Objective: To explore the relationship among children's diet quality, weight status and food environment in subarctic Canada. Design: In the cross-sectional study, children's BMI was calculated, diet quality was assessed using three 24 h dietary recalls and children were asked about their home food environment and source of meals. Setting: Two Aboriginal Cree communities in northern Québec. Subjects: Two hundred and one children in grades 4-6. Results: The majority (64?2 %) of children were overweight (29?9 %) or obese (34?3 %). Weight status was not associated with reported restaurant meal frequency or the home food environment. The 18 % of children who consumed three or more restaurant meals in the three days of recall consumed, on average, 2004 kJ (479 kcal) more energy daily than children consuming no restaurant meals and had higher intakes of fat, saturated fat, Ca and soda. Most foods contributing to energy and dietary fat were energy-dense market foods of low nutritional value such as sweetened beverages and snack foods. Only 68 % of children reported often having fruits and vegetables in the home and 98?5 % of children consumed less than 5 fruits and vegetables daily. Many children (42?8 %) were at risk of Zn inadequacy. Only 19 % of children consumed 2 or more servings of milk daily, and the mean intakes of Ca and vitamin D were below the recommended adequate intake. Traditional game meat was consumed infrequently, but contributed significantly to Fe and Zn intake. Conclusions: Childhood obesity in subarctic communities prevailed in a food environment typified by high-energy-density commercial foods of low nutritional value.
Keywords
Nutrition environment Diet quality Aboriginal Childhood obesityOverweight and obesity is prevalent worldwide and increasing (1,2) , likely due to the dramatic changes in both lifestyle and environment. In recent decades there has been increased accessibility to restaurants and fast-food outlets and people are spending more of their disposable income on foods away from the home. Indeed, since the late 1970s, energy intake from restaurant meals/fast foods has increased by 91 % to 208 % for all age groups (3) ; as many as 25 % of Canadians and 30 % of Americans eat fast-food restaurant meals on any given day (3,4) . Meals served at restaurants and fast-food establishments are generally energy-dense (i.e. high in fat and sugar) and the portions served typically exceed recommended portion sizes (5) . As convenience becomes a priority in many households, home-cooked meals are being replaced with prepared or away-from-home foods (i.e. take-out foods, frozen entrees and pre-cooked, pre-packaged foods) (6)