Development and validity testing of the Canadian Food Scoring System (CFSS), a nutrient profile model based on the recommendations of Canada's food guide 2019.

Canada's food guide (CFG) 2019 provides dietary guidance for all Canadians; however, there is no tool available to help Canadians easily determine how individual foods align with CFG. Therefore, the objectives of this study were (1) to develop a nutrient profile model, Canadian Food Scoring System (CFSS), to rank the healthfulness of individual foods according to the recommendations of CFG; and (2) to assess its validity. The CFSS was developed based on CFG, leveraging existing Canadian labelling regulations to set quantitative criteria to the CFG recommendations. The CFSS included three main steps: (1) classifying foods into the CFG-based food categories and assigning points based on the alignment with the recommendations; (2) deducting points based on the levels of saturated fat, sugars, and sodium using thresholds from Canadian front-of-pack labelling regulations; and (3) calculating the final score from the first two steps to classify foods into one of five categories: "very poor", "poor", "fair", "good", or "excellent" choice. Convergent validity was assessed by examining the alignment of the CFSS with Health Canada's CFG-Food Classification System using a national food composition database and the Healthy Eating Food Index-2019 using nationally representative dietary intake survey data. The CFSS showed strong correlation with the CFG-Food Classification System (ρ=0.782, p<0.001) and moderate correlation with the Healthy Eating Food Index-2019 (r=0.636, p<0.001), indicating good convergent validity both at the food and dietary level. The newly developed CFSS can assess the alignment of individual foods with CFG, which can be used to help Canadians more easily make healthy food choices.

Correction: Nutrient intakes and top food categories contributing to intakes of energy and nutrients-of-concern consumed by Canadian adults that would require a 'high-in' front-of-pack symbol according to Canadian labelling regulations.

[This corrects the article DOI: 10.1371/journal.pone.0285095.].

Family Talk versus usual services in improving child and family psychosocial functioning in families with parental mental illness: a randomised controlled trial and cost analysis.

Background: Parental mental illness (PMI) is common and places children at high risk of developing psychological disorders. Family Talk (FT) is a well-known, whole-family, 7-session intervention designed to reduce the risk of transgenerational psychopathology. However, very few larger-scale evaluations of FT (across only a limited number of settings) have been conducted to date while there have been no cost analyses. This study aimed to assess the effectiveness and costs of delivering FT in improving child and family psychosocial functioning in families with PMI within routine mental health settings. Methods: A total of 83 families with PMI, with children aged 5-18 years, were randomly assigned on a 2:1 ratio to receive either the FT intervention (n=55 families) or usual services (n=28 families) across 10 adult, child and primary care mental health sites in Ireland. Parental disorders included anxiety/depression (57%), Bipolar Disorder (20%), Borderline Personality Disorder (12%), Post-Traumatic Stress Disorder (8%) and psychosis (2%). Detailed assessments with parents were conducted at baseline and 6-month follow up. Results: FT led to significant improvements in family functioning and child behaviour at 6-month follow up when compared to usual services, with medium effect sizes indicated. Parent participants with lower mental health literacy at baseline also showed significant post-intervention improvements. Those parents with less severe mental illness at baseline, and families with more partner and economic supports, reported additional significant post-intervention improvements in child depression/anxiety and parental mental health symptoms. The cost of FT amounted to €761.50 per family, although this decreased to €415.31 when recurring costs only were included. Conclusion: The findings from this study, which was conducted within the context of a national programme to introduce family-focused practice in Ireland, demonstrate that FT is a low-cost intervention that improved child and family psychosocial functioning across different mental health disorders within routine adult, child and primary care mental health services. The findings contribute to the growing evidence base for FT, and provide a robust basis to inform practice and policy development for families with parental mental illness both in Ireland and elsewhere. Clinical trial registration: https://www.isrctn.com/ISRCTN13365858, identifier ISRCTN13365858.

The impact of characters like Tony the Tiger and other child-targeted techniques used in food and beverage marketing.

Introduction: Food marketing's impact is a function of exposure and power, both of which contribute to children's poor diet quality and obesity risk. Children's exposure to food marketing is well documented, however, few studies have assessed the impact of specific persuasive marketing techniques or aspects of 'power' on children. Methods: This study administered an online survey to 1,341 Canadian children (9-12 years) aiming to determine the impact of: (1) child-targeted vs. adult-targeted marketing, and (2) licensed characters vs. spokes characters on children's food preferences and behavioral intentions. Participants were randomized to a single condition in each survey part and viewed 3 static food advertisements displaying the features of that condition (e.g., child-targeted advertising or licensed characters), and answered 3 Likert-scale (5-point) questions after each exposure. For each condition within each research question, there were four outcome variables related to the impact of marketing on children: food preference, purchase intent, pester power, and total impact. ANOVA tested the difference in impact (Likert scores) between conditions overall and for each outcome, with Bonferroni post-hoc tests where necessary. Results: A greater average total impact was observed among children exposed to child-targeted ads (mean Likert score 3.36) vs. adult-targeted ads (mean score 2.75; p < 0.001) or no marketing (mean score 2.81; p < 0.001). Children exposed to ads featuring spokes characters had a higher average total impact (mean score 3.98) vs. licensed characters (mean score 3.80; p < 0.001) and the control (i.e., no characters) (mean score 3.19; p < 0.001), and the total impact of licensed characters was greater than that of no characters. Similar trends were observed for all other outcomes. Discussion: Overall, this study showed that child-targeted ads and those using characters - especially spokes characters - have a strong overall impact on children's food preferences, purchase intents, and pester power, and support the implementation of comprehensive marketing restrictions to protect children.