Dietary Intake and Overweight
in children aged 10-14 years in Saskatoon
Canada Public Health Association, Annual Conference
Toronto May 26-29, 2014
Ha Le, PhD candidate
Community Health and Epidemiology
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Overview
• Background
• Purpose
• Methods
• Results
• Conclusions
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Background



The global burden of obesity among children and
aldolescents is estimated to be 1 in 10 (Lobstein T et al,
2014)
Dramatic temporal increases in the prevalence of
overweight and obesity in Canadian children (31.5% for
children 5-17 years old, CCHS 2009-2011)
Dietary intake is a corner stone of weight management
across the life cycle and play important role in
influencing the likelihood of being overweight during
childhood and adolescence.
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Purpose
The purpose of this study is to examine dietary
intake and the association between overweight
and nutrition-related factors among children
aged 10-14 years old in Saskatoon who
participated in the ‘Smart Cities and Healthy Kids
– Food environment Study’
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Methods (1)


1408 children, ages of 10 -14 years, from all
residential neighbourhoods in Saskatoon (n=61)
were surveyed at school in March/April 2012.
Survey instrument included
• questions on socio-demographic characteristics
• the Harvard Youth and Adolescent Food
Frequency Questionnaire (YAQ) for dietary
assessment (147 items)
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Methods (2)
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

We assessed students’ dietary intake and compared
this with the Canadian food group and nutrient
recommendations.
Children’s height and weight were measured and BMI
calculated using the age and sex specific BMI
calculator from the WHO (2007), AnthroPlus version
3.1.
Using WHO reference (2007), we classified children as
normal weight (+/-1SD), overweight or obese (greater
than +1SD) and obese (greater than +2SD).
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Methods (3)
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
Data was evaluated using SPSS version 18
Logistic regression was performed using 3 models to
determine the associations between overweight and
frequency of consumption for the four food groups
•
•
•
Model 1 included overweight and frequency of consumption
of a food group controlling for socio-demographic variables
Model 2 was the same as Model 1 but included additional
simulteneous adjustments for the frequency of comsumption
of all other 3 food groups
Model 3 included all significant variables at p-value<0.05
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Results
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Recommended and Observed Number of Servings
from Canada’s Food Guide for Healthy Eating
Food group
Recommended # Mean #
Less than the minimum
Servings/Day Servings/Day recommended servings/Day (%)
Grain products
6
4.2
83.2 (81.3-85.2)
Vegetables & Fruit
6
4.3
79.2 (77.1-81.3)
Milk products
3-4
3.1
52.7 (50.0-55.3)
Meat & Alternatives
1-2
1.4
33.9 (31.4-36.4)
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Prevalence of Inadequate Dietary Intake
Saskatoon study vs. Nova Scotia study
90
83.2
Saskatoon Study
79.2
80
NS Study
73.7
70
60
54.4
49.9
50
52.7
42.3
40
33.9
30
20
10
0
Grain products
Vegetables & Fruit
Milk products
Meat & Alternatives
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Macronutrient intake
Macronutrient intake DRI Category Reference Value Mean (SD) % of Inadequacy
Carbohydrate (%)
AMDR
45-65
56.6 (6.2) 10.2 (2.3 + 7.9)
Protein (%)
AMDR
10-30
16.5 (3.2)
1.6 (1.6+0)
Fat (%)
AMDR
25-35
28.0 (5.0) 29.9 (24.4+5.5)
Fibre (g)
AI
Males
31
15.6 (8.9)
Females
26
14.8 (7.6)
DRI: Dietary Reference Intakes. AMDR: Acceptable Macronutrient Distribution Range. AI: Adequate Intake
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Vitamins and Minerals
Vitamins and Minerals
Vitamin A (RAE)
DRI Category
EAR
EAR
EAR
EAR
EAR
Males
Female
Zinc (mg)
Sodium (mg)
Mean (SD)
% of
Inadequacy
445
420
400
39
250
1100
910.0 (530.2)
858.4 (469.3)
238.5 (161.4)
118.2 (85.1)
325.4 (167.7)
1063.9 (574.3)
18.7
16.5
83.7
12.6
36.1
56.0
5.9
5.7
7.0
2200
12.3 (6.7)
11.2 (5.3)
9.3 (4.6)
2218.3 (1114.0)
10.3
10.8
32.3
EAR
Males
Females
Vitamin D (IU)
Vitamin C (mg)
Folate (DFE)
Calcium (mg)
Iron (mg)
Reference
Value
EAR
UL
EAR: Estimated Average Requirement. AI: Adequate Intake. UL: Upper Limit
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Overweight/Obesity
60
51
50
36.3
40
30
24.3
20
12
10
0
Normal
Overw eight
Obese
Overw eight/Obese
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Overweight and frequency of food group consumption
Quartile (Q)
Fruit and Vegetables
Q1
Q2
Q3
Q4
Dairy
Q1
Q2
Q3
Q4
Grain
Q1
Q2
Q3
Q4
Meat and alternatives
Q1
Q2
Q3
Q4
Median
servings/d
Model 1
OR (95% CI)
Model 2
(95% CI)
1.7
3.1
4.5
6.9
1.00
1.21(0.84-1.75)
0.88 (0.60-1.28)
0.83 (0.57-1.22)
1.00
1.23 (0.84-1.81)
0.89 (0.59-1.34)
0.91 (0.58-1.41)
1.2
2.2
3.5
5.2
1.00
0.76 (0.53-1.10)
0.77 (0.54-1.12)
0.63 (0.43-0.92)
1.00
0.77 (0.53-1.13)
0.76 (0.51-1.12)
0.67 (0.44-1.02)
2.2
3.3
4.4
6.4
1.00
0.92 (0.64-1.33)
0.96 (0.67-1.39)
0.79 (0.47-1.02)
1.00
0.85 (0.57-1.28)
0.86 (0.56-1.33)
0.65 (0.39-1.07)
0.6
1.1
1.5
2.2
1.00
1.22 (0.84-1.79)
1.33 (0.92-1.93)
1.06 (0.73-1.55)
1.00
1.41 (0.95-2.10)
1.72 (1.12-2.65)
1.59 (0.98-2.57)
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Overweight and associated risk factors
Associated factors
Milk products
Q1
Q2
Q3
Q4
Dairy
Q1
Q2
Q3
Q4
Gender
Female
Male
Age
10
11
12
13
14
Aboriginal status
Other
Aboriginal status
Family economic
situation
Wealthy
Average
Poor
Percentage
OR (95% CI)
25%
25%
25%
25%
1.00
0.74 (0.51-1.07)
0.73 (0.50-1.06)
0.59 (0.40-0.87)
25%
25%
25%
25%
1.00
1.31 (0.90-1.93)
1.47 (1.01-2.14)
1.23 (0.83-1.82)
56.1
43.9
1.00
2.31 (1.77-3.00)
19.2
28.8
25.4
19.7
7.0
1.68
1.94
3.44
3.53
1.00
(1.10-2.57)
(1.26-2.98)
(2.22-5.33)
(2.00-6.20)
85.9
14.1
1.00
2.17 (1.48-3.18)
12.3
82.1
5.6
1.00
1.27 (0.85-1.92)
2.19 (1.12-4.28)
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Conclusions

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Dietary intake among adolescent children in Saskatoon is
relatively poor.
The proportion of children who are overweight/obese in
Saskatoon (36.3%) is higher than that of Canadian children
(31.5%).
Significant differences observed in prevalence of overweight
across gender, age, aboriginal status and SES.
A protective association for consumption of dairy and a neagative
association for consumption of meats and alternatives was
observed among children living in Saskatoon
The development of evidence-based policies and prevention
initiatives targeting children and their families may improve
dietary quality and prevent obesity.
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Reference
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Lobstein T, Baur L, Uauy R: Obesity in children and young
people: A crisis in public health. Obes Rev 2004, 5(Suppl 1):4104
Matthews, V. L., Wien, M., & Sabaté, J. (2011). The risk of
child and adolescent overweight is related to types of food
consumed. Nutr J, 10(1), 71-74.
Veugelers, P. J., Fitzgerald, A. L., & Johnston, E. (2005). Dietary
intake and risk factors for poor diet quality among children in
Nova Scotia. Canadian Journal of Public Health, 96(3).
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Acknowledgement



Dr. Nazeem Muhajarine
Dr. Rachel Engler-Stringer
Tracy Ridalls and SCHK research team
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Thank you
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