Abstract
Objective
Public health policies promote healthy nutrition but evaluations of children’s adherence to dietary recommendations and studies of risk factors of poor nutrition are scarce, despite the importance of diet for the temporal increase in the prevalence of childhood obesity. Here we examine dietary intake and risk factors for poor diet quality among children in Nova Scotia to provide direction for health policies and prevention initiatives.
Methods
In 2003, we surveyed 5,200 grade five students from 282 public schools in Nova Scotia, as well as their parents. We assessed students’ dietary intake (Harvard’s Youth Adolescent Food Frequency Questionnaire) and compared this with Canadian food group and nutrient recommendations. We summarized diet quality using the Diet Quality Index International, and used multilevel regression methods to evaluate potential child, parental and school risk factors for poor diet quality.
Results
In Nova Scotia, 42.3% of children did not meet recommendations for milk products nor did they meet recommendations for the food groups ‘Vegetables and fruit’ (49.9%), ‘Grain products’ (54.4%) and ‘Meat and alternatives’ (73.7%). Children adequately met nutrient requirements with the exception of calcium and fibre, of which intakes were low, and dietary fat and sodium, of which intakes were high. Skipping meals and purchasing meals at school or fast-food restaurants were statistically significant determinants of poor diet. Parents’ assessment of their own eating habits was positively associated with the quality of their children’s diets.
Interpretation
Dietary intake among children in Nova Scotia is relatively poor. Explicit public health policies and prevention initiatives targeting children, their parents and schools may improve diet quality and prevent obesity.
MeSH terms: Nutrition, obesity, child, lifestyle, prevention & control, public health
Résmé
Objectif
Les politiques de santé publique font la promotion d’une saine alimentation, mais rares sont les évaluations de l’observation par les enfants des recommandations alimentaires et les études des facteurs de risque de la malnutrition, malgré le rôle important que joue le régime alimentaire dans l’augmentation temporelle de la prévalence de l’obésité de l’enfance. Nous examinons ici les apports alimentaires et les facteurs de risque d’une mauvaise alimentation chez les enfants de la Nouvelle-Écosse afin de mieux orienter les politiques sanitaires et les initiatives de prévention.
Méthode
En 2003, nous avons sondé 5 200 élèves de 5e année dans 282 écoles publiques de la Nouvelle-Écosse, ainsi que leurs parents. Nous avons évalué les apports alimentaires des élèves (à l’aide du questionnaire « Youth Adolescent Food Frequency » de l’Université Harvard) et nous les avons comparés aux recommandations canadiennes sur les groupes d’aliments et les apports en nutriments. Nous avons résumé la qualité du régime à l’aide de l’instrument « Diet Quality IndexInternational » (DQI-I) et utilisé des méthodes de régression multiniveau pour évaluer les éventuels facteurs de risque d’une mauvaise alimentation pour les enfants, les parents et les écoles.
Résultats
En Nouvelle-Écosse, 42,3 % des enfants ne respectaient pas les recommandations de consommation de produits laitiers, ni des groupes d’aliments « légumes et fruits » (49,9 %), « produits de céréales » (54,4 %) et « viande et substituts » (73,7 %). Les besoins des enfants en nutriments étaient respectés, à l’exception du calcium et des fibres, pour lesquels les apports étaient faibles, et des matières grasses et du sodium alimentaire, pour lesquels les apports étaient élevés. Le fait de sauter des repas et d’en acheter à l’école ou dans les restaurants rapides étaient d’importants déterminants d’une mauvaise alimentation. L’évaluation par les parents de leurs propres habitudes alimentaires était associée positivement à la qualité du régime de leurs enfants.
Interprétation
L’alimentation des enfants de la Nouvelle-Écosse est relativement mauvaise. Des politiques de santé publique explicites et des initiatives de prévention ciblant les enfants, les parents et les écoles pourraient améliorer la qualité de l’alimentation et prévenir l’obésité.
Footnotes
Source of funding: This research was funded by the Canadian Population Health Initiative and through a Canadian Institutes of Health Research New Investigator award to Dr. Veugelers.
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