Canadian Journal of Dietetic Practice and Research, 2013
Feeding practices for young Canadian children from economically disadvantaged neighbourhoods were... more Feeding practices for young Canadian children from economically disadvantaged neighbourhoods were examined to determine adherence to infant feeding recommendations and factors associated with children's weight status. Data for the study were collected from 1996 to 2003 as part of Better Beginnings, Better Futures, a longitudinal primary prevention initiative in Ontario. Study subjects were 546 children at age three months and 483 children at age 48 months. Mothers who had less than a high school education (odds ratio [OR] = 1.83, confidence interval [CI] = 1.01-3.29) and mothers who did not attend prenatal classes (OR = 2.37, CI = 1.33-4.24) were more likely to use formula. Mothers who were single parents were three times more likely to have an obese child (OR = 3.35, CI = 1.39-8.06) than were mothers who were married or with a partner. Targeted strategies are needed for families as single-parent households were predictive of obesity in young children. Innovative encouragement to participate in prenatal programming for pregnant women who have less than a high school education may improve breastfeeding rates.
To determine the prevalence of smoking, low levels of physical activity, and missing breakfast am... more To determine the prevalence of smoking, low levels of physical activity, and missing breakfast among students (n=318) in grades 9 through 12 in three schools in southwestern Ontario; to see if these behaviours were associated; and, whether there were gender differences. A self-administered survey was conducted in grade 10 English classes. The response rate was 87.1%. The prevalence of smoking was 36.2%; there was no gender difference. Only 42.8% of students ate breakfast daily; 48.8% of boys and 36.1% of girls (chi2 = 5.2; p<0.05). A higher proportion of boys (77.1%) were active for at least 30 minutes > or = 3 times/week compared to girls (66.0%) (chi2 = 4.8; p<0.05). Students who were active > or = 3 times/week were more likely to eat breakfast daily and, among boys, 60.4% of non-smokers ate breakfast daily compared to 31.9% of those currently smoking (chi2 = 13.3; p<0.001). There were no differences among girls. More girls (63.9%) were concerned about gaining weight compared to boys (36.1%) (chi2 = 37.7; p<0.001). Among girls, a higher proportion of those who were concerned about gaining weight were less likely to engage in physical activity or smoke, and more likely to skip breakfast compared to those who were not concerned. Weight concern was not associated with frequency of physical activity, smoking, or breakfast consumption among boys. The high prevalence rates for these behaviours suggests that interventions in high schools should include daily physical activity, promotion of breakfast eating (either at home or in the school), and encouragement to quit smoking.
We conducted in-class written surveys of fourth to eighth grade childrens' eating and smoking beh... more We conducted in-class written surveys of fourth to eighth grade childrens' eating and smoking behaviours in southwestern Ontario (n=870) and Charlottetown (n=423) in order to facilitate local school boards and health units planning of health education initiatives. Using chi-square analysis, we examined sex, grade, provincial and rural-urban differences in behaviours. No ruralurban differences emerged. While students reported few gender differences in food group consumption, more PEI students consumed French fries, snack foods, cakes and cookies, and regular soft drinks daily. Only 60.1% (379 of 630) of girls and 70.0% (462 of 660) of boys (X 2 = 13.8; p<.001) ate breakfast every day, falling to 53.2% (115 of 216) among eighth grade girls, and 32.9% (25 of 76) among students who smoked. The prevalence of smoking was 4.8% (n=40) in Ontario and 8.5% (n=36) in PEI (X 2 = 6.8; p<.01). Compared to non-smokers, a higher proportion of students who smoked consumed snack foods and regular soft drinks daily.
... 21. Tobis JS, Saturen P, Larios G, Posniak AO. Study of growth patterns in cerebral palsy. Ar... more ... 21. Tobis JS, Saturen P, Larios G, Posniak AO. Study of growth patterns in cerebral palsy. Arch Phys Med Rehab 1961;June:475-481. 22. ... 28. Sabry JH, Gibson RS, Pen C. Nutrient Intake System (Revised). Department of Family Studies, University of Guelph, 1984. 29. ...
Background. This study aimed to describe the dietary intakes of adolescent vegetarians and omnivo... more Background. This study aimed to describe the dietary intakes of adolescent vegetarians and omnivores and determine if, and how, attitude toward personal health related to food consumption.
Sontrop J, Avison WR, Evers SE, Speechley KN, Campbell MK. Depressive symptoms during pregnancy i... more Sontrop J, Avison WR, Evers SE, Speechley KN, Campbell MK. Depressive symptoms during pregnancy in relation to fish consumption and intake of n-3 polyunsaturated fatty acids. Paediatric and Perinatal Epidemiology 2008; 22: 389-399.
Journal of the American Dietetic Association, 2005
This study was undertaken to assess how low-carbohydrate-density diets below the acceptable macro... more This study was undertaken to assess how low-carbohydrate-density diets below the acceptable macronutrient distribution range relate to food and micronutrient intake and sociodemographic and health-related characteristics. The multistage stratified cluster design in the 1990 Ontario Health Survey was used. There were 5,194 subjects, 12 to 18 years of age, in sampled households. Dietary data were collected via a food frequency questionnaire. Lowcarbohydrate-density diets were consumed by 27.6% of males and 24.1% of females. Low-carbohydrate-density diets were related (PϽ.05) to reduced sufficiency of vegetables and fruit and higher consumption of meat and alternatives and added fats. The low-carbohydrate-density diet resulted in intakes lower in vitamin C and fiber and higher in cholesterol and total fat. The low-carbohydrate-density diet was directly associated with being Canadian-born (odds ratio [OR]ϭ1.78, 95% confidence interval [CI]ϭ1.27 to 2.50), overweight status (ORϭ1.27, 95%
Objective: This study examined the impact of one person's dietary change on the experiences of a ... more Objective: This study examined the impact of one person's dietary change on the experiences of a significant other with whom they regularly shared meals.
Stakeholders&amp;amp;amp;#39; attitudes about and perceptions of school-based child nutrition... more Stakeholders&amp;amp;amp;#39; attitudes about and perceptions of school-based child nutrition programs (CNPs) in Ontario were examined through focus groups and individual interviews with children (n = 46), participating parents (n = 19), nonparticipating parents (n = 22), volunteers (n = 4), program coordinators (n = 8), and educators (n = 8). Most children did not perceive stigma in participating in a
Canada does not have federally funded child nutrition programs. Instead, programs are local endea... more Canada does not have federally funded child nutrition programs. Instead, programs are local endeavors. We evaluated programs in Ontario against the Breakfast for Learning Canadian Living Foundation Best Practices standards. Three hundred breakfast and snack programs were randomly selected; 39.4% responded. Data collection included a survey completed by program coordinators and site visits conducted by registered dietitians. Results indicate that programs are meeting some, but not all, of the best practices. Only 54.3% of breakfast and 66.0% of snack programs had paid program coordinators. Resources and strategies need to be developed to help all programs meet best practices.
Monographs of the Society for Research in Child Development, 2010
Although comprehensive and ecological approaches to early childhood prevention are commonly advoc... more Although comprehensive and ecological approaches to early childhood prevention are commonly advocated, there are few examples of long-term follow-up of such programs. In this monograph, we investigate the medium- and long-term effects of an ecological, community-based prevention project for primary school children and families living in three economically disadvantaged neighborhoods in Ontario, Canada. The Better Beginnings, Better Futures (BBBF) project is one of the most ambitious Canadian research projects on the long-term impacts of early childhood prevention programming to date. Bronfenbrenner's ecological model of human development informed program planning, implementation, and evaluation. Using a quasi-experimental design, the BBBF longitudinal research study involved 601 children and their families who participated in BBBF programs when children were between 4 and 8 years old and 358 children and their families from sociodemographically matched comparison communities. W...
This study aimed to identify attitudes, health behaviours, social adjustment and self-reported he... more This study aimed to identify attitudes, health behaviours, social adjustment and self-reported health of vegetarian and omnivore teenagers and determine characteristics independently related to vegetarian status. Participants were 630 Grade 9 students, ages 13-15 years, in seven schools in Ontario, Canada. Vegetarian status was determined using a 19-item food inventory. The vegetarian group included lacto, ovo and/or lacto-ovo and semi-vegetarians. Omnivores consumed red meat at least monthly. Social adjustment factors included school misbehaviour, low academic performance, authority-defying risks and unsafe/illegal risks. Logistic regression estimated the relationship of characteristics to vegetarian status. The sample comprised 25 vegetarians (4%) and 605 omnivores. Analyses focussed mainly on females; 22 vegetarians and 315 omnivores. Dieting behaviours (current, frequent and past year), alcohol use, poorer social adjustment and poorer self-rated health were positively related to vegetarian eating ( p < .05). Among females (using logistic regression), past year dieting (OR 9.88; 95% CI 2.19-44.47) and alcohol use (OR 2.91; 95% CI 1.02-8.32) predominated in the presence of attitudes that personal health and animal rights are very important. The model predicted 79.9% of cases. Teenage vegetarians were distinctive in health behaviours. The independent, positive association of alcohol use with vegetarian eating is a unique and concerning finding. Dieting behaviours were strongly, independently and positively linked to female vegetarian eating. Further studies with a greater range of behaviours would be useful to more fully characterize teenage vegetarians and explore subgroups. #
This review outlines the state of knowledge and research gaps in the area of determinants of heal... more This review outlines the state of knowledge and research gaps in the area of determinants of healthy eating among children and youth. The article is structured around individual and collective determinants that affect healthy eating in children and youth. We defined healthy eating as "eating practices and behaviours that are consistent with improving, maintaining and/or enhancing health." Relevant databases were searched for papers published between January 1992 and March 2003 that focussed on children or youth and reported at least one factor relevant to healthy eating. Among collective factors, familial factors and the nature of foods available in the physical environment, including at home, schools and in fast-food establishments, stand out as significant influences on healthy eating in children and youth. The media, particularly television, also have an enormous potential influence and can overshadow familial influences. Individual factors identified include knowledge, attitudes and food preferences; only the latter have been identified as a strong determinant of healthy eating in both children and adolescents. The results of the review identified a significant body of literature in the area of determinants of healthy eating in children and youth; however, very little of this research has taken place in Canada. Only a few determinants, such as economic factors and food security, the content of media nutritional messages, and the issue of flavours, neophobia and food preferences, have undergone some examination by Canadian researchers. Research priorities for Canada in the area of determinants of healthy eating and surveillance of eating behaviours are identified.
Canadian Journal of Dietetic Practice and Research, 2013
Feeding practices for young Canadian children from economically disadvantaged neighbourhoods were... more Feeding practices for young Canadian children from economically disadvantaged neighbourhoods were examined to determine adherence to infant feeding recommendations and factors associated with children&amp;amp;amp;amp;#39;s weight status. Data for the study were collected from 1996 to 2003 as part of Better Beginnings, Better Futures, a longitudinal primary prevention initiative in Ontario. Study subjects were 546 children at age three months and 483 children at age 48 months. Mothers who had less than a high school education (odds ratio [OR] = 1.83, confidence interval [CI] = 1.01-3.29) and mothers who did not attend prenatal classes (OR = 2.37, CI = 1.33-4.24) were more likely to use formula. Mothers who were single parents were three times more likely to have an obese child (OR = 3.35, CI = 1.39-8.06) than were mothers who were married or with a partner. Targeted strategies are needed for families as single-parent households were predictive of obesity in young children. Innovative encouragement to participate in prenatal programming for pregnant women who have less than a high school education may improve breastfeeding rates.
To determine the prevalence of smoking, low levels of physical activity, and missing breakfast am... more To determine the prevalence of smoking, low levels of physical activity, and missing breakfast among students (n=318) in grades 9 through 12 in three schools in southwestern Ontario; to see if these behaviours were associated; and, whether there were gender differences. A self-administered survey was conducted in grade 10 English classes. The response rate was 87.1%. The prevalence of smoking was 36.2%; there was no gender difference. Only 42.8% of students ate breakfast daily; 48.8% of boys and 36.1% of girls (chi2 = 5.2; p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05). A higher proportion of boys (77.1%) were active for at least 30 minutes &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; or = 3 times/week compared to girls (66.0%) (chi2 = 4.8; p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05). Students who were active &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; or = 3 times/week were more likely to eat breakfast daily and, among boys, 60.4% of non-smokers ate breakfast daily compared to 31.9% of those currently smoking (chi2 = 13.3; p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). There were no differences among girls. More girls (63.9%) were concerned about gaining weight compared to boys (36.1%) (chi2 = 37.7; p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). Among girls, a higher proportion of those who were concerned about gaining weight were less likely to engage in physical activity or smoke, and more likely to skip breakfast compared to those who were not concerned. Weight concern was not associated with frequency of physical activity, smoking, or breakfast consumption among boys. The high prevalence rates for these behaviours suggests that interventions in high schools should include daily physical activity, promotion of breakfast eating (either at home or in the school), and encouragement to quit smoking.
We conducted in-class written surveys of fourth to eighth grade childrens' eating and smoking beh... more We conducted in-class written surveys of fourth to eighth grade childrens' eating and smoking behaviours in southwestern Ontario (n=870) and Charlottetown (n=423) in order to facilitate local school boards and health units planning of health education initiatives. Using chi-square analysis, we examined sex, grade, provincial and rural-urban differences in behaviours. No ruralurban differences emerged. While students reported few gender differences in food group consumption, more PEI students consumed French fries, snack foods, cakes and cookies, and regular soft drinks daily. Only 60.1% (379 of 630) of girls and 70.0% (462 of 660) of boys (X 2 = 13.8; p<.001) ate breakfast every day, falling to 53.2% (115 of 216) among eighth grade girls, and 32.9% (25 of 76) among students who smoked. The prevalence of smoking was 4.8% (n=40) in Ontario and 8.5% (n=36) in PEI (X 2 = 6.8; p<.01). Compared to non-smokers, a higher proportion of students who smoked consumed snack foods and regular soft drinks daily.
... 21. Tobis JS, Saturen P, Larios G, Posniak AO. Study of growth patterns in cerebral palsy. Ar... more ... 21. Tobis JS, Saturen P, Larios G, Posniak AO. Study of growth patterns in cerebral palsy. Arch Phys Med Rehab 1961;June:475-481. 22. ... 28. Sabry JH, Gibson RS, Pen C. Nutrient Intake System (Revised). Department of Family Studies, University of Guelph, 1984. 29. ...
Background. This study aimed to describe the dietary intakes of adolescent vegetarians and omnivo... more Background. This study aimed to describe the dietary intakes of adolescent vegetarians and omnivores and determine if, and how, attitude toward personal health related to food consumption.
Sontrop J, Avison WR, Evers SE, Speechley KN, Campbell MK. Depressive symptoms during pregnancy i... more Sontrop J, Avison WR, Evers SE, Speechley KN, Campbell MK. Depressive symptoms during pregnancy in relation to fish consumption and intake of n-3 polyunsaturated fatty acids. Paediatric and Perinatal Epidemiology 2008; 22: 389-399.
Journal of the American Dietetic Association, 2005
This study was undertaken to assess how low-carbohydrate-density diets below the acceptable macro... more This study was undertaken to assess how low-carbohydrate-density diets below the acceptable macronutrient distribution range relate to food and micronutrient intake and sociodemographic and health-related characteristics. The multistage stratified cluster design in the 1990 Ontario Health Survey was used. There were 5,194 subjects, 12 to 18 years of age, in sampled households. Dietary data were collected via a food frequency questionnaire. Lowcarbohydrate-density diets were consumed by 27.6% of males and 24.1% of females. Low-carbohydrate-density diets were related (PϽ.05) to reduced sufficiency of vegetables and fruit and higher consumption of meat and alternatives and added fats. The low-carbohydrate-density diet resulted in intakes lower in vitamin C and fiber and higher in cholesterol and total fat. The low-carbohydrate-density diet was directly associated with being Canadian-born (odds ratio [OR]ϭ1.78, 95% confidence interval [CI]ϭ1.27 to 2.50), overweight status (ORϭ1.27, 95%
Objective: This study examined the impact of one person's dietary change on the experiences of a ... more Objective: This study examined the impact of one person's dietary change on the experiences of a significant other with whom they regularly shared meals.
Stakeholders&amp;amp;amp;#39; attitudes about and perceptions of school-based child nutrition... more Stakeholders&amp;amp;amp;#39; attitudes about and perceptions of school-based child nutrition programs (CNPs) in Ontario were examined through focus groups and individual interviews with children (n = 46), participating parents (n = 19), nonparticipating parents (n = 22), volunteers (n = 4), program coordinators (n = 8), and educators (n = 8). Most children did not perceive stigma in participating in a
Canada does not have federally funded child nutrition programs. Instead, programs are local endea... more Canada does not have federally funded child nutrition programs. Instead, programs are local endeavors. We evaluated programs in Ontario against the Breakfast for Learning Canadian Living Foundation Best Practices standards. Three hundred breakfast and snack programs were randomly selected; 39.4% responded. Data collection included a survey completed by program coordinators and site visits conducted by registered dietitians. Results indicate that programs are meeting some, but not all, of the best practices. Only 54.3% of breakfast and 66.0% of snack programs had paid program coordinators. Resources and strategies need to be developed to help all programs meet best practices.
Monographs of the Society for Research in Child Development, 2010
Although comprehensive and ecological approaches to early childhood prevention are commonly advoc... more Although comprehensive and ecological approaches to early childhood prevention are commonly advocated, there are few examples of long-term follow-up of such programs. In this monograph, we investigate the medium- and long-term effects of an ecological, community-based prevention project for primary school children and families living in three economically disadvantaged neighborhoods in Ontario, Canada. The Better Beginnings, Better Futures (BBBF) project is one of the most ambitious Canadian research projects on the long-term impacts of early childhood prevention programming to date. Bronfenbrenner's ecological model of human development informed program planning, implementation, and evaluation. Using a quasi-experimental design, the BBBF longitudinal research study involved 601 children and their families who participated in BBBF programs when children were between 4 and 8 years old and 358 children and their families from sociodemographically matched comparison communities. W...
This study aimed to identify attitudes, health behaviours, social adjustment and self-reported he... more This study aimed to identify attitudes, health behaviours, social adjustment and self-reported health of vegetarian and omnivore teenagers and determine characteristics independently related to vegetarian status. Participants were 630 Grade 9 students, ages 13-15 years, in seven schools in Ontario, Canada. Vegetarian status was determined using a 19-item food inventory. The vegetarian group included lacto, ovo and/or lacto-ovo and semi-vegetarians. Omnivores consumed red meat at least monthly. Social adjustment factors included school misbehaviour, low academic performance, authority-defying risks and unsafe/illegal risks. Logistic regression estimated the relationship of characteristics to vegetarian status. The sample comprised 25 vegetarians (4%) and 605 omnivores. Analyses focussed mainly on females; 22 vegetarians and 315 omnivores. Dieting behaviours (current, frequent and past year), alcohol use, poorer social adjustment and poorer self-rated health were positively related to vegetarian eating ( p < .05). Among females (using logistic regression), past year dieting (OR 9.88; 95% CI 2.19-44.47) and alcohol use (OR 2.91; 95% CI 1.02-8.32) predominated in the presence of attitudes that personal health and animal rights are very important. The model predicted 79.9% of cases. Teenage vegetarians were distinctive in health behaviours. The independent, positive association of alcohol use with vegetarian eating is a unique and concerning finding. Dieting behaviours were strongly, independently and positively linked to female vegetarian eating. Further studies with a greater range of behaviours would be useful to more fully characterize teenage vegetarians and explore subgroups. #
This review outlines the state of knowledge and research gaps in the area of determinants of heal... more This review outlines the state of knowledge and research gaps in the area of determinants of healthy eating among children and youth. The article is structured around individual and collective determinants that affect healthy eating in children and youth. We defined healthy eating as "eating practices and behaviours that are consistent with improving, maintaining and/or enhancing health." Relevant databases were searched for papers published between January 1992 and March 2003 that focussed on children or youth and reported at least one factor relevant to healthy eating. Among collective factors, familial factors and the nature of foods available in the physical environment, including at home, schools and in fast-food establishments, stand out as significant influences on healthy eating in children and youth. The media, particularly television, also have an enormous potential influence and can overshadow familial influences. Individual factors identified include knowledge, attitudes and food preferences; only the latter have been identified as a strong determinant of healthy eating in both children and adolescents. The results of the review identified a significant body of literature in the area of determinants of healthy eating in children and youth; however, very little of this research has taken place in Canada. Only a few determinants, such as economic factors and food security, the content of media nutritional messages, and the issue of flavours, neophobia and food preferences, have undergone some examination by Canadian researchers. Research priorities for Canada in the area of determinants of healthy eating and surveillance of eating behaviours are identified.
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Papers by Susan Evers