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Are Sub-Saharan African National Food And Agriculture Policies Nutrition-Sensitive? A Case Study Of Ethiopia, Ghana, Malawi, Nigeria, And South Africa, Roshaany Asirvatham

Health Studies Publications

Background

In sub-Saharan Africa (SSA), malnutrition coupled with rising rates of undernutrition and the burden of overweight/obesity remains one of the most significant public health challenges facing the region. Nutrition-sensitive agriculture can play an important role in reducing malnutrition by addressing the underlying causes of nutrition outcomes. Therefore, we aim to assess the nutrition-sensitivity of food and agriculture policies in SSA and to provide recommendations for identified policy challenges in implementing nutrition-sensitive agriculture initiatives.

Methods

We assessed past and current national policies relevant to agriculture and nutrition from Ethiopia, Ghana, Malawi, Nigeria, and South Africa. Thirty policies and strategies were …

Be Healthy In Pregnancy (Bhip): A Randomized Controlled Trial Of Nutrition And Exercise Intervention From Early Pregnancy To Achieve Recommended Gestational Weight Gain, Stephanie A. Atkinson, Atherai Maran, Kendra Dempsey, Maude Perreault, Thuva Vanniyasingam, Stuart M. Phillips, Eileen K. Hutton, Michelle F. Mottola

Paediatrics Publications

A randomized two-arm prospective superiority trial tested the efficacy of a novel structured and monitored nutrition (bi-weekly counselling for individualized energy and high dairy protein diet) and exercise program (walking goal of 10,000 steps/day) (intervention) compared to usual care (control) in pregnant women to achieve gestational weight gain (GWG) within current recommendations. Women recruited in communities in southern Ontario, Canada were randomized at 12–17 weeks gestation with stratification by site and pre-pregnancy BMI to intervention (n = 119) or control (n = 122). The primary outcome was the proportion of women who achieved GWG within the Institute of Medicine recommendations. …

Stroke Prevention: Little-Known And Neglected Aspects, M. Reza Azarpazhooh, Chrysi Bogiatzi, J. David Spence

Department of Medicine Publications

Combining available therapies has the potential to reduce the risk of stroke by 80% or more. A comprehensive review of all aspects of stroke prevention would be very lengthy; in this narrative review, we focus on some aspects of stroke prevention that are little-known and/or neglected. These include the following: (1) implementation of a Mediterranean diet; (2) B vitamins to lower homocysteine; (3) coordinated approaches to smoking cessation; (4) intensive lipid-lowering therapy; (5) lipid lowering in the elderly; (6) physiologically individualized therapy for hypertension based on renin/aldosterone phenotyping; (7) avoiding excessive blood pressure reduction in patients with stiff arteries; (8) …

The Good Food For Learning Universal Curriculum-Integrated Healthy School Lunch Intervention: Protocol For A Two-Year Matched Control Pre-Post And Case Study, Rachel Engler-Stringer, Jennifer Black, Nazeem Muhajarine, Wanda Martin, Jason Gilliland, Janet Mcvittie, Sara Kirk, Hannah Wittman, Amin Mousavi, Sinikka Elliott, Brent Hills, Gordon Androsoff, Debbie Field, Brit Macdonald, Chelsea Belt, Hassan Vatanparast

Paediatrics Publications

Background: Good nutrition affects children's health, well-being, and learning, and schools offer an important setting to promote healthy behaviors that can last a lifetime. Once children reach school age, they spend more of their waking hours in school than in any other environment. Children's eating habits may be easier to influence than those of adults. In Canada, households with children are more likely to experience food insecurity, and school food programs that are universally available to all children can support the development of healthy eating patterns across groups of varying socioeconomic status. There is a significant gap in the rigorous …

Examining The Feasibility Of Delivering A Multi-Component Virtual Lifestyle Medicine Program For Adults With Type 2 Diabetes, Madison S. Hiemstra

Electronic Thesis and Dissertation Repository

BACKGROUND: The virtual delivery of lifestyle medicine programs (e.g., via web-conferencing platforms) can increase program accessibility for adults living with type 2 diabetes (T2D). PURPOSE: To assess the feasibility of virtually delivering a multi-component group-based lifestyle medicine program that uses wearable technologies and exercise prescriptions in an adult population with T2D. METHODS: This was a six-week, single-cohort feasibility study. The virtual lifestyle medicine program included live-video delivery of group education classes, one-on-one exercise counselling phone calls, flash glucose monitors, wearable activity monitors, and exercise prescriptions. Several feasibility outcomes were assessed including recruitment and retention rates, acceptability (e.g., exit survey), and …

Perspectives Of Canadian Midwives On Nutrition For Pregnancy, Yvana T. Sawaya

Electronic Thesis and Dissertation Repository

Limited data exists on Canadian midwives’ experiences with nutrition for pregnancy. An anonymous e-survey was distributed via midwifery associations’ e-newsletters, social media, and clinics’ public e-mail addresses to explore Canadian midwives’ nutrition attitudes, education, and recommendations.

Almost all (99.4%) of the 161 respondents provided nutrition advice to pregnant women and almost two-thirds (63.7%) received nutrition training. Midwives had positive attitudes towards nutrition (median=5 on scale where 1=very unimportant and 5=very important) and their comfort levels in advising on nutrition topics ranged from moderate to high. An average of 85.3% of their recommendations aligned with Health Canada pregnancy guidelines and relevant …

Children’S Perceptions Of A Centrally Procured School Food Program In Southwestern Ontario, Canada, Paige Colley, Linda Miller, Jamie A. Seabrook, Sarah J. Woodruff, Jason Gilliland

Paediatrics Publications

Introduction: This qualitative study investigates children’s perceptions of the influences of a Centrally Procured School Food Program on their dietary behaviours and their recommendations on how to improve the program. Methods: The observations of 208 students aged 9 to 14 years (Grades 5–8) at 21 elementary schools were collected through focus groups in 2017/18. The larger intervention consisted of a 10-week program offering daily snacks (i.e. fruit, vegetables, whole grains, dairy, meat alternatives) for elementary school children in southwestern Ontario, Canada. Results: The participants’ overall impressions of the program were positive. They noted reduced hunger, increased energy and improved nutrition. …

Children’S Perceptions Of A Centrally Procured School Food Program In Southwestern Ontario, Canada, Paige Colley, Linda Miller, Jamie A. Seabrook, Sarah J. Woodruff, Jason Gilliland

Paediatrics Publications

Introduction: This qualitative study investigates children’s perceptions of the influences of a Centrally Procured School Food Program on their dietary behaviours and their recommendations on how to improve the program. Methods: The observations of 208 students aged 9 to 14 years (Grades 5–8) at 21 elementary schools were collected through focus groups in 2017/18. The larger intervention consisted of a 10-week program offering daily snacks (i.e. fruit, vegetables, whole grains, dairy, meat alternatives) for elementary school children in southwestern Ontario, Canada. Results: The participants’ overall impressions of the program were positive. They noted reduced hunger, increased energy and improved nutrition. …

Perspectives And Impact Of A Parent-Child Intervention On Dietary Intake And Physical Activity Behaviours, Parental Motivation, And Parental Body Composition: A Randomized Controlled Trial, Shazya Karmali, Danielle S. Battram, Shauna M. Burke, Anita Cramp, Andrew M. Johnson, Tara Mantler, Don Morrow, Victor Ng, Erin S. Pearson, Robert J. Petrella, Patricia Tucker, Jennifer D. Irwin

Paediatrics Publications

Adults and children in Canada are not meeting physical activity guidelines nor consuming sufficient nutrient-rich foods. High engagement in these unhealthy behaviours can lead to obesity and its associated diseases. Parent-child interventions aimed at obesity prevention/treatment have assisted families with making positive changes to their nutrition and physical activity behaviours. Given that the home environment shapes early health behaviours, it is important to target both parents and children when addressing diet and physical activity. One method that has been shown to improve health outcomes is co-active coaching. The current study explored the impact of a threemonth co-active coaching and/or health …

Influence Of Nutrition Status And Body Composition On Exercise Capacity And Survival Among Individuals With Interstitial Lung Disease: A Cross-Sectional Study In An Outpatient Setting., Sylvia Rinaldi

Electronic Thesis and Dissertation Repository

Interstitial lung disease (ILD) and its associated treatments have the potential to put patients at nutrition risk. However, minimal is known about the relationship between nutritional status on disease severity and prognosis in ILD. Existing research is limited by its focus on weight and body mass index (BMI). Therefore, the primary objective of this cross-sectional, prospective study was to determine the prevalence of malnutrition using the subjective global assessment (SGA) and to estimate body composition using bioelectrical impedance analysis (BIA) among individuals with ILD (n = 78). A second objective of this research was to investigate the appropriateness of bioimpedance …

The Now Trial: A Pragmatic Randomized Controlled Trial Of Personalized, Genetic-Based Lifestyle Advice, Justine Rochelle Horne

Electronic Thesis and Dissertation Repository

Background: The impact of nutrigenomics and lifestyle genomics interventions on health outcomes and behaviours remains controversial and under-explored.

Objectives: To determine the short-term (3-month), moderate-term (6-month) and long-term (12-month) impact of providing personalized, genetic-based lifestyle information and advice on anthropometric measures, as well as dietary intake and adherence.

Methods: The nutrigenomics, overweight/obesity and weight management trial (NOW Trial) is a pragmatic randomized controlled trial that was incorporated into the Group Lifestyle Balance™ (GLB) program (N=140). Inclusion criteria: overweight or obesity (BMI ≥ 25 kg/m²), ≥ 18 years of age, English-speaking, having access to internet at least …

A Coaching And/Or Education Intervention Targeting Physical Activity And Nutrition Behaviours In Parents With Overweight/Obesity And Their Children, Shazya Karmali

Electronic Thesis and Dissertation Repository

The purpose of this dissertation is to provide a detailed overview of, findings from, and experiences participating in a 3-month randomized controlled trial (RCT) targeting obesity-related behaviours in parents with overweight/obesity (body mass index [BMI] ≥ 25 kg/m²) and their children (2.5-10 years old, any weight; N = 50 dyads). A concurrent mixed methods study comprised of an RCT and descriptive qualitative design was utilized. Parent-participants received Co-Active Life Coaching (CALC) and webinar-based health education (intervention) or education only (control). To address the dissertation’s purpose, Chapter II provides a detailed methodological account of the program, including rationale and …

Integsci 3002a: Nutrition: Uncovering The Misconceptions Of What We Consume, Kaitlyn Charnetski, Winston Herold, Emma Davis, Ridwan Bari, Emily Hornung, Reese Gartly

Community Engaged Learning Final Projects

Nutrition misconceptions are widespread and can be harmful to consumers. It is necessary to address and research them to avoid the propagation of misinformation. This investigation revealed the truth behind some commonly debated nutrition topics: frozen produce are equal in nutrition to fresh; protein powders are not a sufficient diet alone because they lack essential nutrients; kombucha has genuine positive health impacts; bottled water is not healthier than tap water; supplements can cause health deterioration over time; and diabetics can manage their condition through diet choices. The information gathered here will provide more power to the consumer to make informed, …

Experiences Regarding Nutrition And Exercise Among Women During Early Postpartum: A Qualitative Grounded Theory Study, Beth Murray-Davis, Lindsay Grenier, Stephanie A. Atkinson, Michelle F. Mottola, Olive Wahoush, Lehana Thabane, Feng Xie, Jennifer Vickers-Manzin, Caroline Rosenblatt, David Watkins, Avraham Shaag, Stanley H. Korman, Samuel N. Heyman, Aya Gal, J. P. Newman, Bettina Steiner-Birmanns, Oded Abramsky, Yoav Kohn

Paediatrics Publications

Background: Excess gestational weight gain has long- and short-term implications for women and children, and postpartum weight retention is associated with an increased risk of long-term obesity. Despite the existence of dietary and exercise guidelines, many women struggle to return to pre-pregnancy weight. Experiences of women in tackling postpartum weight loss are poorly understood. We undertook this study to explore experiences related to nutrition, exercise and weight in the postpartum in women in Ontario, Canada. Methods: This was a nested qualitative study within The Be Healthy in Pregnancy Study, a randomized controlled trial. Women randomized to the control group were …

Nutrition And Exercise Interventions During Pregnancy: How Important Is Adherence?, Taniya S. Nagpal

Electronic Thesis and Dissertation Repository

Lifestyle interventions (nutrition and exercise) offered during pregnancy may prevent excessive gestational weight gain (EGWG) and improve pregnancy outcomes. The efficacy of previous interventions has been inconsistent as some studies ‘successfully’ achieve their health outcome goals while others have had a null effect. A common limitation reported among ‘unsuccessful’ studies is low adherence. The objective of this dissertation was to execute three independent yet interrelated studies to determine if adherence is a key factor in determining the success of a lifestyle intervention during pregnancy. Study 1 compared adherence to ‘successful’ and ‘unsuccessful’ lifestyle interventions during pregnancy using a systematic review. …

Novel Roles Of Mechanistic Target Of Rapamycin Signaling In Regulating Fetal Growth, Madhulika B. Gupta, Thomas Jansson

Paediatrics Publications

Mechanistic target of rapamycin (mTOR) signaling functions as a central regulator of cellular metabolism, growth, and survival in response to hormones, growth factors, nutrients, energy, and stress signals. Mechanistic TOR is therefore critical for the growth of most fetal organs, and global mTOR deletion is embryonic lethal. This review discusses emerging evidence suggesting that mTOR signaling also has a role as a critical hub in the overall homeostatic control of fetal growth, adjusting the fetal growth trajectory according to the ability of the maternal supply line to support fetal growth. In the fetus, liver mTOR governs the secretion and phosphorylation …

Nutrition And Risk Of Stroke, J. David Spence

Department of Medicine Publications

Nutrition is far more important in stroke risk than most physcians suppose. Healthy lifestyle choices reduce the risk of stroke by ~80%, and of the factors that increase the risk of stroke, the worst is diet: only ~0.1% of Americans consume a healthy diet, and only 8.3% consume a somewhat healthy diet. The situation is probably not much better in most other countries. A Cretan Mediterranean diet, high in olive oil, whole grains, fruits, vegetables and legumes, and low in cholesterol and saturated fat, can reduce stroke by 40% or more in high-risk patients. The role of the intestinal microbiome …

Youth Opportunities Unlimited Fiti Plan 2019, Bob Gough, Toby Le

Business and Social Enterprise

Intent of the Collaboration To establish and operate a Fiti probiotic yogurt social enterprise in London Ontario. Many studies, including by Western’s Geography Professor Gilliland, have shown that schools and homes in the poorest part of London, are surrounded by 40 or more fast food outlets. The data correlates with malnutrition, obesity, and diabetes. By bringing highly nutritious food with added health benefits at an affordable price, it will encourage families to include Fiti as a substitute for those ‘harmful foods. One of the key aims of the program is to provide probiotic foods to vulnerable populations through youth engagement …

Vitamin D And Gestational Diabetes Mellitus: Is There A Link?, Gianluca Rizzo, Simone Garzon, Michele Fichera, Marco Marzio Panella, Ursula Catena, Antonio Schiattarella, Pasquale De Franciscis, George Vilos, Jan Tesarik, Péter Török, Giuseppe Grosso

Paediatrics Publications

Gestational diabetes mellitus (GDM) is a very common condition among pregnant women worldwide with important metabolic implications on the mother and the offspring. Vitamin D status has been suggested to potentially play a role in GDM risk with no documented consequences for the offspring. The purpose of this article was to review currently available evidence on the relationship between vitamin D and GDM. Current evidence shows an association between vitamin D blood levels and risk of GDM, despite heterogeneity of results across studies limit the conclusions. Moreover, data from randomized controlled trials is scarce and resulting in null findings. Among …

Study Protocol Of A Pragmatic Randomized Controlled Trial Incorporated Into The Group Lifestyle Balance™ Program: The Nutrigenomics, Overweight/Obesity And Weight Management Trial (The Now Trial), Justine Horne, Jason A. Gilliland, Colleen O’Connor,, Jamie A. Seabrook, Peter Hannaberg, Janet Madill

Human Environments Analysis Lab (HEAL)

Background

The nutrigenomics, overweight/obesity and weight management trial (NOW Trial) is a pragmatic randomized controlled trial of community-dwelling adults recruited from the Group Lifestyle Balance™ (GLB™) Program. The GLB™ Program (formerly referred to as the Diabetes Prevention Program) is an evidence-based, intensive weight management program, which was offered to overweight/obese patients (BMI ≥ 25.0 kg/m2) in a rural Ontario community.

Methods

Patients enrolled in the GLB™ Program were invited to participate in this study. GLB™ groups were randomized 1:1 to receive either the standard GLB™ program + population-based lifestyle advice for weight management, or a modified GLB™ program + personalized, …

Analysis Of Added Sugar Intake Of Canadian Children And Adolescents: Findings From The Canadian Community Health Survey On Nutrition, Ulaina Tariq

Electronic Thesis and Dissertation Repository

Background: The added sugar intake of children and adolescents in Canada warrants more research due to its contribution to obesity, diabetes, and other chronic and mental health issues.

Objective: To assess the trends and correlates of added sugar intake in Canadians aged 6 to 17.

Methods: Data were provided by the Canadian Community Health Survey-Nutrition 2004 and 2015. Statistical analysis included multivariable regression and t-tests.

Results: In 2015, 35.66% of Canadians aged 6 to 17 met sugar intake guidelines. Compared to 2004, in 2015 intake of fruit and vegetables was higher, while sugar and caloric intake was lower. Sedentary activity, …

A Foucauldian Genealogical Analysis Of Healthy Eating Education Materials In Ontario 1942-2015, Janet N. Loughheed

Electronic Thesis and Dissertation Repository

This study examines the introduction of the Official Food Rules in 1942 and the formation of subsequent dietary self-analysis practices in Ontario curriculum and textbooks. Examination of the influences of nutrition science, Ontario education policy and politics, and Canadian health policies are combined with Foucauldian critical discourse analysis of selected classroom materials. The Grade 4 dietary self-analysis, based on the various forms of the food guide, from 1946, 1974 and 2011 are analysed and compared. Themes of truth, power and identity within this regime of truth are examined. The ordering of food in the Food Rules was a discursive event. …

The Development And Evaluation Of A Smartphone Nutrition Intervention For Adolescents, Sarah A. Cappuccitti

Electronic Thesis and Dissertation Repository

A diet high in fruit and vegetables is associated with the prevention of many chronic diseases; however, only one in ten Canadian students in grades 6 to 12 consume the recommended daily intake of fruits and vegetables. Using smartphones to deliver nutrition interventions is an emerging area of research, although to-date these interventions typically limit their focus to weight loss. The overarching purpose of this research is to redevelop and evaluate an existing smartphone application for an adolescent population. This thesis used a mixed-methods approach to gain adolescent perspectives on how to redevelop the app and to evaluate its use …

Probiotic Yoghourt For Health, Nutrition And Women's Empowerment In Kenya: A Community-Based Approach, Ellena Andoniou

Electronic Thesis and Dissertation Repository

The dissertation aims to examine the impacts of probiotic yoghourt on health, nutrition and women’s empowerment within the context of HIV/AIDS in Kenya. Mixed methods that combine quantiative and qualitative approaches are used to understand the effects of probiotic yoghourt on the health, nutrition and quality of life for men and women. Results of the quantiative analysis (n=227) demonstrated that the probiotic yoghourt confers a variety of health benefits – physiological (fewer urogenital conditions and digestive problems; reduced dependence on medical treatment), and psychological (perceived improvements with bodily appearance, felt an increased meaningfulness with life). Results of the qualitative analysis …

Barriers To Recruiting Men Into Chronic Disease Prevention And Management Programs In Rural Areas: Perspectives Of Program Delivery Staff, Adam G. Gavarkovs, Shauna M. Burke, Kristen C. Reilly, Robert J. Petrella

Paediatrics Publications

Chronic disease is becoming increasingly prevalent in Canada. Many of these diseases could be prevented by adoption of healthy lifestyle habits including physical activity and healthy eating. Men, especially those in rural areas, are disproportionately affected by chronic disease. However, men are often underrepresented in community-based chronic disease prevention and management (CDPM) programs, including those that focus on physical activity and/or healthy eating. The purpose of this study was to explore the experiences and perceptions of program delivery staff regarding the challenges in recruitment and participation of men in physical activity and healthy eating programs in rural communities, and suggestions …

Comparing The Nutrition Environment And Practices Of Home- And Centre-Based Child-Care Facilities, Olivia J.M. Martyniuk, Leigh M. Vanderloo, Jennifer D. Irwin, Shauna M. Burke, Patricia Tucker

Paediatrics Publications

Objective To assess and compare the nutrition environment and practices (as they relate to pre-schoolers) of centre- and home-based child-care facilities. Design Using a cross-sectional study design, nineteen child-care facilities (ten centre-based, nine home-based) were assessed for one full day using the Environment and Policy Assessment and Observation (EPAO) tool (consisting of a day-long observation/review of the nutrition environment, practices and related documents). Specifically, eight nutrition-related subscales were considered. Setting Child-care facilities in London, Ontario, Canada. Subjects Child-care facilities were recruited through directors at centre-based programmes and the providers of home-based programmes. Results The mean total nutrition environment EPAO scores …

The Effect Of Nutrition On The Microbiome In Pregnant Women And The Use Of Micronutrient Supplemented Probiotic Yogurt To Improve Outcomes, Megan Kathleen Enos

Electronic Thesis and Dissertation Repository

The aims of this study were to characterize the gut, oral, and vaginal microbiotas of pregnant women with varying nutritional status and to determine if daily supplementation with probiotic yogurt containing Lactobacillus rhamnosus GR-1 and ground Moringa leaves, would ‘normalize’ the microbiota and improve pregnancy outcomes. For the latter, a clinical study was performed in Mwanza, Tanzania, in which consumption of yogurt for 88 ± 31 days, starting from the second trimester, did not result in excess weight gain, altered pregnancy outcomes or increased blood nutrient levels compared to an under-nourished group not taking the yogurt. Ingestion of the probiotic …

Strategies To Improve Health Coverage And Narrow The Equity Gap In Child Survival, Health, And Nutrition, Mickey Chopra

Aboriginal Policy Research Consortium International (APRCi)

Implementation of innovative strategies to improve coverage of evidence-based interventions, especially in the most marginalised populations, is a key focus of policy makers and planners aiming to improve child survival, health, and nutrition. We present a three-step approach to improvement of the effective coverage of essential interventions. First, we identify four different intervention delivery channels—ie, clinical or curative, outreach, community-based preventive or promotional, and legislative or mass media. Second, we classify which interventions’ deliveries can be improved or changed within their channel or by switching to another channel. Finally, we do a meta-review of both published and unpublished reviews to …

Does A Group Lifestyle Behaviour Change Program (Prepare) Have An Impact On The Nutritional And Health Characteristics In Adults With Prediabetes?, Jennifer Broxterman

Electronic Thesis and Dissertation Repository

Objective: Lifestyle interventions that target diet and physical activity have been shown to reduce the development of Type 2 diabetes (T2DM) in individuals at risk; however, accessible and effective community-based prevention programs remain lacking. The purpose of this study was to assess the impact of PREPARE, a group lifestyle behaviour change program in adults with prediabetes.

Methods: Adults diagnosed with prediabetes could self-select PREPARE (n=48, intervention arm), consisting of six monthly group nutrition and physical activity education sessions, or, a one-time group education session (n=15, controls), both aimed to prevent Type 2 Diabetes Mellitus (T2DM). Primary outcome measures included dietary, …

The Impact Of Action Schools! Bc On The Health Of Aboriginal Children And Youth Living In Rural And Remote Communities In British Columbia, Dona Tomlin, P. J. Naylor, Heather Mckay, Alexandra Zorzi, Marc Mitchell, Constadina Panagiotopoulos

Paediatrics Publications

Objectives: The aim of the study was to determine the short-term impact of a 7-month whole-school physical activity and healthy eating intervention (Action Schools! BC) over the 2007-2008 school year for children and youth in 3 remote First Nations villages in northwestern British Columbia. Study design: A pre-experimental pre/post design was conducted with 148 children and youth (77 males, 71 females; age 12.5±2.2 yrs). Methods: We evaluated changes in obesity (body mass index [wt/ht 2] and waist circumference z-scores: zBMI and zWC), aerobic fitness (20-m shuttle run), physical activity (PA; physical activity questionnaire and accelerometry), healthy eating (dietary recall) and …