Sixty Percent of Foods Advertised in Grocery Store Flyers are Not In-line with Canada's Food Guide.

Purpose: To evaluate foods advertised in discount and premium grocery flyers for their alignment with Canada's 2007 Food Guide (CFG) and assess if alignment differed by food category, season, page location, and price.Methods: Weekly flyers (n = 192) were collected from discount and premium grocery chains from each of 4 seasons. Health Canada's Surveillance Tool was used to assess food items as in-line or not in-line with CFG.Results: Of 35 576 food items, 39.7% were in-line with CFG. There were no differences in proportions of foods not in-line in discount versus premium flyers (60.9% and 60.0%, respectively). Other Foods and Meat & Alternatives were advertised most (28.0% and 26.3%, respectively; P < 0.001). Milk & Alternatives were the least advertised food group (10.3%). Vegetables & Fruit (19.6%), Grains (21.6%), Milk & Alternatives (20.6%), and Meat & Alternatives (20.2%) were promoted least in Fall (P < 0.001). A higher proportion of foods advertised on middle pages were not in-line (61.0%) compared with front (56.6%) and back (58.8%) pages (P < 0.001). Not in-line foods were more expensive ($3.49, IQR = $2.82) than in-line foods ($3.28, IQR = $2.81; P < 0.001).Conclusions: While there was no difference in healthfulness of foods advertised in discount versus premium flyers, grocers advertised more foods not in-line with CFG. Government policies to improve the food environment should consider grocery flyers.

Using the Food Skills Questionnaire (FSQ) to Evaluate a Cooking Intervention for University Students: A Pilot Study.

Purpose: To pilot test the Food Skills Questionnaire (FSQ) to evaluate a cooking intervention.Methods: Students attending Western University were invited to participate in 3 cooking classes over a 3-month period. All participants were asked to complete the FSQ pre- and post-intervention. The FSQ evaluated food skills in 3 domains-Food Selection and Planning, Food Preparation, and Food Safety and Storage-with a maximum score of 100 per domain. Domain scores were then computed as a weighted average for the Total Food Skills Score out of 100. Open-ended questions assessed participants' perceptions of the classes.Results: Forty-four students participated. There was a significant increase in food planning (70.6 ± 13.5-77.6 ± 14.3, P < 0.01), food preparation (67.5 ± 14.0-74.9 ± 12.9, P < 0.01), food safety (78.0 ± 9.9-80.8 ± 13.0, P = 0.04), and total food skills (71.9 ± 8.9-77.8 ± 10.6, P < 0.01) post-intervention. Content analysis of open-ended questions indicated that participants enjoyed healthy recipes, supportive Peer Educators, discussions, the cooking experience, socializing, and the safe environment.Conclusions: The FSQ shows strong potential for evaluating basic (e.g., peeling, chopping, slicing) to intermediate (e.g., meal planning) food skills in an effective and feasible manner. It can also capture changes in specific domains, allowing the development of more focused nutrition education and skills-based interventions.

Participating in Faculty-Supervised Extracurricular Experiential Learning Activities Contributes to Dietetic Competency Development.

Purpose: To examine the relationship between Food and Nutrition graduates' involvement in faculty-supervised extracurricular experiential learning activities (FEEs) and the development of dietetic competencies. Methods: An original web-based survey, assessing involvement in FEEs and self-perceived level of Canadian dietetic competencies, was administered to Brescia University College Food and Nutrition graduates for graduation years 2011-2017. Competency scores were calculated for each respondent in 4 practice areas (Professional Practice, Communication and Collaboration, Population and Public Health, and Management), and summed for a Total Competency Score. Multiple linear regressions were used to assess predictors of competency scores. Results: The final sample consisted of 233 respondents who participated in 1.9 ± 1.1 FEEs. The highest average competency score (out of 100) was Communication and Collaboration (59.7 ± 31.7); the lowest was Management (40.3 ± 30.9). Total hours spent and breadth of experiences in FEEs were significant predictors of all scores (P < 0.05). Depth of experiences was a significant predictor of all competency scores (P < 0.05) except for Management (P = 0.27). Conclusions: Participation in FEEs contributes to Food and Nutrition students' development of entry-level dietetic competencies; therefore, counting some FEEs as curricular credits may be warranted. Given the prominence of competency-based learning assessments, these results also have implications for faculty resources, budgets, and collective agreements.

Predictors of Food Skills in University Students.

Purpose: To determine predictors of food skills in university students, specifically, the relative effects of a food and nutrition (FN) course; sex, age, and body mass index; food-related behaviours in the parental home; and food-related behaviours in university. Methods: Undergraduate students (n = 30 310) at Western University were invited to complete an online cross-sectional survey that assessed 7 components of food skills, from mechanical (e.g., peeling/chopping) to conceptual (e.g., weekly meal planning). The primary outcome measure was Total Food Skills Score (TFSS). All variables that were statistically associated with TFSS (P < 0.05) were analyzed hierarchically in 4 regression models. Results: The sample was comprised of 3354 students living independently for 2.6 ± 1.1 years. Students who had taken an FN course had higher food skills than those who had not (B = 30.72; P < 0.001), and this relationship remained significant through all subsequent models. The strongest predictor of food skills was meal preparation as a teen (B = 25.66; P < 0.001). Frequency of using a grocery list, packing a lunch, and time spent preparing meals on weekends were positively associated with food skills (P < 0.001), whereas frequency of buying pre-prepared meals was negatively associated with food skills (P < 0.001). Conclusions: Food skill development should occur well before young adults begin living independently.

SOCIOECONOMIC STATUS AND ADVERSE BIRTH OUTCOMES: A POPULATION-BASED CANADIAN SAMPLE.

This study assessed the strength of the association between socioeconomic status (SES) and low birth weight (LBW) and preterm birth (PTB) in Southwestern Ontario. Utilizing perinatal and neonatal databases at the London Health Science Centre, maternal postal codes were entered into a Geographic Information System to determine home neighbourhoods. Neighbourhoods were defined by dissemination areas (DAs). Median household income for each DA was extracted from the latest Canadian Census and linked to each mother. All singleton infants born between February 2009 and February 2014 were included. Of 26,654 live singleton births, 6.4% were LBW and 9.7% were PTB. Top risk factors for LBW were: maternal amphetamine use, chronic hypertension and maternal marijuana use (OR respectively: 17.51, 3.18, 2.72); previously diagnosed diabetes, maternal narcotic use and insulin-controlled gestational diabetes predicted PTB (OR respectively: 17.95, 2.69, 2.42). Overall, SES had little impact on adverse birth outcomes, although low maternal education increased the likelihood of a LBW neonate (OR: 1.01).

Point-of-Purchase Labels and Reward Cards Improve Sales of Healthy Foods in University Dining Halls.

PURPOSE: To compare sales of Food Resources and Education for Student Health (FRESH) Approved versus non-FRESH Approved menu cycle items pre- and postimplementation of the FRESH program. METHODS: Sales data from 2011-2015 of FRESH Approved versus non-FRESH Approved menu items were analyzed. Fruit and milk items sold, net sales, and the cost of free fruit and milk redeemed through the FRESH Reward Card (FRC) program, were also analyzed. RESULTS: FRESH Approved items sold more often than non-FRESH Approved items in the latter 2 years (P = 0.01). Prices of FRESH Approved menu items were significantly lower than non-FRESH Approved items for all years (e.g., $1.52 ± $0.94 vs $2.21 ± $1.02 per serving in 2014-2015; P < 0.001). Across all FRESH implementation years, FRESH Approved menu items were found more often on the 6-week menu (P < 0.05). The number of fruit items sold increased from a baseline of 143 052 to 170 954, and net sales increased from $135 450 to $154 248 after 3 years of the FRC implementation. CONCLUSIONS: FRESH Approved items were less expensive, available more often, and had higher sales. The FRC increased net fruit sales despite the cost of free fruit. Highlighting and reducing the cost of healthy foods are promising practices to improve campus food environments.

Parental Reports of Lunch-Packing Behaviours Lack Accuracy: Reported Barriers and Facilitators to Packing School Lunches.

PURPOSE: Parents influence the foods their children consume and often provide proxy reports of this intake. One way parents exert this influence is by providing home-packed lunches. This study compared parental reports of foods packed in children's lunches with what was actually packed and identified parental barriers and facilitators to packing lunches. METHODS: Grade 3 and 4 student-parent dyads (n = 321) in 19 elementary schools in Ontario participated. Parental reports and actual packed lunch contents were collected via self-administered surveys and direct observation, respectively. Parental barriers and facilitators were obtained through open and closed survey questions. RESULTS: Median portions packed were significantly higher for sugar-sweetened beverages and snacks and significantly lower for fruits, fruit juice, vegetables, milk/alternatives, and meat/alternatives than parents reported. Packing a healthy lunch was "important/very important/of the utmost importance" for 95.9% of respondents, and 97.5% perceived their nutrition knowledge as "adequate/good/very good". Barriers to packing a lunch included: child's food preferences, time, finances, allergy policies, and food safety. Nutrition resources, observing other children's lunches, child's input, and planning ahead were identified as facilitators. CONCLUSIONS: Strategies to improve packed lunches should move beyond parental nutrition knowledge and importance of lunch packing to address parental barriers and facilitators.

Self-reported food skills of university students.

University students experience a life transition that often results in poor dietary behaviors and weight gain. Adequate food skills may improve diet quality and prevent chronic disease. Research is limited, however, on students' food skills and food-related behaviors. The objective of this study was to assess whether self-perceived food skills and related behaviors of students at a large, Canadian university differed based on sex, having taken a Food and Nutrition (FN) course, and living conditions, using a cross-sectional online survey. The response rate was 21.9% (n = 6638). Students (age, M ± SD 19.9 ± 2.1 years) self-reported their abilities for seven distinct food skills. Students rated (out of 100) their ability for some skills significantly higher than others (79.7 ± 20.9 for peeling, chopping, and slicing vs. 56.1 ± 29.1 for weekly meal planning; p < 0.001). Females reported higher total food skill scores than males (487.0 ± 141.1 out of a possible 700 vs. 441.9 ± 151.8, respectively; p < 0.001). Respondents who had taken a FN course reported higher total food skill scores than those who had not (494.9 ± 137.0 vs. 461.9 ± 149.2; p < 0.001). Students who resided away from their parental home for longer than one year reported significantly higher total food skill scores than those living away for one year or less (488.9 ± 134.6 vs. 443.3 ± 153.0, respectively; p < 0.001). Results indicate that students' self-perceived food skills vary by sex, FN education, and living condition. Higher abilities were reported for mechanical food skills; conceptual skills were significantly lower. These results may assist in effectively targeting this population with nutrition education interventions.

Students' Food Intake from Home-Packed Lunches in the Traditional versus Balanced School Day.

PURPOSE: To assess the type and quantity of foods children brought and consumed at school in the balanced school day (BSD), with two 20-minute eating periods, versus the traditional schedule (TS), with one 20-minute lunch. METHODS: Direct observation identified food items and amounts in BSD and TS lunches of grade 3 and 4 students (n = 321). RESULTS: The mean (SD) servings of foods packed in BSD lunches were significantly higher than the TS lunches for milk and alternatives (0.69 (0.70) vs 0.47 (0.49), P = 0.02), sugar-sweetened beverages (SSBs; 0.91 (1.24) vs 0.57 (0.99), P = 0.01), and snacks (2.74 (1.55) vs 2.24 (1.48), P < 0.01). Regardless of schedule, only 40.8% of students had vegetables packed in their lunch, whereas 92.8% had snacks. When comparing foods eaten, SSBs and snacks remained significantly higher in the BSD (0.75 (1.02) vs 0.48 (0.83), P = 0.03; 2.37 (1.44) vs 1.93 (1.36), P = 0.01, respectively). The proportion of children (%) whose consumption met one-third of Canada's Food Guide recommendations for vegetables and fruit was low (27.5% BSD, 31.0% TS). CONCLUSIONS: The BSD may have unintended negative consequences on the type and amount of foods packed in school lunches. Support for families should focus on encouraging more vegetables and fruit and fewer SSBs and snacks in packed lunches.

Dietitians' Attitudes and Beliefs Regarding Peer Education in Nutrition.

PURPOSE: Peer education (PE) has been used effectively in nutrition; however, research examining dietitians' attitudes regarding PE is lacking. METHODS: An online survey was sent to a random sample of 1198 Dietitians of Canada members to assess attitudes regarding PE by practice area. RESULTS: A representative sample of dietitians by practice area and location was obtained (n = 229; 19%). Their total attitude score (TAS) was 226 ± 26 (mean ± SD) out of 295 (maximum). Community/public health dietitians had significantly higher TASs compared with clinical dietitians (234 ± 23 vs. 221 ± 27, respectively; P = 0.03). Dietitians believed PE to be most useful in community settings (P < 0.001), with cultural groups or adolescents (P < 0.001), and for healthy eating program goals (P < 0.001). The barrier most agreed with was limited financial resources, whereas the highest perceived benefits were social support and experience/employment for participants and peer educators, respectively. Overall, 63% agreed PE is an effective model, and 59% agreed that PE should be used more often in nutrition. CONCLUSIONS: Dietitians have a positive attitude towards PE, with community/public health dietitians having the most positive attitudes. Dietitians believe PE is useful with specific target populations and particular program goals/strategies; however, they could be challenged to consider PE in a greater variety of programs.

Canadian Registered Dietitians' Utilization of the 2018 Diabetes Canada Nutrition Therapy Clinical Practice Guidelines: A Cross-sectional Study.

OBJECTIVES: Our aim in this work was to ascertain Canadian registered dietitians' (RDs) use of the 2018 Diabetes Canada nutrition therapy (NT) recommendations and to identify the degree of agreement with facilitator-to-use statements. METHODS: A national 28-item anonymous cross-sectional survey of RDs who counsel people with diabetes was conducted. RESULTS: Three hundred sixty RDs responded to the survey, but some questions had fewer responses. Mean age of respondents was 36.8±10.1 years and 51.3% were certified diabetes educators (CDEs). Energy/macronutrient recommendations used most were regular timing/spacing of meals (85%), 30 to 50 g/day dietary fibre intake (71%), and maintaining a low glycemic index (65%). Mediterranean and Dietary Approaches to Stop Hypertension (DASH) dietary patterns had similar utilization rates as macronutrient distribution ranges, at 50% to 60%. Specific food recommendations were used most often, with the emphasis on fruits/vegetables and whole grains at 92% and 86%, respectively. Of the special considerations for people on insulin, regular meals/meal spacing was the recommendation used most often (88%). The statements "I trust the content …" and "I understand the scientific basis …" of the NT chapter were the internal facilitators most agreed with, at 86% each. The least agreed upon external facilitators were "my workplace encourages me to use the NT chapter," at 54%, and "I learned about the NT chapter in my formal education," at 44%. CDEs had significantly higher agreement on 12 of the 21 facilitator statements compared with non-CDEs. CONCLUSIONS: Canadian RDs are utilizing the NT guidelines, including the new dietary patterns. Simple, easy-to-implement recommendations, such as specific foods and timing/spacing of meals, were used most frequently. Opportunities for increased use could include encouraging dietetic training programs and worksites to promote utilization of CPGs in practice.

Factors That Predict Food Skills in Canadian Gym Members: A National Cross-Sectional Survey.

This study determined predictors of food skills in Canadian gym members. A random sample of gym members were invited to complete a validated Food Skills Questionnaire with supplementary questions. All questions/variables significantly associated (p < 0.05) and fair-to-moderately correlated (r ≥ 0.40) with Total Food Skills (TFSs) were analyzed by multiple regression. The respondents' (n = 576) mean ± SD age was 41.3 ± 14.8 years, with 67.3% females and 13.2% students. The mean TFSs score was 77.1 ± 11.9 (maximum 100). Females reported higher TFSs than males; however, this did not remain significant when nutrition-related beliefs were considered. Increasing age, taking a nutrition/cooking course, teen meal preparation, primary cook, time preparing weekend meals, believing that preparing healthy food is important, and self-reported nutritional quality of diet and nutrition knowledge were positively associated with TFSs (p < 0.05). Purchasing food/beverages from convenience stores, buying pre-prepared dinners, and being a student were negatively associated with TFSs (p < 0.05). The strongest predictors of TFSs were self-reported nutrition knowledge and nutritional quality of diet. The adjusted R2 increased by 0.30 when food-related experiences/behaviours and nutrition-related beliefs were included in the final model, which accounted for 50% of the variance in TFSs. Food experiences/behaviours and nutrition beliefs, which are associated with food skills, are potential intermediary targets for programs and/or research to improve food skills.

Children's School-Day Nutrient Intake in Ontario: A Cross-Sectional Observational Study Comparing Students' Packed Lunches from Two School Schedules.

This study compared the caloric and nutrient values of packed lunch contents and consumption in the Balanced School Day (BSD) (two 20 min eating periods) versus the Traditional Schedule (TS) (one 20 min lunch). Foods consumed during school were assessed by direct food observation in 321 grade 3 and 4 students, aged 7−10 years, at 9 BSD and 10 TS elementary schools in Ontario. Packed lunch contents in the BSD were significantly higher than the TS in energy (3128.14 ± 1100.36 vs. 2658.98 ± 951.34 kJ, p < 0.001, respectively). Similarly, carbohydrates, total sugar, protein, fat, saturated fatty acids (SFA), calcium, iron, and sodium were significantly higher in the BSD versus TS packed lunches. Correspondingly, students in the BSD consumed significantly more energy, carbohydrates, total sugar, and SFA compared to the TS. Overall, lunches brought by students in the BSD schedule provided more energy across all macronutrients, with only a few micronutrients showing increased amounts, suggesting two 20 min eating opportunities could contribute to excess caloric intake during school, potentially contributing to the prevalence of childhood overweight and obesity in Canada. Furthermore, packed lunches in both schedules had excess amounts of nutrients of concern and much work is needed to ensure that children in Canada receive nutritious lunches at school.

Validity and Reliability of a Food Skills Questionnaire.

OBJECTIVE: Develop, validate, and assess reliability of a food skills questionnaire. DESIGN: Phase 1: Questionnaire development categorized questions into domains (Food Selection and Planning, Food Preparation, and Food Safety and Storage). Phase 2: Content validity included expert panel quantitative and qualitative feedback. Phase 3: Face validity involved pilot testing. Phase 4: Reliability assessed test-retest and inter-item reliability. SETTING: Phase 1: The authors developed a draft questionnaire in London, Ontario, Canada. PARTICIPANTS: Phase 2: Dietitians, home economists, academics, and chefs completed content validity (n = 17; 57% response rate). Phase 3: A convenience sample of students completed face validity (n = 20; 17% response rate). Phase 4: Randomly selected students completed test-retest reliability (time 1: n = 189, time 2: n = 165; 9% response rate). MAIN OUTCOME MEASURES: Lawshe content validity ratio, Lawshe content validity index, intraclass correlation coefficients (ICCs), and Cronbach α. ANALYSIS: Test-retest reliability was evaluated using ICC, and inter-item reliability by Cronbach α coefficient. RESULTS: In phase 2, Lawshe content validity index was 0.80 (90% expert panel consensus). In phase 3, 85% of respondents identified the main construct. In phase 4, Cronbach α coefficients were .67-.88 for domains and .90 for the questionnaire overall, and ICC scores ranged from 0.67-0.92 for questions, 0.86-0.93 for domains, and 0.92 for the questionnaire overall. CONCLUSIONS AND IMPLICATIONS: This questionnaire demonstrated strong content validity, face validity, test-retest reliability, and good inter-item reliability. It is appropriate for evaluating food skills in a population with basic to intermediate skills (eg, young adults).

Impact of the Balanced School Day on Glycemic Control in Children with Type 1 Diabetes.

OBJECTIVE: The balanced school day (BSD) is an alternative elementary school schedule whereby children have 2 20-minute eating periods instead of 1 20-minute lunch, as is found in the traditional schedule (TS). We assessed the glycated hemoglobin (A1C) levels of children with type 1 diabetes in the TS vs. the BSD because 2 eating periods have the potential to impact blood glucose control. METHODS: A1C levels representative of the summer months (SumA1C) and A1C levels occurring at least 3 months after the start of the school year (SchA1C) were obtained retrospectively. A parental survey of perceptions of lunch planning, activity levels and diabetes management at school was also completed. RESULTS: Our sample included 97 students (TS=42, BSD=55). The mean age ± SD was 10.9±2.6 and 10.1±2.8 years in the TS and BSD, respectively (p=0.12). Sex distribution was not statistically different; 54% were female in TS vs. 36% in BSD; p=0.08. SumA1C was similar in the 2 groups (TS: 8.3±1.1% vs. BSD: 8.0±0.8%; p=0.08). There was a significant within-group increase from SumA1C to SchA1C in the BSD group only (p=0.001), with mean A1C values increasing from 8.0%±0.8% to 8.5%±1.0% in the BSD group compared to no significant increase in the TS group. Parental perceptions of lunch planning, physical activity and diabetes management were similar, regardless of school schedule. CONCLUSIONS: Children with type 1 diabetes in the BSD appear to have worse diabetes control during the school year compared to the summer, which is not evident in children in the TS. Additional school supports may assist students in the BSD.

University Students Intend to Eat Better but Lack Coping Self-Efficacy and Knowledge of Dietary Recommendations.

OBJECTIVE: To assess university students' knowledge, intentions, and coping self-efficacy related to dietary recommendations. DESIGN: The study used a cross-sectional online survey. SETTING: Large university campus. PARTICIPANTS: Students (n = 6,638; 22% response). VARIABLES MEASURED: Self-efficacy and intentions were measured using 11-point scales. Students' perceived dietary recommendations were evaluated as correct or incorrect. ANALYSIS: Categorical variables were analyzed using chi-square and continuous variables by t tests or ANOVAs. Significance was set at P ≤ .05 and multiple comparisons at P ≤ .01. RESULTS: Respondents believed that they need fewer vegetables and fruit and more milk or alternatives servings/d than recommended; eg, males aged ≥ 19 years perceived milk or alternatives recommendations to be 4.3 ± 2.1 servings/d, significantly more than the 2 servings/d recommended (P < .001). Students in health sciences or with a food or nutrition course were significantly more likely to claim that they met recommendations (eg, 56% with vs 47% without a food or nutrition course for vegetables and fruit; P < .001); however, they were no more likely to identify them correctly. Males aged < 19 years had higher coping self-efficacy than females aged < 19 years to consume vegetables (68.3 ± 24.2 vs 64.0 ± 24.7; P < .01) and avoid high-calorie foods and beverages (HCFB) (56.2 ± 27.2 vs 49.0 ± 25.2; P < .01) when under stress; however, they had significantly lower intentions to consume vegetables (72.1 ± 24.5 vs 80.9 ± 20.3; P < .01) and avoid HCFB (60.5 ± 30.3 vs 77.7 ± 22.8; P < .01). CONCLUSIONS AND IMPLICATIONS: Students do not have adequate knowledge of age- and sex-specific food guide recommendations. Simpler food guide recommendations or age- and sex-targeted campaigns may enhance knowledge. Students intend to consume more vegetables and less HCFB; however, they have low coping self-efficacy, all of which could be targeted in nutrition interventions.

Factors that influence excessive gestational weight gain: moving beyond assessment and counselling.

One in four Canadian adults is obese, and more women are entering pregnancy with a higher body mass index (BMI) than in the past. Pregnant women who are overweight or obese have a higher risk of pregnancy-related complications than women of normal weight. Gestational weight gain (GWG) is also associated with childhood obesity. Although the factors influencing weight gain during pregnancy are multifaceted, little is known about the social inequality of GWG. This review will address some of the socioeconomic factors and maternal characteristics influencing weight gain and the impact that excessive GWG has on health outcomes such as post-partum weight retention. The effects of an overweight or obese pre-pregnancy BMI on GWG and neonatal outcomes will also be addressed. The timing of weight gain is also important, as recommendations now include trimester-specific guidelines. While not conclusive, preliminary evidence suggests that excessive weight gain during the first trimester is most detrimental.

Is the Balanced School Day truly balanced? A review of the impacts on children, families, and school food environments.

BACKGROUND: The Balanced School Day (BSD) is a scheduling policy that has the potential to impact children's food behaviors because students are provided with two 20-minute eating opportunities versus the traditional 20-minute lunch. METHODS: We aim to raise awareness of this grassroots academic policy and its potential consequences to inform future decision making and minimize potential unintended negative health consequences. RESULTS: While there is limited research on this schedule, it has been shown that there is less time lost in transition from classroom to recess. Perception surveys have shown that principals and custodians are the most satisfied, followed by parents, teachers, and secretaries, with students being the least satisfied. The BSD is also perceived to improve organization of instructional time, playground cleanliness, and student concentration. Despite these purported benefits, there is limited data on the impact of the BSD on children's eating habits, physical activity, and body mass index (BMI). While 1 study reported fewer pedometer-measured step counts during breaks in the BSD, more research is needed on the impact of this alternative schedule on children's food intake and BMI. CONCLUSIONS: School and public health professionals must advocate for "health impact assessments" to assess the health effects of this policy.

Postprandial lipemia in subjects with the threonine 54 variant of the fatty acid-binding protein 2 gene is dependent on the type of fat ingested.

BACKGROUND: The alanine-for-threonine substitution at codon 54 (A54T polymorphism) in the fatty acid-binding protein 2 gene (FABP2) has been associated with hypertriglyceridemia and insulin resistance. Obese and diabetic T54 carriers have greater postprandial lipemia than do A54 homozygotes. The T54 protein isoform is also associated with increased triacylglycerol secretion in vitro. OBJECTIVE: We investigated diet-gene interactions by measuring postprandial lipids, glucose, insulin, and C-peptide in healthy, nonobese A54 homozygotes and T54 carriers after ingestion of 3 different fats. DESIGN: Eleven A54 homozygotes and 11 T54 carriers were given 3 oral-fat-tolerance tests (butter, safflower oil, and olive oil). Cholesterol and triacylglycerol were measured in plasma and in chylomicron fractions. RESULTS: There was no main effect of FABP2 genotype for chylomicron triacylglycerol, glucose, or C-peptide. The area under the insulin curve and the ratio of insulin to C-peptide were lower in T54 carriers than in A54 homozygotes [312 +/- 29 ( +/- SEM) compared with 425 +/- 31 pmol. h/L (P = 0.05) and 0.23 +/- 0.03 compared with 0.40 +/- 0.05 (P = 0.04), respectively], which suggests greater hepatic insulin clearance in T54 carriers. An association between genotype and chylomicron cholesterol was seen only after olive oil: values were higher (P = 0.02) in T54 carriers (0.087 +/- 0.006 mmol. h/L) than in A54 homozygotes (0.058 +/- 0.004 mmol. h/L). The main effect of fat was significant for the areas under the chylomicron cholesterol and chylomicron triacylglycerol curves [higher values for safflower (0.635 +/- 0.053 and 2.48 +/- 0.30 mmol. h/L, respectively) and olive (0.592 +/- 0.052 and 2.48 +/- 0.32 mmol. h/L, respectively) oils than for butter (0.425 +/- 0.043 and 1.69 +/- 0.20 mmol. h/L, respectively); P < 0.05]. CONCLUSIONS: The A54T polymorphism results in a diet-gene interaction: the T54 group had increased chylomicron cholesterol after olive oil only. Nevertheless, the greater hepatic insulin clearance in T54 carriers suggests that the polymorphism may not be deleterious in nonobese subjects.

Development and implementation of FRESH--a post-secondary nutrition education program incorporating population strategies, experiential learning and intersectoral partnerships.

OBJECTIVES: The FRESH (Food Resources and Education for Student Health) peer nutrition education program engages undergraduate and graduate students in experiential learning to improve the campus food and nutrition environment and promote healthy behaviours among university students. TARGET POPULATION: University students in general, and graduate and undergraduate food and nutrition students as program designers and peer educators, respectively. SETTING: Large university campus in southwestern Ontario. INTERVENTION: A peer nutrition education program, utilizing multiple population strategies and intersectoral partnerships, was created by and for university students with faculty and food service personnel as mentors. The population health strategies employed were building awareness and program branding; developing personal skills through peer nutrition education and hands-on cooking demonstrations; and creating supportive environments through incentive programs for fruit and dairy as well as point-of-purchase menu labelling. OUTCOMES: The program has reached students, staff and faculty through over 60 interactive FRESH displays and education sessions. Website and social media have also had a significant reach with over 4,000 website visits and 277 Facebook "likes". FRESH has also improved the food environment for over 5,000 students in residence, e.g., 1,931 FRESH Fruit/Dairy Cards have been returned for free fruit/milk cartons. Graduate students in Foods and Nutrition continue to participate every year (cumulative n=60) in ongoing program development. Peer educators have developed enhanced leadership, public speaking and group facilitation skills, and the ability to creatively apply what they have learned in the classroom to new contexts. CONCLUSION: Increased nutrition knowledge and an improved food environment could, over the long term, support improved university student health.