bluuebunny/crossref_metadata_2025 huggingface dataset:
Dietary Counselling for Dyslipidemia in Primary Care: Results of a Randomized Trial
Authors: Reid Robert , Fodor George , Lydon-Hassen Kathleen , D'Angelo Monika Slovinec , McCrea Jennifer , Bowlby Mary , Difrancesco Loretta
Published: May 2007

This study compared the effectiveness of physician advice versus dietitian advice for a fat-reduced diet, and of dietitian advice for a fat-reduced diet versus a soluble fibre-enhanced diet in patients with moderate dyslipidemia. A total of 111 men and women took part in this 26-week, three-group, randomized, clinical trial. The physician advice fat-reduced diet group (n = 38) and the dietitian advice fat-reduced diet group (n = 35) received dietary advice based on the American Heart Association (AHA) Step II guidelines. The dietitian advice soluble fibre-enhanced diet group (n = 38) consumed one-third cup per day of psylliumcontaining cereal and was advised to increase soluble fibre intake to over 10 grams a day. LDL-C, TC/HDL-C ratio and body weight reductions over six months were –5.3%, –4.6%, and –1.9%, respectively, regardless of whether a physician or a dietitian provided advice, or whether advice was focused on a fat-reduced diet or a soluble fibre-enhanced diet. Both dietitians and physicians can help moderately dyslipidemic patients make clinically meaningful changes in blood lipid levels. Soluble fibre enhancement of the usual diet leads to similar reductions in LDL-C and TC/HDL-C ratio compared to interventions focused on fat reduction.
Dietary reference intakes:A comparison with the Nova Scotia Nutrition Survey
Authors: Fitzgerald Angela L. , Maclean David R. , Veugelers Paul J.
Published: May 2007

The purpose of this study was to compare the newly released dietary reference intakes with the 1990 Nova Scotia Nutrition Survey and identify characteristics that influence compatibility with these new recommendations. For each of 17 nutrient recommendations, we calculated the proportion of participants who consumed intakes within the recommended range. We constructed a score reflecting overall compatibility between the new recommendations and the Nova Scotia Nutrition Survey data. Using this score as the dependent variable, we conducted multivariate regression analysis to evaluate the importance of demographic and behavioural factors for compatibility with the dietary reference intakes. Results indicate that compatibility with the dietary reference intakes was poor among Nova Scotians, particularly for magnesium, vitamins C and E, and macronutrients. Compatibility was lower among females than among males, and differed independently by age, body mass index, socioeconomic factors, smoking status, and alcohol consumption. Dietary intervention is needed in Nova Scotia. Reduced fat intake and increased intake of specific vitamins should be promoted. We recommend that nutrition education campaigns coinciding with the introduction of the dietary reference intakes in Nova Scotia target younger people, those of lower socioeconomic background, smokers, and those who are obese.
Dietary Adequacy of the Rotary Diversified Diet:As a Treatment for “Environmental Illness”
Authors: Taylor Jennifer P. , Krondl Magdalena M. , Spidel Mark , Csima Adele C.
Published: May 2007

The rotary diversified diet, used in the management of environmental illness, consists of eliminating prohibited foods from the diet and rotating remaining non-prohibited foods and their “food families” within a regular cycle. We assessed the adequacy of nutrient intakes in 22 women prescribed the diet, described the nature of supplement use, and assessed the relationship between adherence and nutrient intake levels. Except for calcium and folacin intakes, mean nutrient intakes met or exceeded recommended levels. No subjects had calcium intakes above the adequate intake for calcium; 72.7% had folate intakes below the estimated average requirement. Intakes of other nutrients, except thiamin and magnesium, were below the estimated average requirement in less than 25% of the sample; 31.8% and 45.5% of subjects, respectively, had thiamin and magnesium intakes at this level. Those who adhered more closely to the rotary diversified diet had higher intakes of vitamin C, vitamin B6, folate, and fibre than did those who followed the diet less closely. Supplements conferred some nutritional benefits; however, supplemental niacin and magnesium intakes exceeded tolerable upper intake levels. Those prescribed the rotary diversified diet require nutrition counselling from dietitians to cope with the complexity and restrictiveness of the diet.
A Nutrition and Behaviour Change Group For Patients with Anorexia Nervosa
Authors: Waisberg Jodie L. , Woods Marie T.
Published: May 2007

A pilot outpatient group for patients with anorexia nervosa was developed and co-led by a dietitian and a psychologist on a general hospital eating disorders team. The main goal of the short-term nutrition and behaviour change group was weight gain through normalization of eating. The first three groups conducted in the clinic were evaluated by monitoring group members’ weights, collecting pre-treatment and post-treatment scores on the Eating Attitudes Test-26, and comparing earlier and later food records. The mean (+/− standard deviation) patient weight gain per eight-week group cycle was 1.6 (+/− 1.9) kg (p<0.05) and the Eating Attitudes Test-26 score change was −17.1 (+/− 11.5) points (p<0.01). Statistically significant changes were found in consumption of calories (p<0.01), fat (p<0.005), and protein (p<0.02). This treatment approach warrants further refinement and investigation.
Dietary Intake of Older Adultsin the Kingston Area
Authors: Dewolfe Judith , Millan Kristine
Published: May 2007

The objectives of this research were to describe the dietary intake and identify risk factors for poor dietary intake in communitydwelling older adults living in the Kingston, Frontenac, and Lennox & Addington Health Unit area. Dietary intake information was collected from a convenience sample of 105 relatively healthy, active older adults (84 women, 21 men) using 24-hour recalls from three non-consecutive days. Risk factors for poor dietary intake were identified through a structured interview. Multiple linear regression was used to generate a model to predict dietary intake, which was measured using a diet score based on Canada’s Food Guide to Healthy Eating. Group averages reflected reasonable diet quality, but some subjects had very low nutrient intakes, particularly of zinc and vitamins B6, B12, and C. On average, women had a lower-than-recommended intake from all food groups, while men consumed adequate amounts of all food groups except milk products. Higher scores indicated better overall diet quality, and the following were significant predictors of a high diet score: “almost always” preparing one’s own meals, food “almost always” or “sometimes/never” tasting good, eating lunch every day, and taking fewer prescription medications. This model requires validation with a larger and more diverse population of community-dwelling older adults.
Determining How Low-Income Food Shoppers Perceive, Understand, and Use Food Labels
Authors: Sullivan Ann D.
Published: May 2007

A facilitated group discussion approach was used to explore how a group of eight low-income consumers perceive, understand, and use the current food label for food-shopping decisions. Meeting for one hour on three consecutive weeks in a community facility, the group discussed the total food package, the ingredient list alone and in combination with the nutritioninformation panel, and nutrition claims. All sessions were recorded and later transcribed verbatim. Through inductive analysis, three broad categories (brand name, package feature, and nutritionrelated information) and numerous underlying themes emerged from the data; a theoretical framework was proposed to explain the data and provide future direction. A number of barriers to effective use of the food label were identified, and some actionable tips for dietetic practice were suggested.
Protein and Bone Health:Literature Review and Counselling Implications
Authors: Cloutier Gilles R. , Barr Susan I.
Published: May 2007

For decades, public health promotion campaigns on bone health have emphasized the importance of adequate calcium and vitamin D intakes, as well as weight-bearing physical activity. However, no obvious consensus has emerged on the role of dietary protein. To identify what agreement does exist in the literature, in this article we review the theoretical basis for protein’s role in bone health, assess some recent cross-sectional and prospective studies, and generate recommendations for practice. There is general agreement in the literature that higher protein intake increases urinary calcium loss; the body compensates for this loss by increasing calcium absorption in the gut, providing that calcium intake is sufficient. A possible explanation for calcium loss, the “acid-ash” hypothesis, is discussed, and suggestions are made about food choices that may counter the calciuric effect of protein. A survey of cross-sectional and prospective studies shows equivocal results, with confounding variables complicating the analysis. Both deficient and excessive protein intakes have been shown to affect bone health negatively, although lower and upper thresholds have not been determined. Practical advice on achieving bone health is given, with an emphasis on the use of Canada’s Food Guide to Healthy Eating in setting dietary goals.
Consumer Food Handling Recommendations: Is thawing of turkey a food safety issue?
Authors: Lacroix Bonnie Jeannette , Man Li Kelly Wing , Powell Douglas Alan
Published: May 2007

While it is important that dietitians and other health or food professionals provide consistent messages to the public about food safety, it is equally important that the information be evidencebased. Conflicting recommendations are evident when reviewing consumer publications from food safety advisory groups and the scientific literature. In addition, caveats are attached to the various food-handling methods. Pathogens, spoilage microorganisms, and contamination of the work area are the major concerns in thawing turkey. While several methods, including thawing on the counter at ambient temperatures, can be employed for thawing turkey, cooking to an adequate internal temperature, validated with a meat thermometer, is the more critical step. The findings indicate that providing clients or consumers with clear, consistent, evidence-based messages is difficult for food and health professionals. Further research is required to corroborate best practices in a kitchen setting. This paper is of interest to professionals who counsel clients at high risk for foodborne illness, or who counsel consumers about safe preparation of foods such as turkey.
A New Food GuideFor North American Vegetarians
Authors: Messina Virginia , Melina Vesanto , Mangels Ann Reed
Published: May 2007

This companion paper to the Position of the American Dietetic Association and Dietitians of Canada: Vegetarian Diets, presents a new food guide for vegetarians. Two graphic formats are presented, a rainbow and a pyramid. The guide will assist vegetarians in choosing diets that meet recent recommendations established by the Institute of Medicine for nutrients including protein, iron, zinc, calcium, vitamin D, riboflavin, vitamin B-12, vitamin A, omega-3 fatty acids, and iodine. The guide can be adapted for different types of vegetarian diets and includes a wide variety of foods commonly used by vegetarians. The guide is based on the following food groups: Grains; Vegetables; Fruits; Legumes; nuts, and other protein-rich foods; Fats; and Calcium-rich foods. The Calcium-rich foods food group is planned to offer expanded choices for calcium sources and includes foods from each of the other food groups. Specific guidelines are given for meeting requirements for vitamins B-12 and D. Modifications are provided to meet needs of different stages of the life cycle. This vegetarian food guide has a number of advantages including the promotion of variety and moderation within the context of vegetarian diets, a focus on foods commonly consumed by vegetarians, and a foundation in current nutritional science.
Practice Guidelines: Pedantic Pontification or Pragmatic Progress? 2003 Ryley-Jeffs Memorial Lecture
Authors: Brauer Paula M.
Published: May 2007

Development and use of practice guidelines is one strategy to assist health professionals in translating research into practice. There has been a significant growth in the number of practice guidelines developed, with the increased focus on justifying health care costs and demonstrating outcomes. Quality and influence on established practice, however, has sometimes been lacking. Recognizing both the importance of practice guidelines and some of the controversies surrounding their quality and use, Dietitians of Canada convened a task group to make recommendations on future development. They reviewed the practice guideline programs of others and identified the key elements needed to ensure any dietetics-produced guidelines would be credible, feasible and applicable to clinical counselling, administration and community health promotion. In this memorial lecture, the chair of that task group briefly reviews the history of dietetic practice guidelines, new innovations in systematic review and consensus development methods, and specifically the Delphi process used to develop a new Dietetic Practice Guidelines Framework. The 34 elements of the framework direct overall management of the guideline development process, including topic nomination, systematic literature review, group judgment, and pilot testing.
Diet Quality Among Older QuebecersAs Assessed By Simple Indicators
Authors: Shatenstein Bryna , Nadon Sylvie , Ferland Guylaine
Published: May 2007

To determine whether older Quebecers are eating adequately and whether summary scores represent diet quality, a representative subset of participants aged 55 to 74 (weighted n=460, 47% male) was studied from the 1990 Enquête québécoise sur la nutrition dataset. Participants’ diet quality was scored from adjusted 24-hour recalls. Foods were coded into Canada's Food Guide to Healthy Eating food groups. Usual Dietary Adequacy Score (maximum=18) and Dietary Diversity Score (maximum=4) were calculated from adjusted food guide portions and validated internally in relation to achievement of nutrient recommendations using correlation analysis. Average usual Dietary Adequacy Score (mean ± standard error) was 14.96 ± 0.15 (men) and 13.72 ± 0.15 (women). Only 7% of men and 1% of women achieved the maximum usual score. Fortyfour percent of men and 45% of women scored a usual Dietary Diversity Score of 3, and 55% of men and 50% of women achieved 4. Thus, approximately half of older Quebecers showed inadequate dietary variety, and consumed fewer than the minimum recommended number of servings from certain food groups. Summary diet quality indicators are useful for tracking diet quality, and provide critical data for planning nutrition education programs targeting older persons.
Eat Smart! Ontario's Healthy Restaurant Program: A Survey of Participating Restaurant Operators
Authors: Macaskill Lesley A. , Dwyer John J.M. , Uetrecht Connie L. , Dombrow Carol
Published: May 2007

Eat Smart! Ontario's Healthy Restaurant Program is a standard provincial health promotion program. Public health units grant an award of excellence to restaurants that meet designated standards in nutrition, food safety, and non-smoking seating. The purpose of this study was to assess whether program objectives for participating restaurant operators were achieved during the first year of program implementation, and to obtain operators’ recommendations for improving the program. Dillman's tailored design method was used to design a mail survey and implement it among participating operators (n = 434). The design method, which consisted of four mail-outs, yielded a 74% response rate. Fifty percent of respondents operated family-style or quick-service restaurants, and 82% of respondents learned about the program from public health inspectors. Almost all respondents (98%) participated in the program mainly to have their establishments known as clean and healthy restaurants, 65% received and used either point-of-purchase table stands or postcards to promote the program, and 98% planned to continue participating. The respondents’ suggestions for improving the program were related to the award ceremony and program materials, media promotion, communication, education, and program standards. Program staff can use the findings to enhance the program.
Eat Smart! Ontario’s Healthy Restaurant Program: Focus Groups With Non-participating Restaurant Operators
Authors: Dwyer John J.M. , Macaskill Lesley A. , Uetrecht Connie L. , Dombrow Carol
Published: May 2007

Eat Smart! Ontario’s Healthy Restaurant Program is a standard provincial health promotion program. Public health units give an award of excellence to restaurants that meet nutrition, food safety, and non-smoking seating standards. The purpose of this study was to determine why some restaurant operators have not applied to participate in the program, and how to get them to apply. Four focus group interviews were conducted with 35 operators who didn’t apply to participate. The analysis of responses yielded various themes. The participants’ perceived barriers to participation were misunderstandings about how to qualify for the program, lack of time, concern about different non-smoking bylaw requirements, and potential loss of revenue. Their perceived facilitators to participation were convenience of applying to participate, franchise executives’ approval to participate, a 100% non-smoking bylaw, flexibility in the assessment of restaurants, the opportunity for positive advertising, alternative payment for food handler training, and customer demand. Program staff can use the findings to develop and use strategies to encourage participation.
Implementing the British Columbia Nutrition Survey: Perspectives of Interviewers and Facilitators
Authors: Wassink Heather L. , Chapman Gwen E. , Levy-Milne Ryna , Forster-Coull Lisa
Published: May 2007

The British Columbia Nutrition Survey was the last of ten provincial nutrition surveys completed between 1988 and 1999. A qualitative process evaluation was conducted to identify strengths and weaknesses of British Columbia Nutrition Survey procedures, as perceived by 27 public health nurses and dietitians directly involved in data collection. Data for the process evaluation were collected through in-depth telephone interviews, during which interviewers and facilitators described their experiences working for the survey. Qualitative analysis of interview transcripts identified codes that were then organized into eight categories, including issues arising from interviewer and facilitator training, challenges in recruiting survey participants, reflections on safety for survey personnel and participants, facilitators’ key role, the flexibility required to implement the protocol, and communication within the survey research team. Two final categories related to rewarding aspects of the job: insights affecting professional practice, and meeting survey participants and personnel. Evaluation findings show the importance of establishing open communication between research planners and those conducting surveys. This communication is needed to ensure that workers’ needs are met, the quality of the study is maximized, and evaluations of study protocols include the perspectives of those directly involved in data collection.
Fruit and Vegetable Consumption:Benefits and Barriers
Authors: MacLellan Debbie L. , Gottschall-Pass Katherine , Larsen Roberta
Published: May 2007

Few people on Prince Edward Island meet the goal of consuming five or more servings of vegetables and fruit a day. The main objective of this qualitative study was to explore the perceptions of the nutritional benefits and barriers to vegetable and fruit intake among adult women in Prince Edward Island. Participants were 40 women aged 20-49, with or without children at home, who were or were not currently meeting the objective of eating five or more fruit and vegetable servings a day. In-home, one-on-one interviews were used for data collection. Thematic analysis was conducted on the transcribed interviews. Data were examined for trustworthiness in the context of credibility, transferability, and dependability. Most participants identified one or more benefits of eating fruit and vegetables; however, comments tended to be non-specific. The main barriers that participants identified were effort, lack of knowledge, sociopsychological and socioenvironmental factors, and availability. Internal influences, life events, and food rules were identified as encouraging women to include vegetables and fruit in their diets. Given the challenges of effecting meaningful dietary change, dietitians must look for broader dietary behavioural interventions that are sensitive to women's perceptions of benefits and barriers to fruit and vegetable intake.
Energy Requirements of ChildrenWith Cerebral Palsy
Authors: Hogan S. Eileen
Published: May 2007

Energy requirements of children and adolescents with cerebral palsy appear to be disease-specific and different from the current recommendations for healthy children, varying depending upon functional capacity, degree of mobility, severity of disease, and level of altered metabolism. Feeding problems are prevalent in many of these children, and can result in inadequate energy intake. Wasting of voluntary muscles, a common symptom of cerebral palsy, contributes to reduced resting energy needs; nevertheless, the location of the central nervous system lesion may also influence energy requirements. To guarantee individualized, accurate, and optimal energy recommendations for this population, resting energy expenditure should preferentially be measured by indirect calorimetry. Equations and formulae to predict healthy people's resting energy expenditure are available, but tend to overestimate these children's energy needs. Future studies should address the role of the central nervous system in regulating energy metabolism in this population. When adequately nourished, children and adolescents with cerebral palsy appear more tranquil and require decreased feeding time, which gives caregivers time to develop the child's functional independence and character. Understanding energy requirements of this population will provide caregivers and health professionals with guidelines for providing optimal nutritional status.
Linking Active Living and Nutrition Counselling:Dietitians’ Perceptions
Authors: Spidel Mark A. , Paquette Marie-Claude , Marshall J. Dru , Bell Rhonda C. , McCargar Linda J.
Published: May 2007

Healthy eating and active living have become key concepts in health promotion, and, increasingly, the two messages are being combined. Dietitians are in an ideal position to promote physical activity as an adjunct to nutrition counselling. Focus group interviews were used to identify dietitians’ perceptions and needs related to incorporating active living messages into their practices. Six focus groups, involving 42 participants (40 registered dietitians and two dietetic interns), were conducted in cities throughout Alberta. Issues explored during the interviews included the dietitian's role in promoting active living, barriers to promoting physical activity, opportunities for collaboration between dietitians and exercise professionals, and dietitians’ perceived needs for integrating active living messages into their practices effectively. Findings indicate strong support for incorporating active living messages into nutrition counselling. However, lack of knowledge was identified as a barrier to dietitians’ proactive role, and concerns were raised about public and professional perceptions if dietitians counselled on this issue. Participants felt that they required additional knowledge and training in physical activity in order to promote it effectively. Development and implementation of programs designed to meet these needs would help dietitians integrate active living messages into their practices.
Entrepreneurship of Dietetic Program Graduates
Authors: Mann Linda L. , Blum Ilya
Published: May 2007

Successful dietetic program graduates must have an entrepreneurial mindset and skills to respond to environmental changes and consumer trends. The purpose of this study was to determine current or intended entrepreneurship by graduates of a Dietitians of Canada accredited university program, as influenced by self-efficacy stemming from entrepreneurial experiences in education or early career, as well as by internal and external factors. This study employed an exploratory descriptive methodology with a questionnaire mailed to a discrete sample. Ninety graduates completed and returned the questionnaire for a response rate of 55%. Data analysis included descriptive statistics, two-way table analysis, the chi-square test for independence, and Fisher's exact test. Significant relationships were found between self-efficacy scores and entrepreneurial action, specific entrepreneurial experiences and entrepreneurial intent and action, dietetic internship and intent, and belief in the importance of business skills and intent. Those with entrepreneurial intent and/or action identified creativity, dietetic education/internship, persistence, business skills, and family/friend support as helping factors. These results suggest that undergraduate, internship, and continuing education programs for dietitians should incorporate activities that develop entrepreneurial skills and contribute toward an entrepreneurial mindset.
Seasonal Vitamin D IntakeIn Quebec Preschoolers
Authors: Gagné Doris , Rhainds Marc , Galibois Isabelle
Published: May 2007

As a number of seasonal factors affect cutaneous synthesis of vitamin D, especially in young children, our objective was to verify if winter and summer vitamin D intakes in Quebec preschoolers reach the adequate intake of 5 µg/day. A three-month retrospective food frequency questionnaire and a 24-hour food recall were used with parents of 98 children (mean age 56 months) in summer and of 72 of these children (mean age 65 months) in winter. To ensure completeness of data, vitamin D content of foods not covered in the Canadian Nutrient File was taken from other sources. According to the food frequency questionnaire, total vitamin D intakes were 9.7 ± 4.3 g/day in summer and 11.6 ± 4.8 g/day in winter. Only 10% of children in summer and 7% in winter had an intake below 5 µg/day. The 24-hour food recall vitamin D intake estimate was lower (summer 7.0 ± 3.8 µg/day, winter 7.2 ± 4.2 µg/day). This difference could be partly due to a discrepancy in the estimation of multivitamin supplement intake. However, according to both estimates, vitamin D intakes appeared generally adequate in this sample of Quebec preschoolers.
Infection and AnemiaIn Canadian Aboriginal Infants
Authors: Willows Noreen D. , Gray-Donald Katherine
Published: May 2007

The prevalence of anemia in Aboriginal children is high, but, given the high burden of infection in these children, the extent to which anemia is due to iron deficiency and/or infection is unclear. To determine the contribution of iron deficiency to anemia, we screened 144 Aboriginal infants (70 boys, 74 girls) who were free from infection. The prevalence of anemia (hemoglobin <105 g/L) was 18.8%; caregivers reported that 53.5% of infants had had an infection in the two weeks before screening. Anemic infants were more likely than non-anemic infants to have had an infection before screening (74.1% versus 48.7%, p = 0.02), and anemic infants had a higher prevalence of iron deficiency revealed by low serum iron concentrations (< μ7 mol/L) (73.7% versus 38.3%, p <0.01). Iron deficiency measured using serum ferritin concentration tended to be less marked in infants who had had an infection (13% versus 30.3%, p = 0.06); this is probably because serum ferritin is a positive acute-phase protein. This study indicates the difficulty of isolating the contribution of infection to anemia from the separate effects of dietary iron deficiency.
What Are Entrepreneurial Dietitians Charging? The Consulting Dietitians Network National Fee Survey
Authors: Davison Karen , Mor Anet , Charlebois Helene
Published: May 2007

To respond to a need to develop a national fee guideline, the Consulting Dietitians Network conducted a membership fee survey. A questionnaire requesting fee information for various nutrition consulting services was distributed to members as an insert with the Consulting Dietitians Network quarterly newsletter and by electronic mail. The response rate was 38.4% (98 respondents) and most respondents (74.5%) had urban practices. The most frequently charged fees (mode) for individual counselling ($75/hour), industry and commercial firm consultations ($150/hour), group facilitation ($150/hour), and media consultations ($150/ article) were highest in the region of Ontario, Quebec, and the Atlantic provinces. The most frequently charged fees (mode) for home visits ($100/hour), writing for newspapers ($250/hour), and menu reviews ($60/hour) were highest in the region of Saskatchewan and Manitoba. The minimum and maximum fees were significantly different for the three regions (Ontario, Quebec, and the Atlantic provinces; Manitoba and Saskatchewan; and Alberta, British Columbia, and Yukon Territory) studied for initial client consultations, industry and commercial firm consultations, and menu reviews (p<0.05). For home visits, teaching in an institution, seminar presentations, group facilitation, media consultations, and writing media articles, the differences in the minimum and maximum fees charged were highly significant (p<0.001). Entrepreneurial dietitians may use these data as a reference to establish and negotiate consultation fees.
Effect of Gastrostomy on Growthin Children with Neurodevelopmental Disabilities
Authors: Cook Stephanie , Hooper Vivian , Nasser Roseann , Larsen Derrick
Published: May 2007

Chronic malnutrition and growth failure are frequent consequences of feeding difficulties in neurodevelopmentally disabled children. Gastrostomy feeding has been used successfully to alleviate chronic malnutrition as well as distress and frustration associated with feeding. Unfortunately, caregivers are often resistant to gastrostomy placement. In order to determine the impact of gastrostomies in 20 children with neurodevelopmental disability (NDD), a questionnaire was used to collect caregivers’ perceptions both before and after gastrostomy. The questionnaire assessed caregivers’ retrospective perceptions of quality of life, feeding difficulties, and the burdens and benefits of gastrostomies. To determine impact on growth, height and weight were measured once before and three times after gastrostomy (at six, 12, and 24 months). The number of times a child was fed and the amount of time spent feeding decreased significantly following gastrostomy (p<0.001 and p<0.05, respectively). Growth for all children improved following gastrostomy (p<0.001). Pregastrostomy problems improved significantly following gastrostomy, as did caregivers’ perceptions of quality of life for both themselves and their child (p<0.001). These results indicate that gastrostomy has a positive impact on growth for neurodevelopmentally disabled children, and on quality of life for both children and caregivers. Caregivers may find these results encouraging if they are faced with a decision about gastrostomy placement for their child.
Factors That Influence Adherence to Calcium Recommendations
Authors: French Melissa R. , Moore Kerrina , Vernace-Inserra Filomena , Hawker Gillian A.
Published: May 2007

To identify barriers to following calcium recommendations among women with reduced bone mineral density (BMD), four focus group sessions were held with 30 postmenopausal women diagnosed with low BMD. Key concepts and themes were derived from transcripts. Participants were aware of the importance of calcium to their bone health, and were attempting to follow calcium intake recommendations. Several major themes associated with the ability to obtain adequate calcium were identified, including knowledge and confidence in actions, lifestyle and food preferences, and side effects and conflict with other health conditions. Participants reported that they obtained information in an effort to make a confident decision about calcium intake, but were easily confused by conflicting information. Daily routines and family and personal food preferences influenced dietary behaviours. Women indicated that side effects, particularly those associated with perceived lactose intolerance, caused them to restrict their calcium intake. Our data provide important insight into factors that women believe affect their ability to reach recommended calcium intakes. To optimize osteoporosis prevention and treatment, dietitians should focus on individualized patient assessments to identify factors affecting adherence to dietary calcium recommendations.
Development and Validationof a Food Frequency Questionnaire
Authors: Shatenstein Bryna , Nadon Sylvie , Godin Catherine , Ferland Guylaine
Published: May 2007

Regular diet monitoring requires a tool validated in the target population. A 73-item, semiquantitative, self-administered food frequency questionnaire (FFQ), was adapted in French and English from the Block National Cancer Institute Health Habits and History Questionnaire. The FFQ was used to capture usual long-term food consumption among adults living in Quebec. A representative sample of adults aged 18 to 82 (57% female) was recruited by random digit dialling in the Montreal region. Approximately 64% of recruits completed and returned the instrument by mail (n=248). The FFQ was validated in a subsample (n=94, 61% female) using four nonconsecutive food records (FRs). Median energy intakes (in kcal) for men and women, respectively, were FFQ (total sample) 2,112 and 1,823, FFQ (subsample) 2,137 and 1,752, and FR (subsample) 2,510 and 1,830. Spearman correlation analyses between FFQ and FR nutrients were positive (with r ranging from 0.32 for folate to 0.58 for saturated fatty acids) and statistically significant (p<0.001), with better results among women. On average, cross-classification of energy and 24 nutrients from the FFQ and means of four FRs placed 39% into identical quartiles and 78% into identical and contiguous quartiles, with only 4% frankly misclassified. These results suggest that the FFQ is a relatively valid instrument for determining usual diet in Quebec adults.
Food Choice Motives and the Importance of Family MealsAmong Immigrant Mothers
Authors: Marquis Marie , Shatenstein Bryna
Published: May 2007

To determine the health and social benefits of the family mealtime, we examined the contribution of immigrant mothers’ food motives to the importance placed on family meals, and cultural differences in mothers’ food motives and the importance ascribed to family meals. Data were taken from a study on food choice factors among ten- to 12-year-old children from three cultural communities in Montreal. A 24-item, self-administered questionnaire was used to explore food choice motives. Each mother was also asked how important it was for her family to take the time to eat together, and if the child enjoyed sharing meals with his or her family. In all, 209 of the 653 questionnaires distributed were valid; 68 were from Haitian, 75 from Portuguese, and 66 from Vietnamese mothers. Five factors emerging from factor analyses explained 61.67% of the variance. Analysis of variance indicated significant differences between mothers’ countries of origin for the importance placed on health, pleasure, familiarity, and ingredient properties (p<0.005). Among Haitian and Portuguese mothers, health motivations emerged as the only significant predictor of the importance given to family meals, whereas for Vietnamese mothers, both health and eating familiar foods were predictors (p<0.05).
The Relevance of Seleniumto Immunity, Cancer, and Infectious/Inflammatory Diseases
Authors: Ryan-Harshman Milly , Aldoori Walid
Published: May 2007

Selenium is an essential trace element involved in several key metabolic activities via selenoproteins, enzymes that are essential to protect against oxidative damage and to regulate immune function. Selenium also may have other health benefits unrelated to its enzymatic functions. It may provide important health benefits to people whose oxidative stress loads are high, such as those with inflammatory or infectious diseases like rheumatoid arthritis or human immunodeficiency virus/acquired immunodeficiency syndrome, or who are at high risk for cancers, particularly prostate cancer. Some studies have generated compelling evidence that selenium is beneficial, either alone or in conjunction with other micronutrients. Additional data from large clinical trials that provide the highest level of evidence will be key to determining the benefits accrued at various selenium intake levels. When the strength of the evidence becomes sufficient, clinical health professionals will need to use dietary and clinical assessment methods to ensure that people at increased risk for cancer or inflammatory and infectious diseases can be appropriately advised about selenium intake.
Physical Activity, Aerobic Fitness, Self-Perception, and Dietary Intakein At Risk of Overweight and Normal Weight Children
Authors: Ball Geoff D.C. , Marshall J. Dru , McCargar Linda J.
Published: May 2007

Differences in physical activity, aerobic fitness, self-perception, and dietary intake were examined in a sample of six- to ten-year-olds at risk of overweight, and in normal weight boys and girls. Participants (n=20 at risk of overweight [BMI ≥85th percentile]; n=115 normal weight [BMI <85th percentile]; n=68 boys; n=67 girls) had anthropometric, physical activity, aerobic fitness, self-perception, and dietary intake measurements at zero, three, six, and 12 months. Over the 12-month period, normal weight children were more physically active (F=4.1, p<0.05) and aerobically fit (F=14.3, p<0.001), and possessed higher self-perceptions of social acceptance (F=7.3, p<0.01) than their at risk of overweight peers. Fitness differences between the sexes were not apparent at baseline, but emerged over the long term (F=7.9, p<0.01). Overall, boys consumed more total energy, fat, carbohydrate, and protein than did girls, while the entire sample consumed diets low in vegetables and fruits and meat and alternatives, and high in “other” foods. These observations highlight key disparities in lifestyle-related behaviours and perceptions between groups of children according to overweight status and sex. The findings underscore the importance of longitudinal studies in youth because cross-sectional studies may reflect transient differences.
Canadians’ Level of Confidence in Their Sources of Nutrition Information
Authors: Marquis Marie , Dubeau Caroline , Thibault Isabelle
Published: May 2007

North Americans have a great interest in health and nutrition. However, because sources of nutrition information are vast, the quality of the information varies. We explored the potential benefit of segmenting the Canadian population by geographical location and age in determining the principal sources of nutrition information and level of confidence in these sources. A survey was posted on the Dietitians of Canada website: subjects indicated how frequently they used different healthy eating sources and their level of confidence in the various sources. A total of 870 questionnaires were retained. Magazines, books, the Internet, food labels, and brochures were the most frequently used sources of information. Analyses indicated differences between geographic areas in the use of the media (radio, newspaper, television), dietitians, and naturopaths as sources of nutrition information (p<0.05), and between seven age groups (<18 to 65+ years) in the use of the media (p<0.05). Respondents reported being very confident about nutrition information received from dietitians, physicians, books, the government, and nurses, with some differences occurring between geographic areas (p<0.05).
Food Frequency Questionnairefor Assessing Infant Iron Nutrition
Authors: Williams Patricia L. , Innis Sheila M.
Published: May 2007

A food frequency questionnaire (FFQ) was developed and tested for assessing iron nutrition in infants through comparison with a three-day food record (3d-FR) and measures of iron status. Parents of 148 infants aged eight to 26 months completed a 3d-FR and an FFQ. Blood was collected for measures of hemoglobin (Hgb), ferritin, and transferrin receptor (sTfR). Iron deficiency anemia and iron depletion (ferritin ≤12 µg/L) were found in 9% and 26% of infants, respectively. The intakes of energy, total iron, heme and non-heme iron, vitamin C, and dietary fibre determined by the FFQ were associated with the intakes of the same nutrient determined by the 3d-FR (p<0.05). The intakes of energy, total iron, non-heme and heme iron, vitamin C, and fibre were significantly higher when estimated by the FFQ than by the 3d-FR. Total and heme iron intakes determined by the FFQ were significantly associated with serum ferritin, sTfR, and the sTfR:ferritin ratio (p<0.05). However, iron intakes explained <10% of the variability in iron status. Despite relative validity of the FFQ for evaluating differences in energy, iron, vitamin C, and fibre intake compared with a 3d-FR, FFQs need further development before they can be used to advance assessment of iron intake and status in infants.
Imagination Nourishes Dietetic Practice: 2005 Ryley-Jeffs Memorial Lecture
Authors: Berenbaum Shawna
Published: May 2007

Albert Einstein once stated that imagination is more important than knowledge. How important is imagination to the dietetic profession? What have been the imaginations of dietitians over the years? Where would we be today without these imaginations? Can imagination be fostered and developed? What future imaginations will shape the dietetic profession? This article explores the phenomenon of imagination and why it is important to dietetic practice.
Cultural Relevance of a Fruit and Vegetable Food Frequency Questionnaire
Authors: Paisley Judy , Greenberg Marlene , Haines Jess
Published: May 2007

Purpose: Canada’s multicultural population poses challenges for culturally competent nutrition research and practice. In this qualitative study, the cultural relevance of a widely used semiquantitative fruit and vegetable food frequency questionnaire (FFQ) was examined among convenience samples of adults from Toronto’s Cantonese-, Mandarin-, Portuguese-, and Vietnamesespeaking communities.

Methods: Eighty-nine participants were recruited through community-based organizations, programs, and advertisements to participate in semi-structured interviews moderated in their native language. Data from the interviews were translated into English and transcribed for analysis using the constant comparative approach.

Results: Four main themes emerged from the analysis: the cultural relevance of the foods listed on the FFQ, words with multiple meanings, the need for culturally appropriate portionsize prompts, and the telephone survey as a Western concept.

Conclusions: This research highlights the importance of investing resources to develop culturally relevant dietary assessment tools that ensure dietary assessment accuracy and, more important, reduce ethnocentric biases in food and nutrition research and practice. The transferability of findings must be established through further research.
Estimation of Human Resource Needs And Cost of Adding Registered Dietitians To Primary Care Networks
Authors: Witt Julia , Brauer Paula , Dietrich Linda , Davidson Bridget ,   Steering Committee
Published: May 2007

Purpose: Information on human resources and costs is needed to plan for the addition of registered dietitian (RD) services to new models of primary health care (PHC). Estimates were developed, based on an analysis of an enhanced RD model of counselling and health promotion services in three Ontario Family Health Networks (FHNs).

Methods: Both direct and indirect costs were averaged over the three FHNs. Costs and RD activities were tracked throughout 2005. The FHN staff completed two questionnaires addressing communication, case management, and satisfaction with RD services.

Results: Actual and reported case management indicated that an estimated 1.3% to 2.4% of the 60,000 enrolled patients may require individual nutrition counselling in a year. If one full-time equivalent (FTE) RD can manage 380 new referrals, then one FTE RD is needed per 15,800 to 29,000 patients. The estimated direct costs of adding one FTE RD (including expenses and fixed costs) is $78,169 to $80,169, when the RD is an independent contractor.

Conclusions: Additional studies are needed to develop better estimates of human resource needs and costs of interdisciplinary nutrition services in all PHC settings. These estimates should be based on population characteristics and direct and indirect costs for all models of nutrition services in PHC settings.
Diet Quality of Atlantic Families Headed by Single Mothers
Authors: Glanville N. Theresa , Mcintyre Lynn
Published: May 2007

Purpose: As part of a larger study on food insecurity and dietary adequacy of low-income lone mothers and their children in Atlantic Canada, we examined diet quality among household members.

Methods: Network sampling for ‘difficult to sample’ populations was used to identify mothers living below the poverty line and alone with at least two children under age 14. Trained dietitians administered 24-hour dietary recalls weekly for one month to mothers on the dietary intake of themselves and their children. We calculated Healthy Eating Index category scores for eligible mothers (129) and children (303) using Canada’s Food Guide to Healthy Eating and the Nutrition Recommendations for Canadians.

Results: Diet quality of low-income lone mothers was poor (35.5%) or in need of improvement (64.5%), with no mother having a good diet. The diet quality of children varied by age, with 22.7% of children aged one to three having a good diet or needing improvement (74.6%), 2.1% of children aged four to eight and no child aged nine to 14 having a good diet, while the diets of about 85% of older children in both age categories needed improvement.

Conclusions: Younger children seem to be protected from poor quality diets in households with limited resources to acquire food.
Solution-Focused CounsellingIn Canadian Outpatient Dietetic Practice
Authors: Wunch Daphna , Vandenbussche Katherine
Published: May 2007

Purpose: The use of solution-focused counselling (SFC) in dietetics was examined to determine the demand for an SFC teaching tool for registered dietitians.

Methods: A cross-sectional web-based survey was conducted within the Dietitians of Canada cardiology, eating disorders, and consulting networks, with dietitians who practised in an outpatient setting. Dietitians were surveyed on the seven core components of SFC.

Results: Responses (n=58) were received from dietitians practising in seven provinces, who tended to be younger (mean age=44) and who had practised for a mean of 15 years. The entire sample reported use of at least four of the seven core components of SFC. All respondents were interested in receiving a counselling teaching tool for dietitians.

Conclusions: All respondents were using components of SFC in their outpatient practices. The efficaciousness of SFC in dietetic practice has yet to be determined.