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Lana Vanderlee, Cassondra McCrory & David HammondCPHA Annual MeetingMay 27, 2014

What should I eat?Awareness of Canada’s Food Guide

2Image credit: http://www.hc-sc.gc.ca/fn-an/food-guide-aliment/order-commander/index-eng.php#a1

3Image credit: http://www.cbc.ca/news/health/the-politics-of-food-guides-1.1268575

4Image credit: http://www.hc-sc.gc.ca/fn-an/food-guide-aliment/order-commander/index-eng.php#a1

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• Few adults meet recommendations1,2

– Particularly for Vegetables and Fruits and Grain Products

• 56% could name four food groups in 1997, and 41% in 2001.3

• Government sources have high credibility, but few people use them4

Background

1. Garriguet D. Overview of Canadians’ eating habits. Health Rep 2004;2:82-620. 2. Black JL et al. Do Canadians meet Canada's Food Guide's recommendations for fruits and vegetables? Appl Physiol Nutr Metab 2013;38(3):234-2423. Canadian Council of Food and Nutrition. Tracking Nutrition Trends: A 20-year history. 20094. Goodman S et al. Use of nutritional information in Canada: national trends between 2004 and 2008. J Nutr Educ Behav

2011;43(5):356-365

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1. Examine awareness of Canada’s Food Guide

2. Examine content knowledge of Canada’s Food Guide

3. Examine knowledge of estimated energy requirements from Canada’s Food Guide

Research Objectives

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Methods

• 10 minute intercept exit interviews

• 2 hospital cafeterias in Ottawa, Canada

• Aug/Sept 2013

• Questions on what they ordered, nutrition behaviours and knowledge, and socio-demographics

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Measures • Last use of Canada’s Food Guide

• Knowledge of food groups

• Knowledge of recommended servings of each food group–Vegetables and Fruit = 7-10–Grain Products = 6-8–Milk and Alternatives = 2-3–Meat and Alternatives = 2-3

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Measures • Knowledge of recommended calorie

intake• Physical activity level

• Socio-demographic measures

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Analysis• Linear regression – Number of food groups names (0 – 4 groups)

– Adjusted for socio-demographic variables• Gender• Age• Ethnicity• Income• BMI• How recently they had viewed the food guide

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Results

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Sample Characteristics

• 59% female

• 30.3% 55+ years

• 47.3% > $80,000/yr household income

• 80.8% White

• 53.9% overweight or obese

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Milk and Alterna-

tives

Vegetables and Fruit

Meat and Alternatives

Grain Products

All four groups

80% 78%73%

66%

43%

53%

18%

51%

6%1%

Recalled groupRecalled correct servings

Ability to recall food groups (n=1,048)

Milk and Alternatives

Vegetables and Fruit

Meat and Alternatives

Grain Products

All four groups

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Milk and Alterna-

tives

Vegetables and Fruit

Meat and Alternatives

Grain Products

All four groups

80% 78%73%

66%

43%

53%

18%

51%

6%1%

Recalled groupRecalled correct servings

Ability to recall recommended servings (n=1,048)

Milk and Alternatives

Vegetables and Fruit

Meat and Alternatives

Grain Products

All four groups

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Who recalled more food groups?

• Viewed the food guide (p<0.001 for all)

• Females (p=0.013)

• Younger age categories (p<0.01)

• White participants (p<0.001)

• Higher income groups (p<0.01 for all)

• BMI was not significant

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Knowledge of calorie recommendations

• 4.7% could identify recommendation specific to age, gender and physical activity level

• 29.0% could identify recommendation specific only to age and gender.– 50.0% underestimated– 8.8% overestimated– 12.2% were not able or willing to provide a guess

• Answers ranged from 3 to 20,000 calories

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Limitations & Strengths

Limitations• Sample from hospital cafeterias• Broad categories for “correct” responses

Strengths• Unprompted recall of groups and

recommended servings

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Discussion

• Relatively low levels of use of Canada’s Food Guide and very low levels of knowledge of food guide content.

• Knowledge was lower among populations that face health disparities

• Very few participants knew calorie recommendations – Implications for nutritional literacy and ‘calorie literacy’

21Image credit: http://www.hc-sc.gc.ca/fn-an/food-guide-aliment/order-commander/guide_trans-trad-eng.php and http://www.hc-sc.gc.ca/fn-an/pubs/fnim-pnim/index-eng.php

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Discussion

• Relatively low levels of use of Canada’s Food Guide and very low levels of knowledge of food guide content.

• Knowledge was lower among populations that face health disparities

• Very few participants knew calorie recommendations – Implications for nutritional literacy and ‘calorie

literacy’

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Conclusion

• Poor ‘basic understanding’ of Canada’s official recommendations for diet and nutrition.

• Improving knowledge and understanding of CFG may lead to improved nutrition behaviours

• Sustained campaigns and coordinated efforts with other nutrition programs may improve uptake.

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Additional support provided by:

AcknowledgementsFunding for the project provided by:

Stipend support to Lana Vanderlee funded by the CIHR Training Grant in Population Intervention for Chronic Disease Prevention: A Pan-Canadian Program (Grant #53893)

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Questions?

Lana Vanderlee PhD StudentSchool of Public Health and Health SystemsUniversity of Waterloo

Email: lana.vanderlee@uwaterloo.caTel: 519-888-4567 ext. 31066