Household food insecurity constrains food selection, but whether the dietary compromises associated with this problem heighten the risk of nutrient inadequacies is unclear. The objectives of this study were to examine the relationship between household food security status and adults' and children's dietary intakes and to estimate the prevalence of nutrient inadequacies among adults and children, differentiating by household food security status. We analyzed 24-h recall and household food security data for persons aged 1-70 y from the 2004 Canadian Community Health Survey (cycle 2.2). The relationship between adults' and children's nutrient and food intakes and household food security status was assessed using regression analysis. Estimates of the prevalence of inadequate nutrient intakes by food security status and age/sex group were calculated using probability assessment methods. Poorer dietary intakes were observed among adolescents and adults in food-insecure households and many of the differences by food security status persisted after accounting for potential confounders in multivariate analyses. Higher estimated prevalences of nutrient inadequacy were apparent among adolescents and adults in food-insecure households, with the differences most marked for protein, vitamin A, thiamin, riboflavin, vitamin B-6, folate, vitamin B-12, magnesium, phosphorus, and zinc. Among children, few differences in dietary intakes by household food security status were apparent and there was little indication of nutrient inadequacy. This study indicates that for adults and, to some degree, adolescents, food insecurity is associated with inadequate nutrient intakes. These findings highlight the need for concerted public policy responses to ameliorate household food insecurity.

lmost 1 in 10 Canadian households experienced food insecurity in 2004. 1 In addition to compromising nutrition, [2][3][4] household food insecurity is associated with poorer physical, mental, and social health. [5][6][7] While the existing research suggests that problems of household food insecurity are primarily rooted in inadequate incomes, 1,5-8 few policy directions have been proposed to address factors that constrain food purchasing. Instead, responses have generally been community-based initiatives focused on food and food-related behaviours, including food banks, meal and snack programs for children, and community kitchens and gardens. We undertook a study of low-income families residing in highpoverty Toronto neighbourhoods, employing survey methods, mapping of neighbourhood food access, and qualitative interviewing, to gain an understanding of factors that influence household food security. In this paper, we draw upon the survey and mapping data to examine household food security, participation in community food programs, and resource augmentation strategies employed when running out of food or money for food. A comprehensive examination of the relation between housing affordability, housing subsidies, social assistance, and household food insecurity will be published elsewhere. METHODS Sample and data collectionData collection was completed between November 2005 and January 2007 in 12 census tracts randomly chosen from 23 high-poverty tracts in Toronto. 9 Families with children and who were tenants were studied because of the association between these household characteristics and food insecurity. 1,5,6 Potential respondents resid-ing in rental units in each census tract were approached at the door and screened for inclusion by trained interviewers with personal experience of low income. Tenant families were deemed eligible if their gross household income was at or below the mid-level of Statistics Canada's five-category income adequacy scale. 10 These thresholds, which are slightly higher than Statistics Canada's Low Income Cut-Offs 11 and considerably higher than social assistance rates in Ontario, 12 were selected to ensure that the sample encompassed both the 'working poor' and social assistance recipients. Participation was voluntary and confidential, and the study protocol was approved by the Human Subjects Research Ethics Board at the University of Toronto.Respondents from 501 families were surveyed, reflecting a participation rate of 62%. Seventeen families had incomes exceeding the eligibility threshold based on the detailed data collected in the survey and were excluded, resulting in an analytic sample of 484 families. Household food security over the previous 12 months was

The objective of this study was to evaluate the construct validity and reliability of the Healthy Eating Food Index-2019 (HEFI-2019), which was developed to measure adherence to Canada’s Food Guide 2019 (CFG) recommendations on healthy food choices. Dietary intake data from 24-hour dietary recalls in the 2015 Canadian Community Health Survey - Nutrition were used for that purpose. Multidimensionality was examined using principal component analysis. Mean scores were compared among subgroups of the population. The association between scores and energy intake was assessed using Pearson correlations. Cronbach’s alpha was calculated to assess reliability. The estimated mean HEFI-2019 score (/80) was 43.1 (95%CI, 42.7 to 43.6) among Canadians 2 years and older. The first and 99th percentiles were 22.1 and 62.9 points. The mean HEFI-2019 score for smokers was 7.1 points lower than for non-smokers (95%CI, -8.4 to -5.8). The HEFI-2019 was weakly correlated with energy intake (r=-0.13; 95%CI, -0.20 to -0.06). The principal components analysis revealed at least 4 dimensions. Cronbach’s alpha was 0.66 (95%CI, 0.63 to 0.69). Evidence of construct validity and internal consistency support the use of the HEFI-2019 to assess adherence to CFG-2019’s recommendations on healthy food choices. Novelty: • Examination of the Health Eating Food Index (HEFI)-2019’s psychometric properties is needed prior to implementation • Analyses support the construct validity and internal consistency of the HEFI-2019 • Interpretation of the total HEFI-2019 score must be accompanied by its components’ scores, considering it assesses multiple dimensions of food choices

Despite their resourcefulness, low-income families struggle to feed their families. Dietitians have an important role to play as advocates for adequate income supports to promote food security and nutritional health.

The release of Canada’s Food Guide (CFG) in 2019 by Health Canada prompted the development of indices to measure adherence to these updated dietary recommendations for Canadians. This study describes the development and scoring standards of the Healthy Eating Food Index (HEFI)-2019, which is intended to measure alignment of eating patterns with CFG-2019 recommendations on food choices among Canadians aged 2 years and older. Alignment with the intent of each key recommendation in the CFG-2019 was the primary principle guiding the development of the HEFI-2019. Additional considerations included previously published indices, data on Canadians’ dietary intakes from the 2015 Canadian Community Health Survey (CCHS) – Nutrition, and expert judgement. The HEFI-2019 includes 10 components: Vegetables and fruits (20 points), Whole-grain foods (5 points), Grain foods ratio (5 points), Protein foods (5 points), Plant-based protein foods (5 points), Beverages (10 points), Fatty acids ratio (5 points), Saturated fats (5 points), Free sugars (10 points), and Sodium (10 points). All components are expressed as ratios (e.g., proportions of total foods, total beverages, or total energy). The HEFI-2019 score has a maximum of 80 points. Potential uses of the HEFI-2019 include research as well as monitoring and surveillance of food choices in population-based surveys. Novelty: ● The Healthy Eating Food Index-2019 was developed to measure adherence to the 2019 Canada's Food Guide recommendations on healthy food choices. ● The HEFI-2019 includes 10 components, of which 5 are based on foods, 1 on beverages and 4 on nutrients, for a total of 80 points.

Canadian post-secondary students are vulnerable to food insecurity, yet lack of examination of this issue has prevented identification of policy and program solutions. This mixed-methods study aimed to characterize the experience of food insecurity among undergraduate students by eliciting barriers to food security, strategies used to manage food and money shortages, and perceived implications for health and academic achievement. Surveys and in-depth interviews were conducted with 14 students who demonstrated compromised financial access to food. Students normalized experiences of food insecurity as typical of post-secondary education but expressed anxiety and frustration with financial inaccessibility to healthy food, and described negative implications for their physical and mental health and their ability to perform well in school. Ongoing attempts to adapt or adjust to food insecurity had limited success. Findings highlight the need to challenge the “starving student” ideology, which normalizes the lack of access to healthy food during higher education.

Background Menu labelling, and more specifically calorie labelling, has been posited as an intervention to improve nutrition literacy and the healthfulness of consumers’ food purchases. However, there is some concern calorie labelling may unintentionally trigger or exacerbate disordered eating among vulnerable persons. The purpose of this research was to explore young adults’ experiences with labelling, with a focus on its implications for their relationships with food. Methods Individual semi-structured interviews were conducted with participants from a campus-based menu labelling study. Interview data were inductively coded using thematic analysis and supported by survey data assessing disordered eating, body esteem, and related constructs. Results The sample consisted of 13 participants (10 women, 3 men), most of whom perceived themselves as “about the right weight” (62%). Four key themes included: (1) participants’ support of and skepticism about labelling interventions, (2) the identification of knowledge and autonomy as mechanisms of labelling interventions, (3) the role of the individual’s and others’ relationships with food in experiences with labelling, and (4) disordered eating and dieting as lenses that shape experiences with interventions. Participants’ perceptions of and experiences with calorie labels were shaped by gender, body esteem, and disordered eating risk. Conclusions The results provide insight into the complexity of young adults’ interactions with labelling interventions and context for future research exploring the unintended consequences of public health nutrition interventions.

An unhealthy diet is among the leading global causes of death and disability. Globally, a range of policies are being implemented to support healthy food choices at a population level, including novel polices in the areas of food marketing, nutrition labelling, and taxation of less healthy foods. There is a need to evaluate and inform the implementation of these policies, including their impact on marginalized population subgroups. The International Food Policy Study (IFPS) consists of repeated cross-sectional surveys conducted in five high and upper-middle income countries: Australia, Canada, Mexico, the United Kingdom, and the United States. In each country, approximately 4000 adults and 1200 children and youth (aged 10–17) were recruited from a global commercial panel to complete an online survey using consistent measures and methodologies across countries. The first annual IFPS surveys were conducted in 2017 with adults; annual surveys for young people aged 10–17 were launched in 2019 in the same countries, as well as Chile. The design of the IFPS surveys creates a framework for evaluating ‘natural experiments’ in food policies, including comparisons over time within countries implementing the policy, and comparisons with countries in which the policy was not implemented. IFPS surveys have three primary areas of focus: 1) knowledge, attitudes, and beliefs associated with specific policies; 2) diet-related behaviours; and 3) dietary intake, including 24-hour dietary recalls for adults in four of five countries. Surveys also assess food insecurity, income adequacy, sex and gender, race/ethnicity and a range of other measures to assess trends among priority subgroups. Overall, the IFPS project has the potential to address important gaps in national monitoring surveys for dietary patterns, and to evaluate the impact of novel food policies implemented in any of the five countries over the study period.