Objectives To assess the association between consumption of ultra-processed foods and obesity in the Canadian population. Methods Cross-sectional study including 19,363 adults aged 18 years or more from the 2004 Canadian Community Health Survey, cycle 2.2. Ultra-processed food intake was estimated using daily relative energy intake of ultra-processed food (% of total energy intake) from data obtained by 24-h food recalls. Obesity was assessed using body mass index (BMI ≥ 30 kg/m 2). Univariate and multivariate linear regressions were performed to describe ultra-processed food consumption according to socioeconomic and demographic variables, and multivariate logistic regression was performed to verify the association between ultra-processed food consumption and obesity, adjusting for potential confounders, including socio-demographic factors, physical activity, smoking, immigrant status, residential location, and measured vs self-reported weight and height. Results Ultra-processed foods make up almost half (45%) of the daily calories consumed by Canadian adults. Consumption of these foods is higher among men, younger adults, those with fewer years of formal education, smokers, those physically inactive, and Canadian-born individuals. Ultra-processed food consumption is positively associated with obesity. After adjusting for confounding factors, individuals in the highest quintile of ultra-processed food consumption were 32% more likely of having obesity compared to individuals in the first quintile (predicted OR = e 0.005 × 56 = 1.32; 95% CI = 1.05-1.57). Conclusion Canadians would benefit from reducing consumption of ultra-processed foods and beverages and increasing consumption of freshly prepared dishes made from unprocessed or minimally processed foods. Résumé Objectifs Cette étude vise à évaluer l'association entre la consommation d'aliments ultra-transformés et l'obésité. Méthodes Étude transversale comprenant 19 363 adultes âgés de 18 ans ou plus qui ont participé à l'Enquête sur la santé dans les collectivités canadiennes, 2004, cycle 2.2. La consommation d'aliments ultra-transformés est estimée en utilisant l'apport énergétique relatif provenant des aliments ultra-transformés du rappel alimentaire de 24 heures. L'obésité est déterminée en utilisant l'indice de masse corporelle (IMC) ≥ 30 kg/m 2. Les régressions linéaires univariée et multivariée ont été réalisées pour décrire la consommation d'aliments ultra-transformés selon différents groupes socioéconomiques et démographiques, et la régression logistique multivariée a été réalisée pour évaluer l'association entre la consommation de ces aliments et l'obésité, Electronic supplementary material The online version of this article (

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Objective. To validate users' perception of nurses' recommendations to look for another health resource among clients seeking teleadvice. To analyze the effects of different users' and call characteristics on the incorrectness of the self-report. Data Sources/Study Setting. This study is a secondary analysis of data obtained from 4,696 randomly selected participants in a survey conducted in 1997 among users of Info-Sante´CLSC, a no-charge telenursing health-line service (THLS) available all over the province of Québec. Study Design/Data Collection. Self-reported advice from follow-up survey phone interviews, conducted within 48 to 120 hours after the participant's call, were compared to the data consigned by the nurse in the computerized call record. Covariables concerned characteristics of callers, context of the calls, and satisfaction about the nurses' intervention. Association between these variables and inaccurate reports was identified using multinomial logistic regression analyses. Principal Findings. Advice to consult were recorded by the nurse in 42 percent of cases, whereas 39 percent of callers stated they had received one. Overall disagreement between the two sources is 27 percent (12 percent by false positive and 15 percent by false negative) and kappa is 0.45. Characteristics such as living alone (adjusted OR 5 2.5), calls relating to psychological problems (OR 5 2.8), perceived seriousness (OR 5 B2.6), as well as others, were associated with inaccurate reports. Conclusions. Telephone health-line providers should be aware that many callers appear to interpret advice to seek additional health care differently than intended. Our findings suggest the need for continuing quality control interventions to reduce miscommunication, insure better understanding of advice by callers, and contribute to more effective service.

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