Exploratory analysis of the variable response to an intensive lifestyle change program for metabolic syndrome.

Background: Substantial variability in response to lifestyle interventions has been recognized for many years, and researchers have begun to disentangle sources of error from inherent differences in individual responsiveness. The objective of this secondary analysis of an intensive lifestyle intervention (diet and exercise) for metabolic syndrome (MetS) was to identify potentially important differences among study completers grouped by treatment response as measured by change in a continuous metabolic syndrome score (Gurka/MetS).

Methods: All study completers from a 12-month primary care study were categorized into one of five groups according to change in the Gurka/MetS score.

Campus food service users' support for nudge strategies for fruit and vegetable-rich items: findings from a large Canadian national sample.

Although customer support is critical to the wider uptake of nudging strategies to promote fruits and vegetables (FV) in institutional food service (FS) settings, empirical research is sparse and typically based on small convenience samples. An online survey was conducted to assess support, perceived effectiveness and intrusiveness of nine nudge types drawn from Münscher 's Taxonomy of Choice Architecture. We focused on the setting of campus FSs across Canada.

Meat reduction among post-secondary students: Exploration of motives, barriers, diets and preferences for meals with partial and full meat substitution.

Before developing new meat reduction interventions to support increased sustainability, it is important to understand the motives, diets and preferences of consumers who have already made efforts to reduce meat consumption. While self-declaration has been typically used to identify meat reducers, food frequency data suggests some reducers still identify as omnivores, here termed transitional meat reducers. We compared these "transitional" meat reducers to self-declared meat reducers, unrestricted omnivores and vegetarians/vegans for differences in diet, motives for reducing meat, and perceived barriers to consuming more legumes (dried beans, peas or lentils) and plant-based meat alternative products (PBMAs).

Relationship between Cardiometabolic Factors and the Response of Blood Pressure to a One-Year Primary Care Lifestyle Intervention in Metabolic Syndrome Patients.

Systemic hypertension has been recognized as a modifiable traditional cardiovascular risk factor and influenced by many factors such as eating habits, physical activity, diabetes, and obesity. The objective of this cross-sectional study was to identify factors that predict changes in blood pressure induced by a one-year lifestyle intervention in primary care settings involving a collaboration between family physicians, dietitians, and exercise specialists. Patients with metabolic syndrome diagnosis were recruited by family physicians participating in primary care lifestyle intervention among several family care clinics across Canada.

Key process features of personalized diet counselling in metabolic syndrome: secondary analysis of feasibility study in primary care.

Background: Personalized diet counselling, as part of lifestyle change programs for cardiometabolic risk conditions (combinations of prediabetes or type 2 diabetes, hypertension, dyslipidemia and high waist circumference) has been shown to reduce progression to type 2 diabetes overall. To identify key process of care measures that could be linked to changes in diet, we undertook a secondary analysis of a Canadian pre-post study of lifestyle treatment of metabolic syndrome (MetS). Diet counselling process measures were documented and association with diet quality changes after 3 months were assessed.

Customer support for nudge strategies to promote fruit and vegetable intake in a university food service.

Background: Diverse nudges, also known as choice architectural techniques, have been found to increase fruit and vegetable (FV) selection in both lab and field studies. Such strategies are unlikely to be adopted in mass eating settings without clear evidence of customer support; confirmation in specific contexts is needed. Inspired by the Taxonomy of Choice Architecture, we assessed support for eight types of nudging to increase the choice of FV-rich foods in a university food service.

Nudging food service users to choose fruit- and vegetable-rich items: Five field studies.

Although nudging has been found to promote the choice of healthy foods in lab studies and ad-hoc field studies, relatively little research is available regarding effectiveness in real food venues that operate for profit. The paucity of empirical studies providing "proof of implementation" reveals the difficulty of applying previous empirical findings on nudging to mass-eating food services contexts, which serve meals to a lot of individuals daily. Based on the typology of choice architecture in food choice contexts, we closely collaborated with the in-house food service operator to devise and implement five nudge interventions to promote fruits and vegetables (FV) in university cafeterias.

Recent trends in adult body mass index and prevalence of excess weight: Data from the Canadian Primary Care Sentinel Surveillance Network.

Objective: To explore recent body mass index (BMI) trends over time among Canadian adults seen in primary care to identify the best target groups for preventive interventions.

Design: Retrospective descriptive cohort design.

Setting: Data for this study were derived from the Canadian Primary Care Sentinel Surveillance Network database.

What Practice Issues Over 25 Years Most Interest Registered Dietitians? Survey and Interview Results.

Dietetics has changed substantially; a mixed-methods project was undertaken to: () gauge interest in the profession history since 1993, () identify preferred format(s), () identify possible topics, and () identify possible key informants. An online bilingual survey was conducted in 2018, with follow-up phone interviews among interested respondents. Survey content was organised as 12 major topics.

Evaluation of Latent Models Assessing Physical Fitness and the Healthy Eating Index in Community Studies: Time-, Sex-, and Diabetes-Status Invariance.

Accurate measurement requires assessment of measurement equivalence/invariance (ME/I) to demonstrate that the tests/measurements perform equally well and measure the same underlying constructs across groups and over time. Using structural equation modeling, the measurement properties (stability and responsiveness) of intervention measures used in a study of metabolic syndrome (MetS) treatment in primary care offices, were assessed. The primary study (N = 293; mean age = 59 years) had achieved 19% reversal of MetS overall; yet neither diet quality nor aerobic capacity were correlated with declines in cardiovascular disease risk.

Changes in mammography screening in Ontario and Alberta following national guideline dissemination: an interrupted time series analysis.

 In November 2011, the Canadian Task Force on Preventive Health Care released guidelines for screening women at average breast cancer risk. Weak recommendations (framed using GRADE methodology) were made for screening women aged 50 to 74 years every two to three years, and for not screening women aged 40 to 49 years.  We conducted an interrupted time series analysis using administrative data to examine bilateral mammography use before and after a release of a national breast screening guideline.

Post-Secondary Food Service Manager Perspectives on Fruit and Vegetable Nudging Strategies: Qualitative Study.

Background: Changing the choice architecture in post-secondary food service contexts to "nudge" customers to choose more fruits and vegetables (FV) shows promise in intervention studies to date. If such approaches are to become more widely adopted, they must be feasible and acceptable to food service managers. Among possible early adopters, managers of food services in post-secondary education institutions may have unique insights on implementation of such approaches, as they have dual mandates to support student health and maintain profitability.

Use of the Healthy Eating Index in Intervention Studies for Cardiometabolic Risk Conditions: A Systematic Review.

Researchers and counselors need diet-assessment tools that characterize diet at baseline and over time in diet counseling and coaching interventions. Among possible tools, the Healthy Eating Index (HEI) is of interest in cardiometabolic treatment as it has undergone significant validation and development. The objective of this study was to systematically review relevant intervention studies using the HEI and its adaptations to examine whether diet interventions improve diet quality as measured by the HEI and the magnitude of change in included diet-quality scores following dietary intervention.

Registered Dietitians' Knowledge, Attitudes, and Behaviour Related to Physical Activity and Sedentariness.

To explore knowledge, attitudes, and behaviour related to physical activity (PA) and sedentariness among registered dietitians (RDs) in family health teams in Ontario. This cross-sectional, descriptive study utilized a semi-structured interview guide to conduct qualitative interviews with 20 RDs. Self-administered questionnaires were used to assess personal PA (short version of the International Physical Activity Questionnaire) and sedentary behaviour (Sedentary Behavior Questionnaire).

Registered dietitians' beliefs and behaviours related to counselling patients on physical activity and sedentary behaviour from a theory of planned behaviour perspective.

Background: Registered dietitians working in team-based primary care settings (e.g., family health teams [FHTs]) are positioned to counsel on physical activity and sedentary behaviour when providing nutrition-related services to promote health and prevent disease.

Emerging insights in weight management and prevention: implications for practice and research.

Recent advances in foundational research on energy balance and weight loss shed new light on earlier findings. Emerging evidence and insights around mental illness and client-centred, weight-inclusive approaches have implications for practitioners. This paper provides an overview of opinions from invited experts who presented at the Canadian Nutrition Society Thematic Conference in January 2019.

Dietary Supplement Use among Non-athlete Students at a Canadian University: A Pilot-Survey.

Despite the emerging evidence of adverse consequences and interaction with doping substances, dietary supplements (DS) are commonly used by many Canadians. The purpose of this study was to evaluate the patterns and determinants of current DS use among non-athlete students at a Canadian university using a cross-sectional approach. Of the 475 participants who completed the online survey, 43.

Impact of a multidisciplinary intervention on physical fitness, physical activity habits and the association between aerobic fitness and components of metabolic syndrome in adults diagnosed with metabolic syndrome.

Background: Metabolic syndrome (MetS) is a health disorder characterized by metabolic abnormalities that predict an increased risk to develop cardiovascular disease (CVD) and type 2 diabetes (T2DM). It can be resolved, and its complications reduced, by lifestyle interventions offered in primary care. The objectives of this study were to evaluate the impact of the exercise program of the CHANGE feasibility study on physical fitness and physical activity habits, and assess associations between changes in MetS components and cardiorespiratory fitness (CRF).

Prediction modelling of 1-year outcomes to a personalized lifestyle intervention for Canadians with metabolic syndrome.

Metabolic syndrome (MetS) comprises a cluster of risk factors that includes central obesity, hypertension, dyslipidemia, and impaired glucose homeostasis. Although lifestyle interventions reduce MetS risk, not everyone responds to the same extent. The primary objective of this study was to identify variables that could predict 1-year changes in MetS risk in individuals participating in the Canadian Health Advanced by Nutrition and Graded Exercise (CHANGE) program.

Patterns of Red and Processed Meat Consumption and Risk for Cardiometabolic and Cancer Outcomes: A Systematic Review and Meta-analysis of Cohort Studies.

Unlabelled: This article has been corrected. The original version (PDF) is appended to this article as a Supplement.

Background: Studying dietary patterns may provide insights into the potential effects of red and processed meat on health outcomes.

Understanding the Use of Dietary Supplements among Athlete and Non-Athlete University Students: Development and Validation of a Questionnaire.

Background: The purpose of this study is to develop and test the validity and reliability of a questionnaire to evaluate dietary supplement use based on the Theory of Planned Behaviour (TPB).

Methods: The questionnaire has sections on demographics, physical activity, dietary supplements, and cognitive constructs based on the TPB. Three stages are followed.

Adherence to Dietary Approaches to Stop Hypertension (DASH)-Style Diet and the Risk of Cancer: A Systematic Review and Meta-Analysis of Cohort Studies.

Several investigators have proposed a protective association between dietary approaches to stop hypertension (DASH) style diet and risk of cancers; however, they have had inconsistent results. The present study aimed to systematically review the prospective cohort studies and if possible quantify the overall effect using meta-analysis. PubMed, Scopus, and Google Scholar were searched for cohort studies published up to July 2018.

Nutrient intake and dietary quality changes within a personalized lifestyle intervention program for metabolic syndrome in primary care.

A team-based 12-month lifestyle program for the treatment of metabolic syndrome (MetS) (involving physicians, registered dietitians (RDs), and kinesiologists) was previously shown to reverse MetS in 19% of patients (95% confidence interval, 14% to 24%). This work evaluates changes in nutrient intake and diet quality over 12 months ( = 205). Individualized diet counselling was provided by 14 RDs at 3 centres.

Prenatal Nutrition in Team-Based Care: Current Practices and Opportunities for Optimization of Care.

To describe prenatal nutrition care currently delivered by Family Health Teams (FHTs) and Community Health Centres (CHCs) in Ontario, from the perspectives of health care providers, and to identify opportunities for improving care. Ten 1-hour, interdisciplinary focus groups were conducted in FHTs and CHCs, involving a total of 73 health care providers. Focus groups ranged in size from 3 to 11 team members, and at least 3 different professions participated in each group.