Validation of the French-Canadian Translation of the ecSatter Inventory 2.0 in an Adult Sample.

OBJECTIVE: Evaluate the psychometric proprieties of the French-Canadian translation of the Satter Eating Competence Inventory (FrCanada ecSI 2.0). DESIGN: Cross-sectional validation study. PARTICIPANTS AND SETTING: 424 French-Canadian adult Facebook users (61.8% women, 96.0% White). VARIABLES MEASURED: Eating competence and variables related to eating or body image. ANALYSIS: Factor analyses to assess the structural validity. Cronbach α and intraclass correlation coefficient to estimate reliability. Chi-square test of independence, Student t test, and Pearson's correlations to assess construct validity. RESULTS: The mean eating competence score was 33.0 ± 7.8; 62.0% of participants were considered competent eaters (total score ≥ 32/48). The original 4-factor structure was not reproduced (unsatisfactory fit indices and/or factor loadings). Therefore, it is recommended to use the global score-but not the subscale scores-of the FrCanada ecSI 2.0. The questionnaire showed good internal consistency (Cronbach α = 0.86) and test-retest reliability (intraclass correlation = 0.81). Competent and noncompetent eaters differed according to gender (39.5% vs 27.3% male; P = 0.03), age (49.3 ± 13.6 vs 42.7 ± 14.2 years; P < 0.01), education (62.3% vs 50.6% with a university degree; P = 0.03), intuitive eating (3.6 ± 0.5 vs 3.1 ± 0.6; P < 0.001), cognitive restraint (12.3 ± 3.3 vs 13.8 ± 3.7; P < 0.001), and body esteem (3.3 ± 0.8 vs 2.5 ± 0.8; P < 0.001). CONCLUSION AND IMPLICATIONS: Results suggest that the FrCanada ecSI 2.0 is a valid and reliable tool to measure eating competence in French-Canadian adults.

A latent profile analysis based on diet quality and eating behaviours in participants of the PREDISE study characterized by a higher BMI.

The aim of this study was to identify eating-related latent profiles based on diet quality and eating behaviours within a population characterized by a body mass index (BMI) of at least 25 kg/m2, and to compare metabolic variables between profiles. This analysis was conducted in a sample of 614 adults (45.6% women; 44.8 ± 12.9 years) from the cross-sectional PREDISE study. Participants completed the Three-Factor Eating Questionnaire, the Intuitive Eating Scale-2, the Regulation of Eating Behavior Scale, and three self-administered 24 h food recalls. Waist circumference, blood lipids, blood pressure, and fasting glucose were measured to identify carriers of the metabolic syndrome. A latent profile analysis was performed, and cases of metabolic syndrome were compared between profiles. A three-profile solution was found. Profile 1 (22.8%) was characterized by lower diet quality, lower self-determined motivation for eating, lower restraint, and higher intuitive eating. Profile 2 (44.5%) was characterized by higher diet quality, higher self-determined motivation for eating, higher restraint, lower disinhibition, and higher intuitive eating. Profile 3 (32.7%) was characterized by intermediate diet quality, higher non-self-determined motivation for eating, higher restraint and disinhibition, and lower intuitive eating. We found fewer cases of metabolic syndrome among participants in profile 2 than in the other profiles (p = 0.0001). This study suggests that a profile characterized by a lower disinhibition and higher levels of restraint, intuitive eating, self-determined motivation, and diet quality is associated with a better metabolic health among individuals with a higher BMI.

A perinatal social nutrition approach to improve breastfeeding in a culturally diverse group of low-income women.

Alima, Perinatal Social Nutrition Centre, is an established community organization that adopts a perinatal social nutrition approach to provide multidimensional support to women living in vulnerable conditions, particularly those with a precarious migratory status. This study aims to (i) determine which maternal characteristics, pregnancy-related variables, and structural features of the Alima intervention are associated with breastfeeding; and (ii) examine whether the association between attending breastfeeding workshops and breastfeeding characteristics differ according to maternal factors. The Alima digital database was used to analyze data from women who received the perinatal intervention between 2013 and 2020. Infant feeding data were retrieved at 2 weeks postpartum (T0, n = 2925), 2 months postpartum (T2, n = 1475), and 4 months postpartum (T4, n = 890). Logistic regressions were used to estimate the odds of overall and exclusive breastfeeding depending on sociodemographic characteristics, pregnancy-related variables, and features of the intervention. The prevalence of overall and exclusive breastfeeding was, respectively, 96.1% and 60.7% at T0; 93.0% and 58.5% at T2; 83.0% and 48.4% at T4. Higher education, previous breastfeeding experience, and recent immigration were associated with a higher likelihood of breastfeeding at each time point. Breastfeeding workshop attendance was associated with a greater likelihood of overall and exclusive breastfeeding at T2 and T4, with a stronger effect among women aged 35 or less, those with lower education, and those with excessive gestational weight gain. In conclusion, the Alima intervention is associated with positive breastfeeding outcomes, especially among vulnerable women living with precarious migratory status in Canada.

Social desirability, dietary intakes, and variables related to attitudes and behaviours towards eating among French-speaking adults from Quebec, Canada: The PREDISE study.

The primary objective of this study was to examine how social desirability is associated with self-reported measures of dietary intakes and variables related to attitudes and behaviours towards eating. This analysis was conducted in 1083 adults (50.0% women) from the PREDISE study. Social desirability was assessed using the Balanced Inventory of Desirable Responding (BIDR) questionnaire, which includes two subscales: (1) self-deceptive enhancement (SDE), i.e., having an overly positive self-image and (2) impression management (IM), i.e., intentional response distortion to please. BIDR total score and IM subscore were positively associated with the Canadian Healthy Eating Index (C-HEI) (ß = 0.24 and ß = 0.50; p ≤ 0.0003), calculated using data from three self-administered 24 h food recalls. All BIDR scores were positively associated with self-determined motivation for eating regulation (0.03 ≤ ß ≤ 0.06; p < 0.0001), measured by the Regulation of Eating Behavior Scale, and with the intuitive eating score (0.02 ≤ ß ≤ 0.05; p < 0.0001). Also, all BIDR scores were negatively associated with hunger and disinhibition scores measured by the Three-Factor Eating Questionnaire (-0.17 ≤ ß ≤ -0.09; p < 0.0001). All these associations were adjusted for age, sex, BMI, and the education level. Furthermore, controlling for both dimensions of social desirability did not impact the magnitude of the association between self-determined motivation (the strongest predictor of healthy eating in the PREDISE study) and C-HEI. According to our results, associations are observed with diet quality, as well as with attitudes and behaviours towards eating; therefore, a measurement of social desirability responding would be pertinent in studies using those or related variables.

Examining the associations between mothers' motivation to regulate their own eating behaviors, food parenting practices and perceptions of their child's food responsiveness.

Based on the Self-Determination Theory, this study examined: 1) how mothers' autonomous and controlled motivation to regulate their own eating behaviors relate to their food parenting practices, and 2) whether and how child food responsiveness (i.e., reactivity and attraction to food) interact with mothers' motivation to predict maternal food parenting practices. Participants were 296 French Canadian mothers of at least one child aged between 2 and 8 years old. Results of partial correlation analyses (controlling for demographics and controlled motivation) showed that maternal autonomous motivation to regulate their own eating behaviors was positively related to autonomy-promoting (i.e., child involvement) and structure-based (i.e., modeling, creating a healthy environment, monitoring) food parenting practices. In contrast, controlling for demographics and autonomous motivation, maternal controlled motivation was positively associated with food-related practices based on coercive control (i.e., the use of food to regulate the child's emotions, the use of food as a reward, pressure to eat, restriction for weight reasons, and restriction for health reasons). Furthermore, the child's food responsiveness was found to interact with mothers' motivation to regulate their own eating behaviors in the prediction of maternal food parenting practices such that mothers with high autonomous motivation or low controlled motivation were found to react with more structure-based (i.e., creating a healthy environment) and autonomy-based (i.e., child involvement) practices, as well as less controlling practices (i.e., the use of food to regulate the child's emotions), to a child who is highly responsive to food. In conclusion, findings suggest that guiding mothers toward developing a more autonomous and less controlled motivation to regulate their own eating behaviors might help them adopt more autonomy-promoting and structure-based and less controlling feeding practices, especially with children who are highly responsive to food.

Associations between mind-body practice engagement and diet quality: Exploring the mediating roles of eating behaviour traits and regulation styles for eating behaviours in the PREDISE study.

While engaging in Mind-Body Practices (MBPs) may be related to better diet quality, its association with eating behaviours is unclear. This cross-sectional study explores whether eating behaviour traits and regulation style of eating behaviours mediate the association between MBP engagement and diet quality. A total of 418 women and 482 men, aged between 18 and 65 years and recruited as part of the PREDISE study cohort, reported whether they currently practice one or more MBP (e.g., yoga or meditation). Canadian Healthy Eating Index (C-HEI) was calculated from three 24h dietary recalls. Intuitive Eating Scale (IES-2), and Regulation of Eating Behaviour Scale were completed online. Mann-Whitney tests were conducted to compare C-HEI scores of individuals who currently engage in MBPs (practitioners) to those who do not (non-practitioners). Multiple regression analyses and bootstrapping were performed to test whether eating behaviours and regulation style of eating behaviours mediate the association between MBPs and diet quality. Overall, 88 women and 43 men were practitioners. They had higher C-HEI scores than non-practitioners (62.9 ± 13.0 vs. 55.6 ± 14.3; p = 0.001). Parallel mediation model showed significant indirect effects of the IES-2 subscale relating to Body-Food Choice Congruence (ß = 1.57, SE = 0.41, 95% CI: 0.86, 2.43), self-determined motivation (ß = 1.51, SE = 0.39, 95% CI:0.81, 2.32) and non-self-determined motivation (ß = 0.39, SE = 0.21, 95% CI: 0.03, 0.85) on the association between practitioner status and C-HEI. These findings suggest that the current practice of MBPs is associated with better diet quality, mainly through practitioners' higher intuitive eating skills and more self-determined regulation of eating behaviours. Further studies should investigate the potential impacts of MBPs on the development and maintenance of positive eating habits.

Are Machine Learning Algorithms More Accurate in Predicting Vegetable and Fruit Consumption Than Traditional Statistical Models? An Exploratory Analysis.

Machine learning (ML) algorithms may help better understand the complex interactions among factors that influence dietary choices and behaviors. The aim of this study was to explore whether ML algorithms are more accurate than traditional statistical models in predicting vegetable and fruit (VF) consumption. A large array of features (2,452 features from 525 variables) encompassing individual and environmental information related to dietary habits and food choices in a sample of 1,147 French-speaking adult men and women was used for the purpose of this study. Adequate VF consumption, which was defined as 5 servings/d or more, was measured by averaging data from three web-based 24 h recalls and used as the outcome to predict. Nine classification ML algorithms were compared to two traditional statistical predictive models, logistic regression and penalized regression (Lasso). The performance of the predictive ML algorithms was tested after the implementation of adjustments, including normalizing the data, as well as in a series of sensitivity analyses such as using VF consumption obtained from a web-based food frequency questionnaire (wFFQ) and applying a feature selection algorithm in an attempt to reduce overfitting. Logistic regression and Lasso predicted adequate VF consumption with an accuracy of 0.64 (95% confidence interval [CI]: 0.58-0.70) and 0.64 (95%CI: 0.60-0.68) respectively. Among the ML algorithms tested, the most accurate algorithms to predict adequate VF consumption were the support vector machine (SVM) with either a radial basis kernel or a sigmoid kernel, both with an accuracy of 0.65 (95%CI: 0.59-0.71). The least accurate ML algorithm was the SVM with a linear kernel with an accuracy of 0.55 (95%CI: 0.49-0.61). Using dietary intake data from the wFFQ and applying a feature selection algorithm had little to no impact on the performance of the algorithms. In summary, ML algorithms and traditional statistical models predicted adequate VF consumption with similar accuracies among adults. These results suggest that additional research is needed to explore further the true potential of ML in predicting dietary behaviours that are determined by complex interactions among several individual, social and environmental factors.

A Community Prenatal Intervention in Social Nutrition: Evaluating the Impact on Pregnancy and Birthweight Outcomes.

This study aims to assess the associations between structural features of the Montreal Diet Dispensary's social nutrition intervention and pregnancy (i.e., anemia, gestational diabetes mellitus (GDM), gestational weight gain (GWG), hypertension) and birthweight outcomes (i.e., small- or large-for-gestational-age) among pregnant women, most of them recent immigrants. The study consists of a secondary analysis of the digital client database of the Montreal Diet Dispensary (n = 2925). Logistic regressions were used to estimate the odds of pregnancy and birthweight outcomes, depending on structural features of the intervention. Pregnant women who attended a welcoming group session presented lower odds of GDM and anemia compared to those who did not attend. A longer duration of intervention was also associated with lower odds of GDM and anemia. Each additional appointment with a dietitian was associated with higher odds of excessive GWG and lower odds of insufficient GWG only among women with a pre-pregnancy BMI lower than 25 kg/m2. This study emphasizes the importance of providing nutritional services early in pregnancy to reduce the risk of GDM and anemia. It also stresses the importance of using appropriate nutritional guidelines to avoid increasing the risk of excessive GWG.

Individuals with self-determined motivation for eating have better overall diet quality: Results from the PREDISE study.

The study aimed at documenting motivational orientations for the regulation of eating as defined by self-determination theory and their association with sociodemographic characteristics and overall diet quality. As part of the PREDISE study, French-speaking women (n = 550) and men (n = 547), aged 18-65 years, living in the Province of Québec, Canada, completed online validated questionnaires. The Regulation of Eating Behavior Scale, based on the self-determination theory, assessed self-determined and non-self-determined motivation to regulate one's eating behavior. Three web-based 24-h food recalls were completed and used to compute the Canadian Healthy Eating Index 2007 (C-HEI), an indicator of the overall adherence to Canadian guidelines for healthy eating. Multiple linear regressions were performed to assess how regulation styles are associated with the C-HEI. Model 1 included no covariate, model 2 included sociodemographic covariates, and fully adjusted model 3 included as covariates sociodemographic variables as well as variables that were previously associated with diet quality, namely nutrition knowledge and social support for healthy eating. Women (p < 0.0001), older individuals (p = 0.0002), those with a higher education level (p < 0.0001), and non-smokers (p < 0.0001) reported higher self-determined motivation score than their counterparts. Self-determined motivation was positively (model 1: B = 4.67, p < 0.0001; model 2: B = 3.82, p < 0.0001; model 3: B = 3.61, p < 0.0001) and non-self-determined motivation was negatively (model 1: B = -1.62, p = 0.0009; model 2: B = -1.63, p = 0.0006; model 2: B = -1.49, p = 0.0022) associated with C-HEI. The present study suggests that some subgroups of the general adult population show more self-determined motivation for eating, which is associated with a better diet quality independently of individual characteristics and other individual and social determinants of healthy eating. Strategies to help individuals internalize the regulation of eating should be further investigated.

Associations Between Nutrition Knowledge and Overall Diet Quality: The Moderating Role of Sociodemographic Characteristics-Results From the PREDISE Study.

PURPOSE: To assess how nutrition knowledge is associated with global diet quality and to investigate whether sociodemographic characteristics (ie, sex, age, education, income, marital status, and living with children or not) moderate this association. DESIGN: Cross-sectional web-based study. PARTICIPANTS: The PREDISE study aims at identifying correlates of adherence to healthy eating guidelines in French-speaking adults from the Province of Quebec, Canada. SUBJECTS: A probability sample of 1092 participants (50% female). MEASURES: The Nutrition Knowledge Questionnaire and 24-hour food recalls from which the Canadian Healthy Eating Index (C-HEI) was calculated. ANALYSIS: Multiple linear regressions performed to assess how nutrition knowledge is associated with the C-HEI. Interaction terms tested to evaluate whether sociodemographic characteristics moderate the association between nutrition knowledge and the C-HEI. RESULTS: Nutrition knowledge (B = 0.141 [95% CI: 0.075-0.208], P < .0001) was identified as a significant correlate of the C-HEI. Education significantly moderated the association between nutrition knowledge and the C-HEI (P interaction = .0038), with a significative association among participants with a lower education level (B = 0.295 [95% CI: 0.170-0.421], P < .0001) but not among participants with a higher education level (B = 0.077 [95% CI: -0.004 to 0.157], P = .06). Whether participants lived with or without children also significantly moderated the association (P interaction = 0.0043); nutrition knowledge was associated with the C-HEI only in participants who were not living with children (B = 0.261 [95% CI: 0.167 to 0.355], P < .0001). CONCLUSION: This study suggests that the association between nutrition knowledge and adherence to healthy eating guidelines is not the same in different subgroups of the population. Interventions aiming at increasing nutrition knowledge may be a promising approach to improve diet quality, especially among individuals with a lower education.

Do pregnant women eat healthier than non-pregnant women of childbearing age?

We aimed to compare the dietary quality and intake of pregnant women, women planning to conceive and women of childbearing age. Fifty-five pregnant women were matched for age and pre-pregnancy body mass index with 55 women planning to conceive and 55 women of childbearing age. Three Web-based 24-h recalls were completed, from which the Canadian Healthy Eating Index was calculated. Pregnant women had greater overall diet quality scores (66.8 ± 10.7, 60.3 ± 14.1 and 61.4 ± 12.8, in pregnant vs. planning to conceive and childbearing age women, p = .009), explained by a higher intake in fruits, vegetables and grain products and lower intake of foods that are high in fat, sugar or salt. Energy intake was significantly higher in pregnant versus planning to conceive women only (2283 ± 518 vs. 2062 ± 430 kcal, p = .03). Diet quality was greater among pregnant women, but diet quality scores were low in all groups, indicating that healthier dietary behaviours should be encouraged for all childbearing age women.

Social Support, but Not Perceived Food Environment, Is Associated with Diet Quality in French-Speaking Canadians from the PREDISE Study.

The objectives were to assess whether social support for healthy eating and perceived food environment are associated with diet quality, and to investigate if sociodemographic characteristics moderate these associations. A probability sample of French-speaking adults from the Province of Québec, Canada, was recruited in the context of the PREDISE study. Participants reported their perceptions of supportive and non-supportive actions related to healthy eating from close others at home and outside of home (n = 952), and of the accessibility to healthy foods (n = 1035). The Canadian Healthy Eating Index (C-HEI) was calculated based on three Web-based 24 h food recalls. Multiple linear regression models showed that supportive (B = 1.50 (95% CI 0.46, 2.54)) and non-supportive (B = -3.06 (95% CI -4.94, -1.18)) actions related to healthy eating from close others at home were positively and negatively associated with C-HEI, respectively, whereas actions from close others outside of home were not. The negative association between non-supportive actions occurring at home and C-HEI was stronger among participants with lower (vs. higher) levels of education (p interaction = 0.03). Perceived accessibility to healthy foods was not associated with C-HEI (p > 0.05). These results suggest that the social environment may have a stronger influence on healthy eating than the perceived physical environment. This adds support for healthy eating promotion programs involving entire families, especially for more socioeconomically disadvantaged individuals, whose efforts to eat healthily may be more easily thwarted by non-supportive households.

Does HealthAtEvery Size® fit all? A group-based trajectory modeling of a non-diet intervention.

OBJECTIVE: Health At Every Size® (HAES®) interventions have been increasingly recognized as a sustainable strategy in obesity management. Nevertheless, heterogeneity among obese individuals leads to challenges as it translates in mixed responses to treatment. In this context, our objective was to identify trajectories of responses to a non-diet intervention for adult overweight/obese women to highlight profiles of responders. METHOD: Based on data from a multicentric quasi-experimental study, a latent class growth modeling (LCGM) was performed. Two hundred and ten women with high body mass index (BMI ≥ 25, MBMI = 36.53) who followed a non-diet intervention offered in Health and Social Services Centres completed questionnaires at T = 0, 4 and 16 months. Outcomes used in the LCGM were intuitive eating and body esteem, two central components in HAES® interventions. Types of responders were then profiled on sociodemographic, weight, lifestyle, psychological and eating variables. RESULTS: The LCGM revealed a 4-trajectory model (p < .001), comprising non-responders (14.67%), moderate improvement with low maintenance responders (49.89%), moderate improvement with high maintenance responders (29.28%) and high functioning partial responders (6.56%). Analysis of variances showed significant differences between all types of responders with medium to large effect sizes on depressive symptoms, self-esteem and disinhibited eating (p < .001; η2 = .23, 0.30 and 0.16 respectively). Fewer differences were found on sociodemographic, lifestyle, health and weight variables. Overall, non-responders (14.67%) had a distinctive profile compared to the other groups by consistently expressing poorer psychological functioning, less adapted eating behaviors and reaching more frequently the clinical cutoff for severe depression (p = .001). CONCLUSIONS: Findings strongly support the relevance of considering psychological characteristics to move towards personalized healthcare in obesity management.

Is the Canadian Healthy Eating Index 2007 an Appropriate Diet Indicator of Metabolic Health? Insights from Dietary Pattern Analysis in the PREDISE Study.

The objective of this study was to identify key elements from the 2007 Canada's Food Guide that should be included in a diet quality score aiming to reflect the risk of metabolic syndrome (MetS). Dietary intakes of 998 adults (mean age: 43.2 years, 50% women) were used to obtain the Canadian Healthy Eating Index 2007 (C-HEI 2007) and Alternative Healthy Eating Index 2010 (AHEI) scores, as well as a dietary pattern (DP) generated by the reduced rank regression (RRR) method. Based on these three scores, a modified version of the C-HEI 2007 (Modified C-HEI) was then proposed. The prevalence ratio (PR) of MetS was examined across diet quality scores using multivariate binomial regression analysis. A higher AHEI, Modified C-HEI, and a lower score for DP were all associated with a significantly lower prevalence of MetS (PR = 0.42; 95% confidence interval (CI) 0.28, 0.64; PR = 0.39; 95% CI 0.23, 0.63; and PR = 0.48; 95% CI 0.31, 0.74, respectively), whereas C-HEI 2007 was not (PR = 0.68; 95% CI 0.47, 1.00). Results suggest that a Modified C-HEI that considers key elements from the C-HEI 2007 and the AHEI, as well the DP, shows that participants with a higher score are less likely to have MetS.

Trimester-Specific Intuitive Eating in Association With Gestational Weight Gain and Diet Quality.

OBJECTIVE: To examine the associations between intuitive eating and trimester-specific gestational weight gain (GWG), and between intuitive eating and diet quality at each trimester. DESIGN: At each trimester, participants completed the Intuitive Eating Scale-2 and 3 24-hour recalls from which the Healthy Eating Index was calculated. Trimester-specific GWG was calculated with interpolated weights. PARTICIPANTS: A total of 79 pregnant women. MAIN OUTCOME MEASURES: Intuitive eating, GWG, and diet quality. ANALYSIS: One-way ANOVA was used to compare intuitive eating scores between GWG groups. Pearson correlation analyses were used to assess the association between the intuitive eating score and the Healthy Eating Index score. RESULTS: In the first trimester, women within GWG recommendations had a higher total intuitive eating score compared with women above recommendations (3.9 ± 0.5 vs 3.6 ± 0.6; P = .04). The unconditional permission to eat subscale was associated with lower diet quality in the first trimester (r = -.26; P = .02) whereas the body-food choice congruence subscale was associated with better diet quality in the second and third trimesters (r = .26, P = .02 and r = .27, P = .01, respectively). CONCLUSIONS AND IMPLICATIONS: The researchers found an association between higher levels of intuitive eating and adequate first-trimester GWG. Further research might investigate whether promoting intuitive eating among pregnant women favors healthy GWG.

Trimester-Specific Assessment of Diet Quality in a Sample of Canadian Pregnant Women.

The present study aimed to (1) examine changes in diet quality throughout pregnancy and (2) identify maternal characteristics associated with trimester-specific diet quality. Pregnant women (n = 79) were recruited in their 1st trimester of pregnancy and completed, at each trimester, three web-based 24-hour dietary recalls, from which the Canadian Healthy Eating Index (HEI) was calculated. Physical activity, nutrition knowledge, and socio-demographic web-questionnaires were also completed. Although no variation in total HEI scores was observed across trimesters, we found an overall decrease in the following subscores: adequacy, total fruits and vegetables, unsaturated fats and saturated fats (p < 0.05). In the 1st trimester, overweight and obese pregnant women had a lower diet quality in comparison with normal-weight and underweight women (HEI scores: 63.1 ± 11.9 vs. 68.0 ± 9.3; p = 0.04). In the 3rd trimester, women younger than 28 years old, with no university degree, poorer nutrition knowledge and who reside in an urban setting, had a lower diet quality (p < 0.05). In conclusion, less educated, younger women who reside in an urban setting may be at a higher risk of poor diet quality in late pregnancy and could benefit from public health programs.

Are French Canadians able to accurately self-rate the quality of their diet? Insights from the PREDISE study.

The main objective of this study was to compare self-rated diet quality with a more comprehensive score of diet quality and to assess the ability of self-rated diet quality to predict adherence to healthy eating guidelines. This study also aimed to evaluate the influence of individual characteristics on the association between self-rated diet quality and the overall diet quality score. As part of the PRédicteurs Individuels, Sociaux et Environnementaux (PREDISE) study, 1045 participants (51% women) from the Province of Québec, Canada, self-rated their diet quality ("In general, would you say that your dietary habits are excellent, very good, good, fair, or poor?"). Three Web-based 24-h food recalls were completed, generating data for the calculation of the Canadian Healthy Eating Index (C-HEI) score, an overall diet quality indicator. Participants rated their diet quality as excellent (2.4%), very good (22.7%), good (49.5%), fair (20.3%), or poor (5.1%). C-HEI scores differed significantly between diet ratings, in the expected direction (p < 0.0001). Self-rated diet quality predicted adherence to healthy eating guidelines (i.e., C-HEI > 68) with a sensitivity of 44.5% and a specificity of 81.5% (C-statistic = 0.63). Sex significantly modified the association between self-rated diet quality and C-HEI score (p interaction = 0.0131); women had higher C-HEI scores than did men in the "good" and "fair" ratings. Self-rated diet quality can be useful in obtaining an overview of the diet quality of a population, but the results of this study suggest that such data should be used with caution given their poor ability to predict adherence to healthy eating guidelines. Individual characteristics may influence one's ability to appropriately self-evaluate diet quality.

Eating-Related and Psychological Outcomes of Health at Every Size Intervention in Health and Social Services Centers Across the Province of Québec.

PURPOSE: To report the outcomes of a Health at Every Size (HAES) intervention in a real-world setting. DESIGN: Quasi-experimental design evaluating eating behaviors and psychological factors. SETTING: The HAES intervention is offered in Health and Social Services Centers in Québec (Canada). PARTICIPANTS: For this study, 216 women (body mass index [BMI]: 35.76 [6.80] kg/m2) who participated to the HAES intervention were compared to 110 women (BMI: 34.56 [7.30] kg/m2) from a comparison group. INTERVENTION: The HAES intervention is composed of 14 weekly meetings provided by health professionals. It focuses on healthy lifestyle, self-acceptance, and intuitive eating. MEASURES: Eating behaviors (ie, flexible restraint, rigid restraint, disinhibition, susceptibility to hunger, intuitive eating, and obsessive-compulsive eating) and psychological correlates (ie, body esteem, self-esteem, and depression) were assessed using validated questionnaires at baseline, postintervention, and 1-year follow-up. ANALYSIS: Group, time, and interaction effects analyzed with mixed models. RESULTS: Significant group by time interactions were found for flexible restraint ( P = .0400), disinhibition ( P < .0001), susceptibility to hunger ( P < .0001), intuitive eating ( P < .0001), obsessive-compulsive eating ( P < .0001), body-esteem ( P < .0001), depression ( P = .0057), and self-esteem ( P < .0001), where women in the HAES group showed greater improvements than women in the comparison group at short and/or long term. CONCLUSION: The evaluation of this HAES intervention in a real-life context showed its effectiveness in improving eating-, weight-, and psychological-related variables among women struggling with weight and body image.

Development and validation of a dietary screener for carbohydrate intake in endurance athletes.

BACKGROUND: Studies have shown that the majority of endurance athletes do not achieve the minimal recommended carbohydrate (CHO) intake of 6 g/kg of body weight (BW), with potentially negative impacts on recovery and performance. The purpose of this study was to develop and validate a rapid and easy to use dietary screener to identify athletes who do and do not achieve a CHO intake > 6 g/kg BW in the context of endurance sports. METHODS: The dietary screener was developed using multiple logistic regression modeling of data from a sample of 1571 non-athlete adults (826 women and 745 men, mean age 44.75 ± 14.2 years) among whom dietary intake was assessed using a validated web-based food frequency questionnaire (web-FFQ). Three models were developed based on whole food intake using the 5, 10 and 15 most significant variables predicting CHO intake. The three models were then validated in a target population of non-elite endurance athletes having taken part in multisport events (n = 175, 64 women and 111 men, mean age 37.1 ± 11.3 years) and compared using sensitivity, specificity, positive and negative predictive values (PPV and NPV, respectively) and c-statistics. RESULTS: The 15-variables model provided significantly better accuracy in predicting CHO intake adequacy in non-elite endurance athletes (c-statistic = 0.94) compared with the 10- and 5-variables model (c-statistic = 0.90 and 0.71 respectively). The 15-variables model predicts CHO intake adequacy in the target population of endurance athlete with a sensitivity of 89.5%, a specificity of 87.3% and PPV and NPV of 77.3 and 94.5%, respectively. CONCLUSION: We have successfully developed a short and valid dietary screener that identifies endurance athletes at risk of not achieving a CHO intake > 6 g/kg BW. Use of this rapid screener may help alleviate the highly prevalent issue of suboptimal CHO consumption in the endurance sports realm.

Social support for healthy eating: development and validation of a questionnaire for the French-Canadian population.

OBJECTIVE: The present study aimed to develop and validate a questionnaire assessing social support for healthy eating in a French-Canadian population. DESIGN: A twenty-one-item questionnaire was developed. For each item, participants were asked to rate the frequency, in the past month, with which the actions described had been done by family and friends in two different environments: (i) at home and (ii) outside of home. The content was evaluated by an expert panel. A validation study sample was recruited and completed the questionnaire twice. Exploratory factor analysis was performed on items to assess the number of subscales. Internal consistency reliability was assessed using Cronbach's ɑ. Test-retest reliability was evaluated with intraclass correlations between scores of the two completions. SETTING: Online survey. SUBJECTS: Men and women from the Québec City area (n 150). RESULTS: The content validity assessment led to a few changes, resulting in a twenty-two-item questionnaire. Exploratory factor analysis revealed a two-factor structure for both environments, resulting in four subscales: supportive actions at home; non-supportive actions at home; supportive actions outside of home; and non-supportive actions outside of home. Two items were removed from the questionnaire due to low loadings. The four subscales were found to be reliable (Cronbach's ɑ=0·82-0·94; test-retest intraclass correlation=0·51-0·70). CONCLUSIONS: The Social Support for Healthy Eating Questionnaire was developed for a French-Canadian population and demonstrated good psychometric properties. This questionnaire will be useful to explore the role of social support and its interactions with other factors in predicting eating behaviours.