Food Guide Recommendations Research Articles

Poor Adherence to Dietary Guidelines Among French-Speaking Adults in the Province of Quebec, Canada: The PREDISE Study

BackgroundRegular monitoring of the population’s food and nutrient intake is essential to develop effective nutrition-focused public health policies. The aim of this study was to provide dietary intake estimates using an age- and sex-representative sample of French-speaking adults with Internet access from 5 administrative regions in the province of Quebec, Canada. MethodsPRÉDicteurs Individuels, Sociaux et Environnementaux (PREDISE) is a multicentre cross-sectional study that used a Web-based approach to collect individual, social, and environmental data on factors associated with adherence to dietary recommendations. Dietary intake was estimated from the average of 3 validated Web-based 24-hour recalls. ResultsMean (± SD) age of the 1147 participants (50.2% women) was 43.2 ± 4.6 years and median body mass index was 26.3 (interquartile range, 23.3-30.3). Less than 25% of participants met Canada’s Food Guide recommendations for vegetables and fruit intake (prevalence, 23.6%; 95% confidence interval [CI], 21.1-26.0). Most participants reported consuming more than 2300 mg of sodium (prevalence, 80.5%; 95% CI, 78.2-82.7) and more than 10% energy as saturated fats (prevalence, 74.2%; 95% CI, 71.6-76.7). Mean Canadian Healthy Eating Index score on a scale of 0-100 was 54.5 (95% CI, 53.8-55.2), reflecting relatively poor diet quality according to current dietary recommendations. ConclusionsSelf-reported dietary intakes measured using a new validated Web-based 24-hour recall in this sample of French-speaking adults from Quebec and with access to Internet suggest low adherence to current Canadian dietary guidelines. These data emphasize the need for more effective nutrition-focused public health policies to maximize cardiovascular disease prevention at the population level.

Adherence to Canada's Food Guide recommendations among Alberta's multi-ethnic youths is a major concern: findings from the WHY ACT NOW project.

Dietary habits formed during youth may result in the development of obesity and chronic diseases in adulthood. We aimed to determine the frequency of the consumption of foods and beverages and the degree of adherence to Canada's Food Guide recommendations among multi-ethnic youths. Participants were recruited from 12 schools in the Edmonton, Alberta area by use of posters, school newsletters and advertisements. A 30-item food frequency questionnaire was administered by a trained interviewer to assess dietary intake in a convenience sample of 557 (328 females and 229 males) youths aged 11-23years; for the purpose of the present study, only the 14-18years age group was considered in the analysis. Participants were divided by sex and self-identified ethnicity into four groups [Indigenous, African & Middle Eastern (AME), Asian, and European]. Statistical analysis of the data was undertaken using t-tests, Welch's analysis of variance and Games-Howell tests. P<0.05 was considered statistically significant. Vegetables and Fruit recommendations were the least likely to be followed, with 90.7-96.8% of participants in all groups not consuming the recommended number of servingsday-1 . The mean frequency of fruit consumption was lower among Indigenous youths compared to Asian youths (0.90 versus 1.37 timesday-1 ). A greater proportion of males than females (55.9% versus 44.3%) did not meet the minimum recommendations for Meat and Alternatives (P=0.016). The percentage of youths not adhering to recommendations for Milk and Alternatives was 81.7% for Indigenous, 73.3% for AME, 78.6% for Asian and 63.5% for European youths. Indigenous youths more frequently consumed potato chips and soft drinks compared to other ethnic youths. The most frequently consumed beverage was milk (1.25 timesday-1 ). The majority of youths did not consume minimum daily recommended servings of Vegetables and Fruit, Milk and Alternatives, and/or Meat and Alternatives food groups. Evidence-based dietary interventions and public health strategies are needed.

Adherence to Canada’s Food Guide Recommendations during Pregnancy

BackgroundIn Canada, pregnant women are typically referred to Canada’s Food Guide (CFG), a set of national dietary recommendations designed to promote adequate nutrient intake. Pregnant women are also advised to gain weight within the Institute of Medicine guidelines, which differ by prepregnancy body mass index (BMI). However, CFG recommendations do not account for prepregnancy BMI and provide no guidance on “less healthy” (LH) foods. ObjectiveThe aim of this study was to score women’s diets according to adherence to CFG recommendations and consumption of LH foods and to examine differences between these diet scores by prepregnancy BMI. MethodsParticipants enrolled in the APrON (Alberta Pregnancy Outcomes and Nutrition) prospective cohort study completed a 24-h recall in their second trimester (n = 1630). A score was created on the basis of each daily dietary CFG recommendation met, ranging from 0 to 9. The distribution of consumption (grams per day) of 8 LH food groups was given a score of 0 (none) or 1, 2, or 3 (representing the lowest, middle, or highest tertiles, respectively) and summed giving a total LH score of 0–24. ResultsThere were few differences in CFG recommendations met by prepregnancy BMI status, although fewer women who were overweight or obese prepregnancy met the specific recommendation to consume 7–8 servings of fruit or vegetables/d than did those who were under- or normal weight (47% and 41% compared with 50% and 54%, respectively). Although differences were small, women who were obese prepregnancy had lower CFG scores (β = −0.28; 95% CI:−0.53, −0.02) and higher LH scores (β = 0.45; 95% CI: 0.04, 0.86) than did those who were normal weight. ConclusionThe study results suggest that more attention may need to be paid to individualized counseling on dietary recommendations that take account of prepregnancy BMI.

Unregulated serving sizes on the Canadian nutrition facts table \u2013 an invitation for manufacturer manipulations

BackgroundServing sizes on the Nutrition Facts table (NFt) on Canadian packaged foods have traditionally been unregulated and non-standardized. The federal government recently passed legislation to regulate the serving sizes listed on the NFt. The objective of this study was to compare the serving sizes on food product NFts to the recommendations in the 2003 Nutrition Labelling regulation (Schedule M) reference amounts, the Canadian Food Inspection Agency (CFIA) ranges, and Canada’s Food Guide recommendations. An additional objective was to determine if food and beverage products that report smaller serving sizes have a higher calorie density, compared to similar products with a larger serving size.MethodsData for 10,487 products were retrieved from the 2010 Food Label Information Program (FLIP) database and categorized according to Schedule M categories. Correlations between calorie density and manufacturer stated serving size were tested and the proportion of products meeting recommendations were tabulated.Results35% of products had serving sizes on the NFt that were smaller than the Schedule M reference amount and 23% exceeded the reference amount. 86% of products fell within the CFIA’s recommended serving size ranges; however, 70% were within the lower-half of the range. Several bread and juice categories exceeded CFG’s recommendations, while several dairy product categories were smaller than the recommendations. Of the 50 Schedule M sub-categories analyzed, 31 (62%) exhibited a negative correlation between serving size and calorie density.ConclusionWhile most products fell within the CFIA’s recommended serving size ranges, there was a tendency for products with a higher calorie density to list smaller serving sizes.

The economic benefits of fruit and vegetable consumption in Canada.

The objectives of this study were to determine the proportion of the population that meets or exceeds Canada's Food Guide (CFG) recommendations regarding the number of daily servings of fruits and vegetables (F/V), to assess trends in this proportion between 2000 and 2013, to estimate the annual economic burden attributable to inadequate F/V consumption within the context of other important risk factors, and to estimate the short- and long-term costs that could be avoided if modest improvements were made to F/V consumption in Canada. We used a previously developed methodology based on population-attributable fractions and a prevalence-based cost-of-illness approach to estimate the economic burden associated with low F/V consumption. Over three quarters of Canadians are not meeting CFG recommendations regarding the number of daily servings of F/V, leading to an annual economic burden of $4.39 billion. If a 1% relative increase in F/V consumption occurred annually between 2013 and 2036, the cumulative reduction in economic burden over the 23-year period would reach $8.4 billion. Consumption levels of F/V, and the resulting economic burden, varied by sex, age and province. A significant majority of Canadians are not consuming the recommended daily servings of F/V, with important consequences to their health and the Canadian economy. Programs and policies are required to encourage F/V consumption in Canada.

Vegetable, fruit, and phytonutrient consumption patterns in Taiwan

Phytonutrients may play important roles in human health and yet only recently a few studies have described phytonutrient consumption patterns, using data obtained from daily consumption methods. We aimed to estimate the phytonutrient content in Taiwanese diets and analyzed main food sources of 10 major phytonutrients. In this study, food items and dietary data gathered with the 24-hour dietary recall from 2908 participants in the 2005–2008 Nutrition and Health Survey in Taiwan were used to create a food phytonutrient database with 933 plant-based foods through integrating database, literature search, and chemical analysis and to appraise phytonutrient consumption status of participants. SUDAAN (Survey Data Analysis) was used for generating weighted phytonutrient intake estimates and for statistical testing. In Taiwanese adults, ∼20% met the recommended number of servings for fruits and 30% met that for vegetables from the Taiwan Food-Guide recommendations. However, only 7.4% consumed the recommended numbers for both fruits and vegetables. Those meeting the recommendations tended to be older and with more females compared with those who did not. Phytonutrient intake levels were higher in meeters than nonmeeters. More than 60% of α-carotene, lycopene, hesperetin, epigallocatechin 3-gallate, and isoflavones came from a single phytonutrient-specific food source. In addition, sweet potato leaf, spinach, and water spinach were among the top three sources of multiple phytonutrients. Cross-comparison between this study and two previous studies with similar methodology showed higher mean levels of lycopene and quercetin in the United States, anthocyanidins in Korea, and lutein and zeaxanthin in Taiwan. The Taiwanese phytonutrient pattern is different from that of the Korean and American. It would be interesting to relate phytonutrient patterns to health profiles in the future.

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

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. Direct observation identified food items and amounts in BSD and TS lunches of grade 3 and 4 students (n = 321). 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). 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.

Exploring the nutritional vulnerability of homeless men in a Canadian urban setting

Homelessness, Aboriginal ethnicity, and nutritional vulnerability are key determinants of health. Substance abuse further compounds health risk. This study explored the nutritional vulnerability of homeless men, some of who were solvent-users, to assess nutrition-related chronic disease risk factors. Anthropometric data were used to calculate disease risk using body mass index. Diet was assessed using a 24-hr food recall and data were compared to Canada’s Food Guide recommendations. A significant proportion of participants had low intakes of vegetables and fruit and milk and alternatives. More than half of the participants met the intake recommendations for grain servings and meat and alternatives. Solvent-using participants consumed significantly higher intakes of vegetables and fruit, grain products, and other foods and beverages, than non-solvent using men. More than half of the participants were classified as overweight or obese. Healthy food consumption was influenced by lack of stable housing, reliance on charitable food, and substance abuse.

A Multi-Center Assessment of Nutrient Levels and Foods Provided by Hospital Patient Menus.

Diets of high nutritional quality can aid in the prevention and management of malnutrition in hospitalized patients. This study evaluated the nutritional quality of hospital patient menus. At three large acute care hospitals in Ontario, Canada, 84 standard menus were evaluated, which included regular and carbohydrate-controlled diets and 3000 mg and 2000 mg sodium diets. Mean levels of calories, macronutrients and vitamins and minerals provided were calculated. Comparisons were made with the Dietary Reference Intakes (DRI) and Canada’s Food Guide (CFG) recommendations. Calorie levels ranged from 1281 to 3007 kcal, with 45% of menus below 1600 kcal. Protein ranged from 49 to 159 g (0.9–1.1 g/kg/day). Energy and protein levels were highest in carbohydrate-controlled menus. All regular and carbohydrate-controlled menus provided macronutrients within the Acceptable Macronutrient Distribution Ranges. The proportion of regular diet menus meeting the DRIs: 0% for fiber; 7% for calcium; 57% for vitamin C; and 100% for iron. Compared to CFG recommended servings, 35% met vegetables and fruit and milk and alternatives, 11% met grain products and 8% met meat and alternatives. These data support the need for frequent monitoring and evaluation of menus, food procurement and menu planning policies and for sufficient resources to ensure menu quality.

Awareness and Knowledge of Recommendations from Canada's Food Guide.

To examine use and content knowledge of Canada's Food Guide recommendations. A total of 1048 intercept exit surveys were conducted with adults who had purchased food that day at 2 hospital cafeterias in Ottawa, Ontario. Most respondents (85.9%) reported looking at Canada's Food Guide over their lifetime; however, less than half reported looking at the food guide in the past year. Milk and Alternatives were the most commonly recalled food group (80.1%) and Grain Products were least commonly recalled (66.0%). Of the entire sample, 42.8% correctly recalled all 4 food groups. Overall, 0.8% correctly recalled the correct number of servings for all 4 food groups. Females, younger respondents, white respondents, respondents with higher annual income, and respondents who had reported looking at Canada's Food Guide recalled more food groups (P < 0.05 for all). Despite high levels of awareness, the study found relatively low levels of reported use and very low levels of knowledge of Canada's Food Guide, particularly among population subgroups that face health disparities. Improving awareness, knowledge, and use of Canada's Food Guide may contribute to improving the nutrition profile of Canadians.

Effect of an intervention mapping approach to promote the consumption of fruits and vegetables among young adults in junior college: A quasi-experimental study

Objective: This study evaluates the effectiveness of an intervention mapping developed to promote fruit and vegetable consumption.Design: Students (n = 394) from two similar public colleges in the Quebec City area (Canada) were asked to participate. A quasi-experimental design was used with a 14-week pause between the pretest and posttest. The control and experimental groups both received information on Canada’s Food Guide recommendations. The experimental group was submitted to an intervention consisting of six interactive workshops carried out inside the college, and three personal exercises to be completed at home.Main outcome: proportion of respondents consuming at least five servings of fruits and vegetables daily. Secondary outcomes: psychosocial variables assessed (theory of planned behaviour).Results: The data collected from 344 participants by means of a self-administered questionnaire were analysed (167 experimental and 177 control). The posttest revealed a significant increase (15%) in the number of participants in the experimental group achieving the primary outcome (d = .38). The intervention also had a significant effect on the targeted psychosocial variables (η2 = .03 to .06). Regularity of consumption acts as a mediator between intention and behaviour.Conclusion: These results may be used to guide health promoters working with college students.

Examining the Promotion of Healthy Eating among Exercise Specialists: A Cross-sectional Study.

The aim of this cross-sectional study was to survey exercise specialists about nutrition counselling practices, their own dietary practices, and to identify potential relationships. An electronic survey was used to examine characteristics and strategies used for assessing and promoting healthy eating to clients. Exercise specialists (n = 94) were recruited through a public registry and through targeted advertising on 2 professional websites in Alberta, Canada. Eighty-five percent of respondents promoted healthy eating to clients. Confidence in assessing and promoting healthy eating was moderate to low. Those with more than 6 years of professional experience reported higher confidence compared with those with less than 1 year of experience in assessing healthy eating (P < 0.05) and promoting healthy eating (P < 0.01). Confidence was higher among those with more professional experience but who did not meet Canada's Food Guide recommendations (P < 0.05). Professional experience, personal dietary practices, and confidence are important characteristics when considering the assessment and promotion of healthy eating by exercise specialists. Promoting collaborative relationships between registered dietitians and exercise specialists would likely benefit exercise specialists when they are assessing and promoting healthy eating among their clients.

Micronutrients on the Menu: Enhancing the Quality of Food in Long-term Care for Regular, Nontherapeutic Menus.

Micronutrient (vitamin and mineral) deficiencies may exacerbate prevalent health conditions occurring in long-term care (LTC) residents, and current food provision may potentiate this problem. A micronutrient-focused, food-first approach to menu planning may address this gap by emphasizing nutrient-dense foods. The objectives were to determine if: (i) selected LTC menus met micronutrient and Canada's Food Guide (CFG) recommendations, and (ii) recommendations can be met through food alone with strategic menu planning. Regular, nontherapeutic menus (week 1, all meals) from diverse LTC homes (n = 5) across Canada were analyzed for micronutrient content using Food Processor and CFG servings. Site dietitians confirmed menu analyses. Five super-menus were created and analyzed for comparison. The nutrient content of the menus varied significantly across homes. Micronutrients of greatest concern were (mean ± SD) vitamin D (8.90 ± 5.29 µg/d) and vitamin E (5.13 ± 1.74 mg/d). Folate, magnesium, and potassium were also below recommendations. Super-menus of equal food volume met recommendations for all micronutrients except vitamin D (56%), vitamin E (84%), and potassium (85%). Meeting most micronutrient recommendations is possible with creative and deliberate menu planning. Knowledge translation of best practices is needed.

Nutritional quality and price of food hampers distributed by a campus food bank: a Canadian experience.

Food insecurity is a mounting concern among Canadian post-secondary students. This study was conducted to evaluate the content of food hampers distributed by University of Alberta Campus Food Bank (CFB) and to assess the cost savings to students, using these hampers. Contents of hampers distributed among 1,857 students and their dependants since 2006 were evaluated against Canada's Food Guide (CFG) recommendations and Dietary Reference Intakes (DRI). Hampers were aimed at serving university students and one to five members of their households located in Edmonton, Western Canada. One thousand eight hundred fifty-seven clients in Alberta, Canada, were included in the study. Although all hampers provided adequate energy, their fat and animal protein contents were low. Compared to the CFG recommendations, the requirements of milk and alternatives and meat and alternatives were not sufficiently met for clients using > or = 3-person hampers. None of food hampers (i.e. one- to five-person hampers) met the DRI recommendations for vitamin A and zinc. Clients of CFB received Canadian dollar (CN$) 14.88 to 64.3 worth of non-perishable food items in one- to five-person hampers respectively. Hampers provided from the CFB need improvement. Nutrients missing from the food hampers could be provided from fresh fruits, vegetables, dairy, and meat products; however, these foods are more expensive than processed food items. The CFB provides a significant amount of savings to its clients even without considering the additional perishable donations that are provided to clients. Interpretation of our data required the assumption that all clients were consuming all of their hampers, which may not always be the case. Clients that do not fully consume their hampers may benefit less from the food bank.

Challenges in Planning Long-term Care Menus: That Meet Dietary Recommendations

Long-term care (LTC) homes plan menus based on Eating Well with Canada's Food Guide (CFG) recommendations for older adults. To determine whether recommended CFG servings and nutrients were being provided, we analyzed the menu of a large LTC facility in a metropolitan area and compared our analysis with a similar one conducted in 2000. A full week's menu from a large Saskatoon LTC facility was analyzed and compared with CFG and recent Dietary Recommended Intake nutrient recommendations. The menu was analyzed using The Food Processor SQL. The 2011 menu was compared with the similar 2000 menu analysis to permit an evaluation of changes over a decade. The 2011 menu demonstrated a significant improvement in servings of vegetables and fruit (4.6 to 7.2 servings). Servings of grain products had declined from 4.9 to 3.6 and servings of milk and alternatives had declined from 2.4 to 1.2 since 2000. Servings of meat and alternatives, total carbohydrate, and protein were not significantly different. Foods on the 2011 menu were lower in fat and higher in dietary fibre and offered more vitamins and minerals. Greater attention to the planning of LTC menus may explain improvements in the 2011 LTC menu. The current menu, however, needs to overcome the challenges that prevent it from meeting CFG recommendations for older adults.

Do Canadians meet Canada's Food Guide's recommendations for fruits and vegetables?

National dietary guidelines pertaining to the intake of fruits and vegetables (FV) were recently amended, in both Canada and the United States, to provide specific recommendations about dark green and orange vegetables and juice consumption. However, little is known about the extent to which Canadians meet the updated recommendations for FV. This study fills current gaps by applying the National Cancer Institute's methodology for assessing the distribution of usual intake of foods to examine reported FV intake using 24-h recalls from the 2004 Canadian Community Health Survey, cycle 2.2, a nationally representative health survey. After identifying plausible respondents, usual intake distributions were estimated after adjustment for respondents' age, sex, body mass index, frequency of FV consumption, sequence effect, weekend-weekday effect, income, and ethnicity. The majority of Canadians did not meet Health Canada's 2007 recommendations for FV intake. Only 26% of the population aged 2 years and older consumed the minimum number of daily servings recommended for their respective age-sex group. Approximately 1 in 5 Canadians consumed at least 1 daily serving of dark green vegetables, and 9% consumed 1 or more daily servings of orange vegetables or their substitutes. Juice was a substantial contributor to FV intake, particularly for children and teens who, on average, consumed 32%-41% of their daily FV servings as juice. These findings provide insight into the quantity and composition of FV intake and adherence to national dietary recommendations in Canada.

Should an anti-inflammatory diet be used in long-term care homes?

Background: Inflammation is associated with the pathogenesis of several age-related chronic conditions such as diabetes, cardiovascular disease, arthritis and dementia. Most older adults residing in long-term care (LTC) homes have at least one of these conditions; they also have some degree of compromised nutritional intake due to management, personal and medical challenges. We hypothesized that an anti-inflammatory diet in LTC is necessary and feasible, and may lead to improvements in the health and wellbeing of residents. Methods: A literature review was carried out to evaluate the evidence on effectiveness of anti-inflammatory diet changes in adults as well as the feasibility of LTC menu revision. Results: Dietary components have both positive and negative influences on inflammation in older adults. LTC menu revisions using the anti-inflammatory diet popularized by Weil, which is designed as a food guide, are feasible. This diet could be used in LTC menu planning to complement and expand upon Canada’s Food Guide recommendations. Conclusions: Implementation of a nutrient-dense, anti-inflammatory diet may lead to improved health and wellbeing among LTC residents.

Changes in food group consumption and associations with self-rated diet, health, life satisfaction, and mental and physical functioning over 5 years in very old Canadian men: the Manitoba Follow-Up Study.

To identify longitudinal food group consumption trends and the relationship to perceived changes in diet, health, and functioning. A prospective longitudinal study. Canada. Seven hundred and thirty-six community-dwelling Canadian men (mean age: 2000=79.4 yrs; 2005=84.5 yrs) participating in the Manitoba Follow-up Study. Self-reported food consumption, self-rated diet and health, life satisfaction, physical and mental functioning from questionnaires completed in 2000 and 2005. The majority of participants did not consume from all four food groups daily, based on Canada's Food Guide recommendations, with only 8% in 2000 and up to 15% in 2005. However, over a five year period, more men improved their consumption in each food group than declined. An association was found between change in the self-rating of the healthiness of their diet and change in consumption of vegetables and fruit, or grain products. Men whose self-rating of the healthiness of their diet remained high or improved between 2000 and 2005, were 2.15 times more likely (95% CI=1.45, 3.17) to also have increased consumption of vegetables and fruit, and 1.71 times more likely (95% CI=1.51, 2.54) to have increased consumption of grain products, relative to men whose self-rating of the healthiness of their diet declined between 2000 and 2005. Men who consumed more food groups daily had better mental and physical component scores. Dietary improvements are possible in very old men. Greater daily food group consumption is associated with better mental and physical functioning. Given these positive findings, there is still a need to identify older men who require support to improve their dietary habits as nearly half of the participants consumed two or fewer groups daily.

Adolescents’ diets do not comply with 2007 Canada’s food guide recommendations

This study evaluated the eating behaviours of students in grade six and, three years later when they were in grade nine, relative to the recommendations of Canada’s 2007 Food Guide. Students completed a self-administered questionnaire on eating behaviours in 2002 (n=647) and again in 2005 (n=520) as part of Better Beginnings, Better Futures, a primary prevention initiative among economically disadvantaged communities. McNemar analysis and X2 analysis were used to assess differences in compliance with the recommendations of the Food Guide. Differences in the mean number of servings of the four food groups and the Other Foods group were examined using independent sample t-tests and paired t tests. In grade six, 5% of males and 7% of females met the minimum number of recommended servings for all four food groups. By grade nine this had dropped to 0.4% and 2% respectively. Among males who completed the questionnaire in both grade six and grade nine there was a decline in the mean number of daily servings for all four food groups. For females a similar trend was observed. The likelihood of adolescents meeting all Food Guide recommendations decreased from grade six to grade nine.

Intakes of milk and alternatives among on-reserve First Nations youth in northern and southern Ontario, Canada.

To assess the adequacy of milk and alternatives, Ca and vitamin D intakes in First Nations (FN) youth in Ontario, Canada. Intakes were compared with the general population and dietary standards. Variation in intakes by community (proxy for remoteness) and BMI was examined. Data were collected by 24 h recall between November 2003 and June 2010. Intakes were analysed descriptively. Variation in intakes, by community and BMI category, was assessed using ANOVA. Five remote FN communities of the Mushkegowuk Territory (northern Ontario, Canada) and two less-remote southern Ontario FN communities. Schoolchildren (n 457) in grades 6 to 12. Compared with Canada's Food Guide recommendations, 72.6 to 84.7% had an inadequate intake of milk and alternatives depending on age and sex group; 86.2% of individuals fell below the RDA for Ca; 96.4% fell below the RDA for vitamin D. Community variation in intakes was detected, although in all cases Fort Albany had higher intakes, even when it was the more northern (remote) community. A BMI × sex interaction was found for intake of milk and alternatives (P = 0.041): an inverse relationship between intake and BMI was seen in females; in males, those who were overweight had the highest intake, followed by normal-weight and obese youth. The nutritional inadequacies parallel the results of other Canadian studies of Aboriginal populations. Population health interventions to improve intakes are warranted. Moreover, community variation in intakes exists among FN youth in the present study (Fort Albany pairs only), but results were not as expected.