Investigation of vegetable and fruit intake of First Nation schoolchildren: Do school nutrition programs make a difference?

nutrition;First Nation;Aboriginal;children;vegetable and fruit;school;Health Studies and Gerontology

Gates, Allison

University of Waterloo

关键词: nutrition;    First Nation;    Aboriginal;    children;    vegetable and fruit;    school;    Health Studies and Gerontology;   

Others  :  https://uwspace.uwaterloo.ca/bitstream/10012/5434/1/A%20Gates%20Master%27s%20Thesis%202010.pdf

瑞士|英语

来源: UWSPACE Waterloo Institutional Repository

【 摘 要 】

Objectives: To investigate the vegetable and fruit, ;;other” foods, fibre, folate, vitamin A, and vitamin C intakes ofFirst Nations children and adolescents residing in seven communities in northern and southern Ontario, includingvariations by year and community, and comparisons to current dietary standards and national averages based on ageand sex. Also, to implement and assess the impact of two school nutrition programs (in Kashechewan and FortAlbany, Ontario) on dietary intakes of vegetable and fruit, ;;other” foods, fibre, folate, vitamin A, and vitamin C.Also, to evaluate the two school nutrition programs, one a simple food provision program in Kashechewan, Ontarioand the other a more comprehensive school nutrition program in Fort Albany, Ontario, in terms of student andteacher impressions and program integrity. For the program in Fort Albany, the impact of the program on nutritionknowledge, self-efficacy, and intentions to eat more vegetables and fruit will also be assessed. Finally, toinvestigate the association between Body Mass Index (BMI) and vegetable and fruit and fibre intake in First Nationschildren and adolescents living on reserve in Ontario.Methods: Dietary intakes were evaluated using 24-hour dietary recall data collected via the validated Web-BasedEating Behaviour Questionnaire (WEB-Q) between 2003 and 2010 in seven First Nations communities in northern(Attawapiskat, Fort Albany, Kashechewan, Moose Factory, and Peawanuck) and southern (Christian Island andGeorgina Island) Ontario. Vegetable and fruit, ;;other” foods, fibre, folate, vitamin A, and vitamin C intakes werecompared to current dietary standards and Canadian Community Health Survey Cycle 2.2 (CCHS). Yearly andcommunity differences in intakes were assessed using specific dataset pairs to control for season, year, andcommunity, where conditions were comparable. The association between vegetable and fruit and fibre intake andBMI was investigated using the weight classifications described by Cole and colleagues (2000) and based on selfreportedheights and weights. The impact of a simple food provision program in Kashechewan First Nation wasexamined in terms of vegetable and fruit, ;;other” foods, fibre, folate, vitamin A, and vitamin C intakes pre-, oneweekpost, and one-year post program using the WEB-Q. Finally, the impact of a comprehensive school vegetableand fruit education program was evaluated in terms of vegetable and fruit, ;;other” foods, fibre, folate, vitamin A,and vitamin C intakes, nutrition knowledge and preferences, and intentions and self-efficacy to eat more vegetablesand fruit pre- and post-program using validated questionnaires. Within each program, parent/guardian, student, andteacher impressions of the program were evaluated via questionnaires and focus groups.ivResults: The majority of participants (n=443 students from seven communities) had intakes of vegetables and fruitand relevant nutrients below current standards, with the exception of vitamin C. Mean intakes of vegetables andfruit fell below Canadian Community Health Survey averages. Mean intakes of ;;other” foods exceeded vegetableand fruit intakes in all age and sex groups in terms of servings. There was no significant association betweenvegetable and fruit or fibre intake and BMI. In certain instances, significant variation in intakes existed betweendifferent years and communities. Under ideal conditions (short-term, investigator-run portion of the program), theschool food provision program in Kashechewan First Nation produced improvements in vegetable and fruit intakes(n.s.). Long-term intakes did not improve. Teacher and principal impressions of the program were overwhelminglypositive. In the short term, the vegetable and fruit, relevant nutrient, and ;;other” foods intakes of students in FortAlbany did not significantly change following a comprehensive school nutrition education program, and neither didintentions or self-efficacy to eat more vegetables and fruit. However, the program resulted in significantly improvednutrition knowledge, as well as significant improvements in the number of vegetables and fruit that participants hadbeen exposed to and liked. The majority of parents, teachers, and students had positive impressions of the program.Conclusions: Overall, the dietary intakes of the study participants were characterized by poor intakes of vegetablesand fruit and intakes of ;;other” foods that exceeded vegetable and fruit intakes in all age and sex groups. Rates ofoverweight and obesity were higher than those reported in the CCHS. With adequate resources and support, schoolnutrition programs have the potential to improve the vegetable and fruit intakes of children and adolescents living inthe communities involved in this research. However, it is probable that the numerous barriers to healthy eatingidentified in the communities examined blunted the positive effects of the program piloted in this study. Futureinitiatives should include community-based approaches to improve accessibility of affordable, healthy foods ofreasonable quality. In conjunction with school nutrition programs, such programs may have the ability to positivelyimpact the dietary intakes of children and adolescents living on reserve in Ontario.