Development of the Canadian Eating Practices Screener to assess eating practices based on 2019 Canada's Food Guide recommendations.

In 2019, Health Canada released a new iteration of Canada's Food Guide (2019-CFG), which, for the first time, highlighted recommendations regarding eating practices, i.e., guidance on where, when, why, and how to eat. The objective of this study was to develop a brief self-administered screener to assess eating practices recommended in the 2019-CFG among adults aged 18-65 years. Development of the screener items was informed by a review of existing tools and mapping of items onto 2019-CFG recommendations. Face and content validity were assessed with experts in public health nutrition and/or dietary assessment (n = 16) and individuals from Government of Canada (n = 14). Cognitive interviews were conducted with English-speaking (n = 16) and French-speaking (n = 16) adults living in Canada to assess face validity and understanding of the screener items. While some modifications were identified to improve relevance or clarity, overall, the screener items were found to be relevant, well-constructed, and clearly worded. This comprehensive process resulted in the Canadian Eating Practices Screener/Questionnaire court canadien sur les pratiques alimentaires, which includes 21 items that assess eating practices recommended in the 2019-CFG. This screener can facilitate monitoring and surveillance efforts of the 2019-CFG eating practices as well as research exploring how these practices are associated with various health outcomes.

Action Schools! BC implementation: from efficacy to effectiveness to scale-up.

OBJECTIVES: To describe Action Schools! BC (AS! BC) from efficacy to scale-up. PARTICIPANTS/SETTING: Education and health system stakeholders and children in grades 4-6 from elementary schools in British Columbia, Canada. INTERVENTION: At the provincial level, the AS! BC model reflected socioecological theory and a partnership approach to social change. Knowledge translation and exchange were embedded as a foundational element. At the school level, AS! BC is a comprehensive school health-based model providing teachers and schools with training and resources to integrate physical activity (PA) and healthy eating (HE) into the school environment. Our research team partnered with key community and government stakeholders to deliver and evaluate AS! BC over efficacy, effectiveness and implementation trials. RESULTS: On the basis of significant increases in PA, cardiovascular fitness, bone and HE in AS! BC schools during efficacy trials, the BC government supported a provincial scale-up. Since its inception, the AS! BC Support Team and >225 trained regional trainers have delivered 4677 teacher-focused workshops (training approximately 81,000 teachers), reaching approximately 500,000 students. After scale-up, PA delivery was replicated but the magnitude of change appeared less. One (HE) and 4 (PA) years after scale-up, trained AS! BC teachers provided more PA and HE opportunities for students even in the context of supportive provincial policies. CONCLUSIONS: Whole school models like AS! BC can enhance children's PA and health when implemented in partnership with key stakeholders. At the school level, adequately trained and resourced teachers and supportive school policies promoted successful scale-up and sustained implementation. At the provincial level, multisectoral partnerships and embedded knowledge exchange mechanisms influenced the context for action at the provincial and school level, and were core elements of successful implementation. TRIAL REGISTRATION NUMBER: Clinical Trials Registry NCT01412203.

Sports drink consumption and diet of children involved in organized sport.

BACKGROUND: Organized sport provides one option for children to be physically active. However, there is a paucity of information about the relationship between children's participation in organized sport and their diet, and specifically their sports drink consumption. Therefore, the relationship between sports participation in children and the consumption of sports drinks, sugar-sweetened beverages (SSBs) and other components of diet was examined. METHODS: A cross-sectional descriptive study was conducted using baseline data from the Action Schools! BC Dissemination study cohort (n = 1421; 9.90 (0.58) y; 736 girls, 685 boys). The differences between the dietary behaviours of children participating in organized sport (sport) versus those that did not participate (non-sport) was examined. A modified Physical Activity Questionnaire for Older Children (PAQ-C) was used to measure physical activity levels and participation in organized sport. A Food Frequency Questionnaire (FFQ) and 24-hour dietary recall were used to assess eating behaviour and macronutrient intake (including protein, fat, and carbohydrate as well as sugar, fibre and total calories). Fruit, vegetable and beverage quantities were hand-tallied from the dietary recall. Fruit, vegetable and beverage frequency was assessed using the FFQ. Analysis of covariance (ANCOVA) was used to analyse differences between groups and a chi-square test of association was use to determine if participation in sport was significantly associated with the proportion of children consuming sports drinks and SSBs, and with gender. RESULTS: Children involved in sport had a lower body mass index (BMI) and were more physically active than children in the non-sport group (p < 0.01). Only a small number (n = 20/1421) of children consumed sports drinks and no difference in consumption of sports drink between sport and non-sport participants (p > .05) was observed. However, children involved in organized sport consumed more total calories, fat, fibre, fruit, vegetables and non-flavoured milk (p < 0.01) than non-sport children. CONCLUSIONS: Children involved in organized sport were more physically active, consumed a healthier diet than non-participants and on average had lower BMI's despite consuming more calories. As consumption of sports drinks among this age group was low, this may be an ideal time to begin educating children and their parents about the appropriate consumption of sports drinks and the perils of consuming too many SSBs, specifically.

Availability of limited service food outlets surrounding schools in British Columbia.

OBJECTIVE: The purpose of this study was to provide a descriptive profile of the availability of limited service food outlets surrounding public schools in British Columbia, Canada. METHODS: Data from the 2010 Canadian Business Data Files were used to identify limited service food outlets including fast food outlets, beverage and snack food stores, delis and convenience stores. The number of food outlets within 800 metres of 1,392 public schools and the distance from schools to the nearest food outlets were assessed. Multivariate regression models examined the associations between food outlet availability and school-level characteristics. RESULTS: In 2010, over half of the public schools in BC (54%) were located within a 10-12 minute walk from at least one limited service food outlet. The median closest distance to a food outlet was just over 1 km (1016 m). Schools comprised of students living in densely populated urban neighbourhoods and neighbourhoods characterized by lower socio-economic status were more likely to have access to limited service food outlets within walking distance. After adjusting for school-level median family income and population density, larger schools had higher odds of exposure to food vendors compared to schools with fewer students. CONCLUSION: The availability of and proximity to limited service food outlets vary widely across schools in British Columbia and school-level characteristics are significantly associated with food outlet availability. Additional research is needed to understand how food environment exposures inside and surrounding schools impact students' attitudes, food choices and dietary quality.

Action schools! BC--Healthy Eating: effects of a whole-school model to modifying eating behaviours of elementary school children.

OBJECTIVES: The rate of obesity and associated risk factors in Canadian youth is increasing at an alarming rate. Nutrition plays an important role in weight maintenance. This study reports the effectiveness of Action Schools! BC---Healthy Eating, a school-based fruit and vegetable (FV) intervention, in effecting change in: 1) students' intake of FV, 2) students' knowledge, attitudes and perceptions regarding FV, and 3) students' willingness to try new FV. METHODS: Five schools that represented geographic, socio-economic and size variation were recruited as Action Schools! BC--Healthy Eating intervention schools. A second set of five schools were selected as matched healthy eating usual practice schools. Student outcomes were measured at baseline and at 12-week follow-up using self-report questionnaires. Classroom logs and progress reports were used to assess implementation dose and fidelity. The intervention included school-wide activities based on individualized Action Plans addressing goals across six Action Zones. RESULTS: Significant differences were found between conditions over time while controlling for baseline levels. Fruit servings, FV servings, FV variety, and percent of FV tried from a fixed list increased in intervention schools. Teachers implemented a mean of 64% of requested classroom dose, and school Action Teams implemented activities across 80% of the whole-school model. DISCUSSION: A whole-school framework can impact FV intake, but results were modest due to implementation issues. Further implementation and evaluation are necessary to fully understand the effectiveness of this initiative.

Monitoring exercise intensity during resistance training using the session RPE scale.

This study investigated the reliability of the session rating of perceived exertion (RPE) scale to quantify exercise intensity during high-intensity (H), moderate-intensity (M), and low-intensity (L) resistance training. Nine men (24.7 +/- 3.8 years) and 10 women (22.1 +/- 2.6 years) performed each intensity twice. Each protocol consisted of 5 exercises: back squat, bench press, overhead press, biceps curl, and triceps pushdown. The H consisted of 1 set of 4-5 repetitions at 90% of the subject's 1 repetition maximum (1RM). The M consisted of 1 set of 10 repetitions at 70% 1RM, and the L consisted of 1 set of 15 repetitions at 50% 1RM. RPE was measured following the completion of each set and 30 minutes postexercise (session RPE). Session RPE was higher for the H than M and L exercise bouts (p < or = 0.05). Performing fewer repetitions at a higher intensity was perceived to be more difficult than performing more repetitions at a lower intensity. The intraclass correlation coefficient for the session RPE was 0.88. The session RPE is a reliable method to quantify various intensities of resistance training.