The Effects of the Food Environment on the Healthy Eating Score of Canadian Women Runners

Study objective: The goal of the study was to test the construct validity of the Healthy Eating Score (HES) by exploring the influences of the individual, family, social, environmental and cultural influences on diet quality of active Canadian women. The study also attempted to determine the associations between these variables and the food groups in “Eating Well with Canada’s Food Guide" (CFG). Methodology: Our study used data from the iRun survey, an online questionnaire developed for female Canadian runners (n = 1216). The survey contained 160 questions, separated into 18 components. The HES was comprised of two components, the Food Group Score (FGS) including the 4 food groups from CFG, and the Directional Guidance Score (GDS), using 6 of the 10 directional statements from CFG (i.e. "Eat at least one dark green and one orange vegetable each day", "Have vegetables and fruit more often than juice", "Make at least half of your grain products whole grain each day", "Drink 2 cups of milk or fortified soy beverage each day", "Have meat alternatives such as beans, lentils and tofu often", "Eat at least two Food Guide servings of fish each week"). The individual, family, social, environmental and cultural variables of interest were isolated using previously published literature, and then reduced into factors through principle components analysis (PCA). Next, these factors were used to compare, using Analysis of variance (ANOVA), sample tertiles, divided on the basis of their HES score. Lastly, the factors were analyzed for associations with the HES and the 4 food groups using hierarchical multiple regression based using our 5-level food environment model. This model was adapted from Daveluy’s work (2001) and included the individual level (level 1), the family level (level 2), the social level (level 3), the environmental level (level 4) and the cultural level (level 5). The analyses were performed by SAS 9.3 (SAS Institute Inc., Cary, NC) with P<0.05 defined as significant.Results: The PCA results determined 4 different facets of the HES, which were the fruit & vegetable food group and fibre-related dietary recommendations, grains and meat & alternative food groups, milk & alternatives food group, and fish intake. The PCA also showed that the HES identified with the fruit & vegetable food group and fibre-related dietary recommendations. The ANOVA demonstrated that the highest tertile for the HES achieved significantly higher scores for all the food group and dietary guidance recommendations, as well as higher self-reported health. The hierarchical multiple regression analysis identified a negative association between snack consumption and the HES, albeit only in the first 2 levels of the model. The average HES for the sample population was 5.6 ± 1.8. Conclusion: Canadian women runners only met approximately half of the adapted recommendations from CFG. The results from this study demonstrated that the HES was able to assess nutritional recommendations, to differentiate and to identify individual-level independent variables. These findings suggest that the HES is a valid assessment tool, and more time- and cost-efficient when compared to previous Canadian dietary indices. The results from the hierarchical regression analyses elucidate the need to better define the food environment of an individual in order to grasp the complexity of the influences on diet quality. With a more comprehensive understanding of the diet quality within a food environment, health practitioners can improve the implementation of a client-specific nutritional care plan in order to achieve optimal health.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.