with the CPNP. Two 24-hour recalls and information regarding lifestyle habits, peer support, and infant-feeding practices were obtained between 26 and 34 weeks of gestation and 21 days and 6 months after birth. Women who received a university education (completed or not completed) versus women with < or = high school education (odds ratio [OR], 8.40; 95% confidence interval [CI], 1.02-69.50), women born outside Canada (OR,8.81; 95% CI, 3.34-23.19), and women of low birth weight infants (OR, 0.39; 95% CI, 0.16-0.96) were more likely to initiate breastfeeding. Late introduction of solid foods (P = .004), nonsmoking (P = .005), multiparity (P = .012), and a higher level of education (P = .049) were positively associated with the duration of breastfeeding among initiators. Understanding factors associated with initiation and duration of breastfeeding among low-income women is critical to better target breastfeeding promotion.

Maternal dietary intake and pregnancy outcome.

OBJECTIVE: To study the relationship between maternal diet and infant anthropometric measurements in 56 women, aged 28 +/- 5.1 years, with singleton pregnancies. STUDY DESIGN: The overall quality of the diet (three 24-hour recalls), including supplementation, was evaluated at 34 +/- 1.3 weeks using a total mean adequacy ratio (TMAR) of 12 nutrients. Specific interviewing techniques were used to minimize social desirability bias. Anthropometric measurements of both parents and maternal lifestyle practices were also obtained. Infant weight, crown-heel length and head circumference were measured 14.6 +/- 4.4 days after birth. RESULTS: Stepwise multiple regression analysis revealed that maternal diet quality (TMAR) was significantly related to infant weight (r = .039, P = .036) and crown-heel length (r = .071, P = .007). Other significant predictors included gestational age, maternal height, sex, smoking and physical activity. CONCLUSION: Maternal diet was positively associated with infant weight and crown-heel length.

Estimated absorbable iron intakes in quebec adults.

In the last 30 years, the prevalence of low dietary iron intake has increased, partly because North Americans have been encouraged to choose lower fat foods, including leaner meats. As a result, there has been a decrease in red meat consumption. The objective of this study was to estimate absorbable iron intakes of a representative sample of the Quebec adult population and to compare these results with the new North American recommendations for iron. Dietary intakes were obtained by 24-hour recall and absorbable iron intakes were estimated using Monsen & coworker's model. While 18.9 % and 2.5% of women and men respectively had an iron intake below the estimated average requirement (EAR), 66.2 % and 25.6% had an estimated available iron intake below the recommended level for absorbed iron. Beef consumption had the strongest association with estimated absorbable iron, followed by vegetables. Subjects with a high education level consumed significantly less meat, beef and heme iron than subjects whose education level was low or moderate. These results indicate that there is a need for improving iron intake in the Quebec adult population.