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12. School Food Policies and Student Eating Behaviors in Canada: Examination of the 2015 Cancer Risk Assessment in Youth Survey

Author

Acton, Rachel B., Nguyen, Nghia, and Minaker, Leia M.

Abstract

Background: Limited evidence exists on effects of school-based nutrition policies. This study explored the influence of mandatory versus voluntary provincial school nutrition policies on student eating behaviors. Methods: A cross-sectional, school-based survey assessed student eating behaviors using self-report survey measures in a representative sample of Canadian high school students from 7 provinces (N = 12,110). Provincial school nutrition policies were characterized as mandatory or voluntary. Healthful and nonhealthful eating behaviors were analyzed across sociodemographic characteristics. Regression models were used to assess the association between policy type and eating behaviors, and to explore potential moderating variables. Results: Healthful and nonhealthful eating behaviors differed significantly across several sociodemographic characteristics. Overall, neither healthful nor nonhealthful eating behaviors differed significantly between schools with voluntary and mandatory nutrition policies (odds ratio [OR] = 0.83, 95% confidence interval [CI] 0.64-1.08; OR = 1.16, 95% CI 0.83-1.64). Frequency of buying lunch at school and buying lunch out moderated the association between policy enforcement level and healthful eating behaviors (p = 0.0472, p = 0.0119). Frequency of buying lunch out moderated the association between policy enforcement levels and nonhealthful eating behaviors (p = 0.0009). Conclusions: This study documents nonhealthful components of Canadian adolescents' diets, and the results highlight important areas for future research in assessing the effectiveness of school nutrition policies.

Published
2018
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17. Estimating the dietary and health impact of implementing front-of-pack nutrition labeling in Canada : A macrosimulation modeling study

Author

Flexner, Nadia, Ng, Alena P., Ahmed, Mavra, Khandpur, Neha, Acton, Rachel B., Lee, Jennifer J., L’Abbe, Mary R., Flexner, Nadia, Ng, Alena P., Ahmed, Mavra, Khandpur, Neha, Acton, Rachel B., Lee, Jennifer J., and L’Abbe, Mary R.

Abstract

Background: Front-of-pack labeling (FOPL) has been identified as a cost-effective policy to promote healthy diets. Health Canada has recently published FOPL regulations that will require food and beverages that meet or exceed set thresholds for sodium, sugars, or saturated fat to display a ‘high in’ symbol on the front of the package. Although a promising measure, its potential impact on dietary intakes and health have not yet been estimated in Canada. Objective: This study aims to estimate (1) the potential dietary impact of implementing a mandatory FOPL among Canadian adults; and (2) the number of diet-related non-communicable disease (NCD) deaths that could be averted or delayed due to these estimated dietary changes. Methods: Baseline and counterfactual usual intakes of sodium, total sugars, saturated fats, and calories were estimated among Canadian adults (n = 11,992) using both available days of 24 h recalls from the 2015 Canadian Community Health Survey-Nutrition. The National Cancer Institute method was used to estimate usual intakes, and adjusted for age, sex, misreporting status, weekend/weekday, and sequence of recall. Estimated counterfactual dietary intakes were modeled from reductions observed in experimental and observational studies that examined changes in sodium, sugars, saturated fat, and calorie content of food purchases in the presence of a ‘high in’ FOPL (four counterfactual scenarios). The Preventable Risk Integrated ModEl was used to estimate potential health impacts. Results: Estimated mean dietary reductions were between 31 and 212 mg/day of sodium, 2.3 and 8.7 g/day of total sugars, 0.8 and 3.7 g/day of saturated fats, and 16 and 59 kcal/day of calories. Between 2,183 (95% UI 2,008–2,361) and 8,907 (95% UI 8,095–9,667) deaths due to diet-related NCDs, mostly from cardiovascular diseases (~70%), could potentially be averted or delayed by implementing a ‘high in’ FOPL in Canada. This estimation represents between 2.4 and 9.6% of the total nu

Published
2023

21. Awareness, use and understanding of nutrition labels among adults from five countries: Findings from the 2018-2020 International Food Policy Study

Author

Acton, Rachel B, Rynard, Vicki L, Adams, Jean, Bhawra, Jasmin, Cameron, Adrian J, Contreras-Manzano, Alejandra, Davis, Rachel E, Jáuregui, Alejandra, Sacks, Gary, Thrasher, James F, Vanderlee, Lana, White, Christine M, Hammond, David, Adams, Jean [0000-0002-5733-7830], and Apollo - University of Cambridge Repository

Subjects
understanding, Canada, Nutrition and Dietetics, Cross-Sectional Studies, nutrition labeling, Australia, Humans, awareness, Mexico, General Psychology, Article, food policy, Nutrition Policy
Abstract

Few studies have compared the effects of different front-of-package label (FOPL) systems in the 'real world'. This study assessed adults' awareness, use and understanding of nutrition facts labels (NFLs) and nationally implemented FOPLs such as Health Star Ratings (HSR), Traffic lights, and Guideline Daily Amounts (GDAs) in five countries, including before and after implementation of Mexico's warning FOPLs in 2020. Data were from the International Food Policy Study, an annual repeat cross-sectional study conducted in 2018-2020 among adults (N=64,032) in Australia, Canada, Mexico, the UK and the US. Self-reported awareness, use, and understanding of NFLs (in all five countries) and FOPLs (in Australia, Mexico, and UK) were assessed over time, between countries, and between NFLs and FOPLs. Most respondents in all countries reported seeing their country's NFLs (awareness) 'often' or 'all the time' across all three years, with one third to half of respondents using NFLs 'often' or 'all the time' (Australia: 43-45%; Canada: 47-50%; Mexico: 36-39%; UK: 32-34%; US: 47-49%), and approximately one half to two thirds finding NFLs 'easy' or 'very easy to understand' (56-57%; 67-69%; 51-54%; 48-51%; 70-71%). In 2020, awareness, use and self-reported understanding of the Warning FOPLs in Mexico were highest among all countries with a FOPL (p

Published
2023

24. Additional file 2 of Tax awareness and perceived cost of sugar-sweetened beverages in four countries between 2017 and 2019: findings from the international food policy study

Author

Acton, Rachel B., Vanderlee, Lana, Adams, Jean, Kirkpatrick, Sharon I., Pedraza, Lilia S., Sacks, Gary, White, Christine M., White, Martin, and Hammond, David

Abstract

Additional file 2. Unadjusted percentages of participants responding that the SSB tax changed whether they buy drinks for themselves or their family, in Mexico (2017, 2018 and 2019) the United Kingdom (2018 and 2019) and the United States (2019). (‘Buy less’ or ‘buy more’ for taxed and untaxed beverage categories, respectively.)

Published
2022
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25. Additional file 4 of Tax awareness and perceived cost of sugar-sweetened beverages in four countries between 2017 and 2019: findings from the international food policy study

Author

Acton, Rachel B., Vanderlee, Lana, Adams, Jean, Kirkpatrick, Sharon I., Pedraza, Lilia S., Sacks, Gary, White, Christine M., White, Martin, and Hammond, David

Subjects
digestive, oral, and skin physiology, food and beverages, health care economics and organizations
Abstract

Additional file 4. Full year comparisons from binary and multinomial logistic regression models investigating perceived cost of beverages with sugar, awareness of sugar-sweetened beverage taxes, and reported purchase changes in response to a sugar-sweetened beverage tax.

Published
2022
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26. Additional file 1 of Tax awareness and perceived cost of sugar-sweetened beverages in four countries between 2017 and 2019: findings from the international food policy study

Author

Acton, Rachel B., Vanderlee, Lana, Adams, Jean, Kirkpatrick, Sharon I., Pedraza, Lilia S., Sacks, Gary, White, Christine M., White, Martin, and Hammond, David

Subjects
stomatognathic diseases, stomatognathic system, skin and connective tissue diseases, health care economics and organizations, eye diseases
Abstract

Additional file 1. Unadjusted percentages for all outcomes, among US respondents living in a city with an SSB tax versus without an SSB tax (weighted).

Published
2022
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27. Additional file 3 of Tax awareness and perceived cost of sugar-sweetened beverages in four countries between 2017 and 2019: findings from the international food policy study

Author

Acton, Rachel B., Vanderlee, Lana, Adams, Jean, Kirkpatrick, Sharon I., Pedraza, Lilia S., Sacks, Gary, White, Christine M., White, Martin, and Hammond, David

Abstract

Additional file 3. Results from multinomial logistic regression models investigating correlates of participants in Mexico, the United Kingdom and the United States reporting that they ‘bought less’ and ‘bought more’ untaxed beverages (versus ‘mixed response / no change’) in response to a sugar-sweetened beverage tax.

Published
2022
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34. Trends in food and nutrition behaviours, knowledge and attitudes among youth in six countries: findings from the 2019-2021 International Food Policy Study Youth Surveys.

Author

Acton RB, White CM, Hock K, Vanderlee L, and Hammond D

Subjects
Humans, Adolescent, Child, Female, Male, Cross-Sectional Studies, Australia, Feeding Behavior psychology, Mexico, Canada, Food Labeling, United States, United Kingdom, Chile, Diet trends, Nutrition Surveys, Health Behavior, Food Supply statistics & numerical data, Health Knowledge, Attitudes, Practice, Nutrition Policy trends
Abstract

Objective: This commentary highlights the release of findings now available in the report International Food Policy Study Youth Surveys: Summary of Findings 2019-2021., Design: The survey data described in this commentary consist of repeated cross-sectional surveys conducted annually beginning in 2019., Setting: Online surveys were conducted in 2019 to 2021 among respondents living in Australia, Canada, Chile, Mexico, the United Kingdom and the USA., Participants: Survey respondents were youth aged 10-17 years in 2019 ( n 12 031), 2020 ( n 11 108) and 2021 ( n 10 459)., Results: The report described in this commentary summarises findings on food and nutrition behaviours, attitudes and knowledge among youth, including their diet sources and patterns, school nutrition environments, food security, diet intentions, weight perceptions and weight loss behaviours, sugary drink perceptions, awareness of public education and mass media campaigns, perceptions of food labels and exposure to food and beverage marketing., Conclusion: Results from the IFPS Youth surveys provide important insights into key policies of global interest, including front-of-package nutrition labelling, levies on sugary beverages and restrictions on marketing unhealthy food and beverages to children. As policymakers continue to seek effective strategies to improve adolescent health outcomes, ongoing cross-country monitoring of food and nutrition-related indicators, such as the data from the International Food Policy Study, will be critical in assessing dietary trends and evaluating upcoming policies.

Published
2024
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