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1.
Int J Drug Policy ; 77: 102666, 2020 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-32171107

RESUMO

Alcohol labels are one strategy for raising consumer awareness about the negative consequences of alcohol, but evidence to inform labels is limited. This quasi-experimental study sought to test the real-world impact of strengthening health messages on alcohol container labels on consumer attention, message processing (reading, thinking, and talking with others about labels), and self-reported drinking. Alcohol labels with a cancer warning, national drinking guidelines, and standard drink information were implemented in the intervention site, and usual labelling practices continued in the comparison site. Changes in key indicators of label effectiveness were assessed among a cohort of adult drinkers in both the intervention and comparison sites using three waves of surveys conducted before and at two time-points after the alcohol label intervention. Generalized Estimating Equations with difference-in-difference terms were used to examine the impact of the label intervention on changes in outcomes. Strengthening health messages on alcohol container labels significantly increased consumer attention to [Adjusted Odds Ratio (AOR)=17.2, 95%CI:8.2,36.2] and processing of labels (e.g., reading labels: AOR=2.6, 95%CI:1.8,3.7), and consumer reports of drinking less due to the labels (AOR=3.7, 95%CI: 2.0,7.0). Strengthening health messages on alcohol containers can achieve their goal of attracting attention, deepening engagement, and enhancing motivation to reduce alcohol use. Strengthening alcohol labelling policies should be a priority for alcohol control globally.

2.
BMJ Open ; 10(2): e036602, 2020 Feb 18.
Artigo em Inglês | MEDLINE | ID: mdl-32075847

RESUMO

INTRODUCTION: Aspects of the built environment that support physical activity are associated with better population health outcomes. Few experimental data exist to support these observations. This protocol describes the study of the creation of urban trials on cardiovascular disease (CVD)-related morbidity and mortality in a large urban centre. METHODS AND ANALYSIS: Between 2008 and 2010, the city of Winnipeg, Canada, built four, paved, multiuse (eg, cycling, walking and running), two-lane trails that are 5-8 km long and span ~60 neighbourhoods. Linking a population-based health data with census and environmental data, we will perform an interrupted time series analysis to assess the impact of this natural experiment on CVD-related morbidity and mortality among individuals 30-65 years of age residing within 400-1200 m of the trail. The primary outcome of interest is a composite measure of incident major adverse CVD events (ie, CVD-related mortality, ischaemic heart disease, stroke and congestive heart failure). The secondary outcome of interest is a composite measure of incident CVD-related risk factors (ie, diabetes, hypertension and dyslipidaemia). Outcomes will be assessed quarterly in the 10 years before the intervention and 5 years following the intervention, with a 4-year interruption. We will adjust analyses for differences in age, sex, ethnicity, immigration status, income, gentrification and other aspects of the built environment (ie, greenspace, fitness/recreation centres and walkability). We will also assess trail use and trail user profiles using field data collection methods. ETHICS AND DISSEMINATION: Ethical approvals for the study have been granted by the Health Research Ethics Board at the University of Manitoba and the Health Information Privacy Committee within the Winnipeg Regional Health Authority. We have adopted an integrated knowledge translation approach. Information will be disseminated with public and government partners. TRIAL REGISTRATION NUMBER: NCT04057417.

3.
Artigo em Inglês | MEDLINE | ID: mdl-31936173

RESUMO

Knowledge that alcohol can cause cancer is low in Canada. Alcohol labels are one strategy for communicating alcohol-related harms, including cancer. Extending existing research observing an association between knowledge of the alcohol-cancer link and support for alcohol policies, this study examined whether increases in individual-level knowledge that alcohol is a carcinogen following an alcohol labelling intervention are associated with support for alcohol polices. Cancer warning labels were applied to alcohol containers at the intervention site, and the comparison site did not apply cancer labels. Pre-post surveys were conducted among liquor store patrons at both sites before and two-and six-months after the intervention was stopped due to alcohol industry interference. Limiting the data to participants that completed surveys both before and two-months after the cancer label stopped, logistic regression was used to examine the association between increases in knowledge and support for policies. Support for pricing and availability policies was low overall; however, increases in individual-level knowledge of the alcohol-cancer link was associated with higher levels of support for pricing policies, specifically, setting a minimum unit price per standard drink of alcohol (OR = 1.86, 95% CI: 1.11-3.12). Improving knowledge that alcohol can cause cancer using labels may increase support for alcohol policies. International Registered Report Identifier (IRRID): RR2-10.2196/16320.

4.
Artigo em Inglês | MEDLINE | ID: mdl-31569652

RESUMO

Background: Very few experimental studies exist describing the effect of changes to the built environment and opportunities for physical activity (PA). We examined the impact of an urban trail created on a frozen waterway on visitor counts and PA levels. Methods: We studied a natural experiment in Winnipeg, Manitoba, Canada that included 374,204 and 237,362 trail users during the 2017/2018 and 2018/2019 winter seasons. The intervention was a 10 km frozen waterway trail lasting 8-10 weeks. The comparator conditions were the time periods immediately before and after the intervention when ~10 kms of land-based trails were accessible to the public. A convenience sample of 466 participants provided directly measured PA while on the frozen waterway. Results: Most trail users were 35 years or older (73%), Caucasian (77%), and had an annual household income >$50,000 (61%). Mean daily trail network visits increased ~four-fold when the frozen waterway was open (median and interquartile range (IQR) = 710 (239-1839) vs. 2897 (1360-5583) visits/day, p < 0.001), compared with when it was closed. Users achieved medians of 3852 steps (IQR: 2574-5496 steps) and 23 min (IQR: 13-37 min) of moderate to vigorous intensity PA (MVPA) per visit, while 37% of users achieved ≥30 min of MVPA. Conclusion: A winter-specific urban trail network on a frozen waterway substantially increased visits to an existing urban trail network and was associated with a meaningful dose of MVPA. Walking on water could nudge populations living in cold climates towards more activity during winter months.


Assuntos
Planejamento Ambiental , Exercício , Promoção da Saúde/métodos , Férias e Feriados , Camada de Gelo , Estações do Ano , Saúde da População Urbana , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Manitoba , Pessoa de Meia-Idade , Estudos Prospectivos , Caminhada , Adulto Jovem
5.
Am J Prev Med ; 56(6): e195-e203, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31104725

RESUMO

INTRODUCTION: The objective of this study is to investigate the early impact of Canada's first provincewide mandatory menu-labeling legislation on calorie levels in foods offered on chain restaurant menus before, leading up to, and at the point-of-implementation. METHODS: Data were obtained from Menu-FLIP, a database of publicly available nutrition data from chain restaurants in Canada. Data were collected in 2010, 2013, 2016, and 2017. Core food products, newly introduced products, discontinued products, and full menus were compared before (2010, 2013, 2016) and at the point-of-implementation (2017) of the policy. Calories and serving sizes of 2,988 unique foods (excluding beverages) from 28 chains were analyzed using mixed models comparing time points while controlling for covariates. Sub-analyses were stratified by restaurant type. RESULTS: Full menu mean calories and serving sizes increased between 2010 and 2017 (>40 calories and 17 grams, respectively). There were no significant changes in mean calories or serving sizes among core menu items (p=0.47). New products in 2013 and 2017 were significantly higher in calories and serving size versus discontinued foods and foods already on the menu. Discontinued foods did not differ in calories or serving size compared with foods already on the menu; however, in 2017, the calories of discontinued foods in sit-down restaurants were higher than foods discontinued in 2013 (p=0.02). CONCLUSIONS: The results of this investigation show that at the point-of-implementation of the Ontario Healthy Menu Choices Act supply-side calories in core food products, new products, or full menus evaluated in this study did not significantly change.

6.
J Nutr ; 149(6): 1019-1026, 2019 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-31006813

RESUMO

BACKGROUND: Technological innovations allow for collection of 24-h recalls (24HRs) in a broader range of studies than previously possible. The web-based Automated Self-Administered 24-Hour Dietary Assessment Tool (ASA24) has been shown to be feasible and to perform well in capturing true intake among adults. However, data to inform use with children are limited. OBJECTIVE: This observational feeding study was conducted to evaluate children's ability to accurately report a lunchtime meal using ASA24 without assistance. METHODS: The study was conducted among children (n = 100) aged 10-13 y within a school setting. Students were served an individual cheese pizza, baby carrots, ranch dip, yogurt, a cookie, and 1 choice of water, juice, or milk. Plate waste was collected and weighed. The next day, participants completed ASA24 and a sociodemographic questionnaire. Descriptive statistics were generated to determine match rates by food item and age, and linear regression analyses were conducted to examine associations between sociodemographic characteristics and accuracy of reported energy and nutrient intake. Associations between true and reported energy and nutrient intakes and portion sizes were assessed with use of t tests. RESULTS: Just under half (49%) of children fully completed ASA24 (median time, 41 min). Children reported an exact, close, or far match for 58% of all foods and beverages consumed, ranging from 29% for dip to 76% for pizza, but also reported some items not consumed as part of the study meal. Older children completed the recall in a shorter time than younger children (mean 31 among 13 y compared with 52 min among 10 y). Intakes of energy (39%), protein (33%), and sodium (78%) were significantly overestimated, whereas portion sizes for cookies (53%) and juice (69%) were underestimated. CONCLUSIONS: Children can report some foods and drinks consumed using ASA24, but our findings suggest challenges with independent completion, necessitating research to examine strategies, such as training and resources, to support data quality.

7.
Can J Diet Pract Res ; 80(3): 111-115, 2019 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-30724112

RESUMO

We estimated calorie intake from alcohol in Canada, overall and by gender, age, and province, and provide evidence to advocate for mandatory alcohol labelling requirements. Annual per capita (aged 15+) alcohol sales data in litres of pure ethanol by beverage type were taken from Statistics Canada's CANSIM database and converted into calories. The apportionment of consumption by gender, age, and province was based on data from the Canadian Tobacco, Alcohol and Drug Survey. Estimated energy requirements (EER) were from Canada's Food Guide. The average drinker consumed 250 calories, or 11.2% of their daily EER in the form of alcohol, with men (13.3%) consuming a higher proportion of their EER from alcohol than women (8.2%). Drinkers consumed more than one-tenth of their EER from alcohol in all but one province. By beverage type, beer contributes 52.7% of all calories derived from alcohol, while wine (20.8%); spirits (19.8%); and ciders, coolers, and other alcohol (6.7%) also contribute substantially. The substantial caloric impact of alcoholic drinks in the Canadian diet suggests that the addition of caloric labelling on these drinks is a necessary step.

8.
Can J Diet Pract Res ; 79(4): 157-163, 2018 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-30280918

RESUMO

PURPOSE: The current study aimed to characterize grocery shopping and dinner preparation behaviours among young people in Canada and to examine associations with eating habits. METHODS: A cross-sectional online survey was conducted with 2008 participants aged 16-24 from across Canada. The survey measured self-reported grocery shopping and dinner preparation behaviours, frequency of eating breakfast and eating meals prepared away from home, frequency of vegetable and fruit intake, and socio-demographic characteristics. Chi-square tests examined differences in proportions; logistic and linear regressions examined dietary habits, including covariates for grocery shopping and dinner preparation and socio-demographics. RESULTS: Overall, 37.3% had helped with grocery shopping in the past week, and 84.3% had participated in dinner preparation at least 1 day in the past week. Engaging in shopping at least once weekly was associated with increased vegetable and fruit consumption only, whereas more frequent engagement in dinner preparation was associated with increased vegetable and fruit consumption, more frequent breakfast consumption, and fewer meals consumed that were prepared away from home (P < 0.001 for all). CONCLUSIONS: Increased participation in grocery shopping and dinner preparation were associated with healthier dietary habits. Interventions that increase these behaviours may contribute to improving dietary behaviours among adolescents and young adults.


Assuntos
Culinária/estatística & dados numéricos , Comportamento Alimentar , Alimentos , Refeições , Adolescente , Desjejum , Canadá , Dieta/estatística & dados numéricos , Feminino , Frutas , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Verduras , Adulto Jovem
9.
Nutr J ; 17(1): 73, 2018 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-30068342

RESUMO

BACKGROUND: The contribution of beverages to overall diet is of increasing interest to researchers and policymakers, particularly in terms of consumption of drinks high in added sugars; however, few tools to assess beverage intake have been developed and evaluated. This study aimed to evaluate the relative validity of a new online Beverage Frequency Questionnaire (BFQ) among young adults in Canada. METHODS: A cross-sectional relative validation study was conducted among young adults aged 16-30 years (n = 50). Participants completed a 17-item BFQ, a 7-day food record (7dFR), and a single-item measure of sugary drink intake. Pearson correlations and paired t-tests were used to evaluate correlation and agreement between the measures for 17 individual beverage categories, total drink consumption, total alcoholic beverage consumption, and two definitions of drinks with excess sugars. Cognitive interviews were conducted to examine participant interpretation and comprehensiveness of the BFQ. RESULTS: Estimates of beverage intake based on the BFQ and the 7dFR were highly correlated, specifically for the total number and volume of beverages consumed, total alcoholic beverage consumption, sugary drink intake, and each of the 17 beverage categories with 3 exceptions: coffee or tea with sugar or cream, specialty coffees, and hard alcohol with caloric mix. Paired t-tests between the BFQ and the 7dFR indicated that the average reported volume was significantly different only for sweetened fruit drinks. The single-item measure of sugary beverage intake was not significantly correlated with the 7dFR. Cognitive interviewing demonstrated high comprehension levels, and confirmed the appropriateness of the BFQ beverage categories and sizes. CONCLUSIONS: Overall, the results suggest that the BFQ performed well relative to a 7dFR and had high usability among this study population, indicating its promise for collecting population-level data on beverage intake, including sugar-sweetened beverages, which are known indicators of diet and health.


Assuntos
Bebidas/estatística & dados numéricos , Inquéritos sobre Dietas/estatística & dados numéricos , Comportamento Alimentar , Internet , Adolescente , Adulto , Canadá , Estudos Transversais , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Inquéritos e Questionários , Adulto Jovem
10.
BMC Public Health ; 18(1): 802, 2018 06 27.
Artigo em Inglês | MEDLINE | ID: mdl-29945575

RESUMO

BACKGROUND: This paper examines school and classroom effects on Daily Physical Activity (DPA) policy implementation in classrooms in Ontario, Canada. In 2005 the Ontario Ministry of Education mandated a policy requiring school boards to "ensure that all elementary students, including students with special needs, have a minimum of twenty minutes of sustained MVPA each school day during instructional time". Based on an adaptation of Chaudoir's conceptual framework, this paper contributes to understanding the extent to which school factors (as reported by administrators) and classroom factors (as reported by teachers) are associated with policy implementation fidelity at the classroom level. METHODS: Cross-sectional online surveys were conducted in 2014 with elementary school administrators and teachers, based on representative random samples of schools and classrooms. A measure assessing implementation fidelity was developed from the six required components of the policy and for this paper fidelity at the classroom level is treated as the outcome variable. Several school- and classroom-level measures were also included in the surveys and a number of these were selected for inclusion here. Data from the two surveys were merged and selected variables were included in the multi-level analysis. Two-level logistic regression models were conducted to account for nesting of classrooms within schools and a series of models were conducted to identify factors associated with implementation fidelity. RESULTS: The analytic sample for this study included 170 school administrators and 307 classroom teachers from corresponding schools. Findings from the multi-level logistic regression analyses indicated that only classroom/teacher-level factors were significantly associated with implementation fidelity at the classroom level. None of the school/administrator predictors were significantly related to fidelity. The most parsimonious model included five significant classroom/teacher predictors: teachers' perception of DPA as realistic and achievable; confidence (self-efficacy); scheduling DPA in timetables; lack of space; and lack of time. CONCLUSIONS: Findings from the study indicate the theoretical and practical importance of addressing classroom and teacher factors since they are most proximal to implementation fidelity to the policy. Several of these factors also reflect complex structural and organizational contexts, indicating that a systems approach to understanding and supporting DPA implementation fidelity is warranted.


Assuntos
Exercício , Política de Saúde , Instituições Acadêmicas/organização & administração , Criança , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , Análise Multinível , Ontário , Percepção , Professores Escolares/psicologia , Professores Escolares/estatística & dados numéricos , Inquéritos e Questionários
12.
Alcohol Alcohol ; 53(1): 3-11, 2018 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-29016708

RESUMO

Aims: Despite the introduction of national drinking guidelines in Canada, there is limited public knowledge of them and low understanding of 'standard drinks (SDs)' which limits the likelihood of guidelines affecting drinking behaviour. This study tests the efficacy of alcohol labels with SD information and Canada's Low-Risk Drinking Guidelines (LRDGs) as compared to %ABV labels on consumers' ability to estimate alcohol intake. It also examines the label size and format that best supports adults' ability to make informed drinking choices. Methods: This research consisted of a between-groups experiment (n = 2016) in which participants each viewed one of six labels. Using an online survey, participants viewed an alcohol label and were asked to estimate: (a) the amount in a SD; (b) the number of SDs in an alcohol container and (c) the number of SDs to consume to reach the recommended daily limit in Canada's LRDG. Results: Results indicated that labels with SD and LRDG information facilitated more accurate estimates of alcohol consumption and awareness of safer drinking limits across different beverage types (12.6% to 58.9% increase in accuracy), and labels were strongly supported among the majority (66.2%) of participants. Conclusion: Labels with SD and LRDG information constitute a more efficacious means of supporting accurate estimates of alcohol consumption than %ABV labels, and provide evidence to inform potential changes to alcohol labelling regulations. Further research testing labels in real-world settings is needed. Short summary: Results indicate that the introduction of enhanced alcohol labels combining standard drink information and national drinking guidelines may be an effective way to improve drinkers' ability to accurately assess alcohol consumption and monitor intake relative to guidelines. Overall support for enhanced labels suggests probable acceptability of introduction at a population level.


Assuntos
Consumo de Bebidas Alcoólicas/psicologia , Bebidas Alcoólicas , Informação de Saúde ao Consumidor , Rotulagem de Produtos , Adulto , Idoso , Cerveja , Canadá , Feminino , Guias como Assunto , Humanos , Internet , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Inquéritos e Questionários , Vinho , Adulto Jovem
13.
Alcohol Alcohol ; 53(1): 20-25, 2018 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-29016716

RESUMO

Aims: This study aimed to refine content and design of an enhanced alcohol label to provide information that best supports informed drinking and to gauge consumer acceptability of enhanced alcohol labels among a subset of consumers. Methods: Five focus groups (n = 45) were conducted with stakeholders and the general public (age 19+) across one jurisdiction in northern Canada. Interviews were transcribed and analyzed using NVivo software. Results: The majority of participants showed strong support for enhanced alcohol labels with an emphasis on the consumers' right to know about the health risks related to alcohol. Participants preferred larger labels that included standard drink (SD) information, national low-risk drinking guidelines presented as a chart with pictograms, cancer health messaging and a pregnancy warning. Supporting introduction of the labels with a web resource and an educational campaign was also recommended. Conclusions: Displaying enhanced labels on alcohol containers that include SD information, low-risk drinking guidelines and other health messaging in an accessible format may be an effective way to better inform drinkers about their consumption and increase awareness of alcohol-related health risks. Introduction of enhanced labels shows potential for consumer support. Short summary: Focus group findings indicate strong support for enhanced alcohol labels displaying SD information, national drinking guidelines, health messaging and a pregnancy warning. Introduction of enhanced alcohol labels in tandem with an educational campaign may be an effective way to better inform Canadian drinkers and shows potential for consumer support.


Assuntos
Bebidas Alcoólicas , Informação de Saúde ao Consumidor , Rotulagem de Produtos , Adulto , Idoso , Canadá , Feminino , Grupos Focais , Guias como Assunto , Conhecimentos, Atitudes e Prática em Saúde , Promoção da Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/epidemiologia , Risco , Adulto Jovem
14.
Can J Public Health ; 108(4): e409-e413, 2017 Nov 09.
Artigo em Inglês | MEDLINE | ID: mdl-29120313

RESUMO

Greater availability of low nutritional quality foods and decreased consumption of nutrient-dense foods have negatively impacted the nutrient profile of the Canadian diet. Poor diet is now the leading risk factor for chronic disease and premature death in Canada. To help consumers choose healthful foods, nutrition labelling is one policy tool for communicating relevant nutrition information. However, there are notable shortcomings with current nutrition labelling systems, which make it difficult for Canadians to navigate the complex food environment. Government action on nutrition labelling systems, including front-of-package (FOP), shelf, and menu labelling, is required. In May 2016, we hosted a consensus conference with experts from research, policy and practice to review available evidence, share experiences and come to consensus regarding the next best steps for action on nutrition labelling in Canada. In this paper, we examine the evidence, opportunities and challenges surrounding FOP, shelf, and menu labelling. We outline recommendations, emphasizing FOP, shelf, and menu labelling as part of a standardized, coordinated and multi-pronged strategy supported by a robust, evidence-based nutrition profiling system. Recommendations for monitoring adherence to regulations and participation of stakeholders to avoid conflict of interest in policy development, implementation and evaluation are included. Within a comprehensive strategy, these recommendations can help to improve the nutrition information environment for Canadians.


Assuntos
Rotulagem de Alimentos , Política Nutricional , Canadá , Consenso , Humanos
15.
Milbank Q ; 95(3): 494-534, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-28895220

RESUMO

Policy Points: On-shelf nutrition labelling systems in supermarkets, such as the Guiding Stars system, are intended to provide consumers with simple, standardized nutrition information to support more informed and healthier food choices. Policies that support the provision of simplified nutrition labelling systems may encourage consumers to make positive shifts in food-purchasing behaviors. The shifts in consumer food-purchasing patterns observed in our study after the introduction of the Guiding Stars system in supermarkets translated into measurable nutritional benefits, including more items purchased with slightly less trans fat and sugar and more fiber and omega-3 fatty acids. This study is one of the first to report the positive impact of an on-shelf nutrition labelling system on supermarket sales and revenues-key information that was specifically requested by the US National Academies, as such labelling interventions may be more sustainable if they lead to higher revenues. CONTEXT: Providing a nutrition rating system on the front of food packages or on retail shelf tags has been proposed as a policy strategy for supporting healthier food choices. Guiding Stars is an on-shelf nutrition labelling system that scores foods in a supermarket based on nutritional quality; scores are then translated into ratings of 0 to 3 stars. It is consistent with evidence-informed recommendations for well-designed labels, except for not labelling 0-star products. The largest supermarket retailer in Canada rolled out the Guiding Stars system in supermarkets across Ontario, Canada. The aim of our study was to examine the extent to which consumers respond to an on-shelf nutrition labelling system in supermarkets to inform current and future nutrition labelling policies and practices. METHODS: Capitalizing on a natural experiment, we conducted a quasi-experimental study across 3 supermarket banners (or "chains") in Ontario, one of which implemented the Guiding Stars system in 2012. We used aggregated supermarket transaction data to test the effect of Guiding Stars on the nutritional quality of food purchases in intervention supermarkets relative to control supermarkets. We also conducted exit surveys among 783 randomly selected shoppers from intervention and control supermarkets to assess consumer awareness, understanding, trust, and self-reported use of the labelling system. FINDINGS: Relative to control supermarkets, shoppers in intervention supermarkets made small but significant shifts toward purchasing foods with higher nutritional ratings; however, shifts varied in direction and magnitude across food categories. These shifts translated into foods being purchased with slightly less trans fat and sugar and more fiber and omega-3 fatty acids. We also found increases in the number of products per transaction, price per product purchased, and total revenues. Results of the exit surveys indicate a modest proportion of consumers were aware of, understood, and trusted Guiding Stars in intervention supermarkets, and a small proportion of consumers reported using this system when making purchasing decisions. However, 47% of shoppers exposed to Guiding Stars were confused when asked to interpret the meaning of a 0-star product that does not display a rating on the shelf tag. CONCLUSIONS: This study demonstrates support for policies promoting on-shelf nutrition labels designed according to evidence-informed principles, but policymakers should move forward with caution when investing in such systems until research has confirmed optimal label design, clarified the mechanisms through which dietary intake is improved, and assessed associations with nutrition-related health outcomes.


Assuntos
Comportamento do Consumidor , Informação de Saúde ao Consumidor , Rotulagem de Alimentos , Preferências Alimentares/psicologia , Promoção da Saúde/métodos , Canadá , Humanos , Política Nutricional , Valor Nutritivo
16.
Int J Behav Nutr Phys Act ; 14(1): 98, 2017 07 19.
Artigo em Inglês | MEDLINE | ID: mdl-28724390

RESUMO

BACKGROUND: The purpose of this paper is to examine the impact of a province-wide physical education (PE) policy on secondary school students' moderate to vigorous physical activity (MVPA). METHODS: Policy: In fall 2008, Manitoba expanded a policy requiring a PE credit for students in grades 11 and 12 for the first time in Canada. The PE curriculum requires grades 11 and 12 students to complete a minimum of 55 h (50% of course hours) of MVPA (e.g., ≥30 min/day of MVPA on ≥5 days a week) during a 5-month semester to achieve the course credit. STUDY DESIGNS: A natural experimental study was designed using two sub-studies: 1) quasi-experimental controlled pre-post analysis of self-reported MVPA data obtained from census data in intervention and comparison [Prince Edward Island (PEI)] provinces in 2008 (n = 33,619 in Manitoba and n = 2258 in PEI) and 2012 (n = 41,169 in Manitoba and n = 4942 in PEI); and, 2) annual objectively measured MVPA in cohorts of secondary students in intervention (n = 447) and comparison (Alberta; n = 224) provinces over 4 years (2008 to 2012). ANALYSIS: In Study 1, two logistic regressions were conducted to model the odds that students accumulated: i) ≥30 min/day of MVPA, and ii) met Canada's national recommendation of ≥60 min/day of MVPA, in Manitoba versus PEI after adjusting for grade, sex, and BMI. In Study 2, a mixed effects model was used to assess students' minutes of MVPA per day per semester in Manitoba and Alberta, adjusting for age, sex, BMI, school location and school SES. RESULTS: In Study 1, no significant differences were observed in students achieving ≥30 (OR:1.13, 95% CI:0.92, 1.39) or ≥60 min/day of MVPA (OR:0.92, 95% CI: 0.78, 1.07) from baseline to follow-up between Manitoba and PEI. In Study 2, no significant policy effect on students' MVPA trajectories from baseline to last follow-up were observed between Manitoba and Alberta overall (-1.52, 95% CI:-3.47, 0.42), or by covariates. CONCLUSIONS: The Manitoba policy mandating PE in grades 11 and 12 had no effect on student MVPA overall or by key student or school characteristics. However, the effect of the PE policy may be underestimated due to the use of a nonrandomized research design and lack of data assessing the extent of policy implementation across schools. Nevertheless, findings can provide evidence about policy features that may improve the PE policy in Manitoba and inform future PE policies in other jurisdictions.


Assuntos
Currículo , Exercício , Educação Física e Treinamento , Políticas , Instituições Acadêmicas , Estudantes , Adolescente , Alberta , Feminino , Humanos , Masculino , Manitoba
17.
CMAJ Open ; 5(1): E1-E6, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28401111

RESUMO

BACKGROUND: Excess consumption of added sugars has been associated with a variety of health problems, but there is little information available characterizing added sugar in the Canadian food supply. This study examined the presence and types of added sugars in the packaged food and beverage products available at a major Canadian grocery retailer. METHODS: We searched the ingredients lists of over 40 000 packaged food products available for sale in March 2015 for a variety of added sugar terms. Proportions of food products containing added sugar were identified overall and within food product categories. Differences in total sugar content were identified between food products with and without added sugar. RESULTS: Overall, 66% of the packaged food products analyzed contained at least 1 added sugar. The added sugar term "sugar" (and its variations) appeared the most frequently, followed by "dextrose." Added sugar presence and total sugar content varied within many product categories but were consistently higher in expected categories such as "beverages." Mean total sugar content was significantly higher in products with added sugar than in those without, both overall (p < 0.001) and within most product subcategories (p < 0.02). INTERPRETATION: About two-thirds of the packaged foods and beverages available at a major Canadian grocery retailer contain added sugar, similar to recent patterns estimated for the US food supply. The results provide an estimation of the baseline characterization of added sugar in the Canadian food supply, which can be used to assess outcomes of future changes to sugar labelling policies in Canada.

18.
Nutrients ; 9(2)2017 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-28146125

RESUMO

With technological innovation, comprehensive dietary intake data can be collected in a wide range of studies and settings. The Automated Self-Administered 24-hour (ASA24) Dietary Assessment Tool is a web-based system that guides respondents through 24-h recalls. The purpose of this paper is to describe lessons learned from five studies that assessed the feasibility and validity of ASA24 for capturing recall data among several population subgroups in Canada. These studies were conducted within a childcare setting (preschool children with reporting by parents), in public schools (children in grades 5-8; aged 10-13 years), and with community-based samples drawn from existing cohorts of adults and older adults. Themes emerged across studies regarding receptivity to completing ASA24, user experiences with the interface, and practical considerations for different populations. Overall, we found high acceptance of ASA24 among these diverse samples. However, the ASA24 interface was not intuitive for some participants, particularly young children and older adults. As well, technological challenges were encountered. These observations underscore the importance of piloting protocols using online tools, as well as consideration of the potential need for tailored resources to support study participants. Lessons gleaned can inform the effective use of technology-enabled dietary assessment tools in research.


Assuntos
Inquéritos sobre Dietas , Rememoração Mental , Sistemas On-Line , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Canadá , Criança , Pré-Escolar , Comportamento do Consumidor , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação Nutricional , Reprodutibilidade dos Testes , Autorrelato
19.
Perspect Public Health ; 137(3): 173-181, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-27436235

RESUMO

INTRODUCTION: Childhood obesity is a serious public health concern internationally, and population-level interventions are needed to support healthy food choices. Existing reviews of menu labelling have focused predominantly on adults. However, childhood and adolescence are distinct periods of development during which longer term eating behaviours and food preferences are established. Although some studies have examined the effect of menu labelling among children and adolescents, no reviews have synthesised this evidence. OBJECTIVE: To assess whether menu labelling influences the amount of calories ordered by children and adolescents (or parents on behalf of youth) in food outlets including restaurants and cafeterias. METHODS: Comprehensive literature searches were conducted in Medline, Scopus, PsycINFO, CINAHL, SocINDEX and Embase databases. Eleven relevant studies were identified from an initial search yielding 1,682 results. Studies were assessed using a validated quality assessment tool. RESULTS: Examinations of hypothetical food purchases in artificial environments suggest that menu labelling may be efficacious in reducing calories purchased for or by children and adolescents. Real-world studies are less supportive, although school-based studies were generally positive. It is unclear whether contextual or interpretive menu-labelling formats are more effective compared to numeric calorie information alone. CONCLUSION: Evidence supporting the impact of menu labelling on lowering the energy content of restaurant and cafeteria food choices made for or by children or adolescents is limited. There remains a need for high-quality studies conducted in real-world settings.


Assuntos
Comportamento de Escolha , Ingestão de Energia , Rotulagem de Alimentos/estatística & dados numéricos , Preferências Alimentares , Restaurantes/estatística & dados numéricos , Adolescente , Criança , Humanos , Avaliação de Programas e Projetos de Saúde , Fatores Socioeconômicos
20.
BMC Public Health ; 16: 746, 2016 08 08.
Artigo em Inglês | MEDLINE | ID: mdl-27502505

RESUMO

BACKGROUND: School-based structured opportunities for physical activity can provide health-related benefits to children and youth, and contribute to international guidelines recommending 60 min of moderate-to-vigorous physical activity (MVPA) per day. In 2005, the Ministry of Education in Ontario, Canada, released the Daily Physical Activity (DPA) policy requiring school boards to "ensure that all elementary students, including students with special needs, have a minimum of twenty minutes of sustained MVPA each school day during instructional time". This paper reports on the first provincial study evaluating implementation fidelity to the DPA policy in Ontario elementary schools and classrooms. Using an adapted conceptual framework, the study also examined associations between implementation of DPA and a number of predictors in each of these respective settings. METHODS: Separate cross-sectional online surveys were conducted in 2014 with Ontario elementary school administrators and classroom teachers, based on a representative random sample of schools and classrooms. An implementation fidelity score was developed based on six required components of the DPA policy. Other survey items measured potential predictors of implementation at the school and classroom levels. Descriptive analyses included frequency distributions of implementation fidelity and predictor variables. Bivariate analyses examining associations between implementation and predictors included binary logistic regression for school level data and generalized linear mixed models for classroom level data, in order to adjust for school-level clustering effects. RESULTS: Among administrators, 61.4 % reported implementation fidelity to the policy at the school level, while 50.0 % of teachers reported fidelity at the classroom level. Several factors were found to be significantly associated with implementation fidelity in both school and classroom settings including: awareness of policy requirements; scheduling; monitoring; use of resources and supports; perception that the policy is realistic and achievable; and specific barriers to implementation. CONCLUSIONS: Findings from the surveys indicate incomplete policy implementation and a number of factors significantly associated with implementation fidelity. The results indicate a number of important implications for policy, practice and further research, including the need for additional research to monitor implementation and its predictors, and assess the impacts of study recommendations and subsequent outcomes of a reinvigorated DPA moving forward.


Assuntos
Exercício , Política de Saúde , Promoção da Saúde/métodos , Serviços de Saúde Escolar/estatística & dados numéricos , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Ontário , Professores Escolares , Estudantes
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