Nutritional quality of the food choices of Canadian children

Abstract

Background: The release of the Canadian Community Health Survey (CCHS), Nutrition 2015 provides a unique opportunity since CCHS 2004 to investigate food choices of Canadian children and adolescents at a national level.

Objective: This study examined the quality and quantity of food choices of children ages 2-8 years and adolescents 9-18 years, using Health Canada's Surveillance Tool Tier System 2014. It is hypothesized that Canadian children and adolescents are consuming diets poor in nutritional quality based on evidence from the last national nutrition survey in 2004.

Design: Intakes from CCHS 2015, 24-h dietary recall were categorized into Health Canada's Tiers 1-4, based on CNF/CFG classification system and thresholds for nutrients to limit i.e., total fat, saturated fats, sugars, and sodium to assess quality of food choices. Additionally, dietary intakes were grouped according to Canada's 2007 food guide servings as the 2019 food guide was not available.

Results: Majority of foods reported by children 2-18 years were categorized as Tier 2 and Tier 3 foods. Investigation of energy contributions from the Tier 4 and "other foods" represented 21-25% of daily calorie intake and of these foods, high fat and/or high sugar foods contributed majority of daily calories to these categories.

Conclusions: This study showed Canadian children 2-18 years are consuming diets high in nutrients recommended to limit. Evidence from this study provides a unique opportunity to improve the nutritional quality of foods, and the food choices of children.

Keywords: Canada’s food guide; Diet quality; Dietary intakes; Health Canada’s Surveillance Tool, Tier System; Nutrition policy; The Canadian Community Health Survey, Nutrition 2015.

Fig. 1

Weighted age-stratified analysis of foods consumed by food category based on the 2014 Health Canada’s Surveillance Tool, Tier system, among children a 2–8 years, b boys 9–18 years, and c girls 9–18 years results are energy adjusted. Tiers are classified according to lower and upper thresholds for nutrients of public health concern: sodium, saturated fats, total fats and sugars. Lower thresholds: total fat: ≤ 3 g/RA, sugars: ≤ 6 g/RA and sodium: ≤ 140 mg/RA [8]. Upper thresholds: total fat: > 10 g/RA, sugars: > 19 g/RA, sodium: > 360 mg/RA, and saturated fats: > 2 g/RA [8]. Tier 1 foods do not exceed lower thresholds for total fat, sugar, and sodium. Tier 2 may exceed one or two lower thresholds but no upper thresholds. Tier 3 Vegetable and Fruit, and Grain Products: exceeds all lower threshold and no upper thresholds, or only one upper threshold. Tier 3 Milk and Alternatives, and Meat and Alternatives: exceeds all lower threshold and no upper thresholds, or only one upper threshold for total fat, sugars, or sodium. Tier 4 Vegetable and Fruit, and Grain Products: exceeds two upper thresholds. Tier 4 Milk and Alternatives, and Meat and Alternatives: exceeds upper thresholds for total fat, sugars, or sodium [8]