Healthy Eating in Ontario: What Do We Know?
An Analysis of Eating Behaviours, Food Literacy and Food Insecurity Indicators
II A Summary of Key Findings
-IIa Healthy Eating
-IIb Food Literacy and Skills
-IIc Food Insecurity
-IId Self-Reported Health and Physical Activity
III Limitations of this Study
IV Future Recommendations
This report summary was reprinted with permission from its authors, the Nutrition Resource Centre (thank you!). You can find the full report here: http://opha.on.ca/getmedia/0d69cc84-a38a-45ff-a552-b3c31ea9cadf/Healthy-Eating-in-Ontario-FINAL-October-2017_1.pdf.aspx
Citation: Roblin L, Smith D, Purno N, Mehandra A. Healthy Eating in Ontario: What Do We Know? An Analysis of Eating Behaviours, Food Literacy and Food Insecurity Indicators. Toronto (ON): Nutrition Resource Centre, Ontario Public Health Association; 2017. September, 57 p.
This exploratory study draws on existing population-based survey data sources to develop a cross-sectional analysis of several determinants of dietary intake among Ontarians, including healthy eating, food literacy and skills, and food insecurity. We also examined general health indicators, including self-rated health and physical activity. These indicators are important as they can be used to inform evidence-based and targeted policy and programming that promotes healthy eating and chronic disease prevention.
Stakeholders working in public health, arm’s-length government organizations and academia were consulted to identify relevant indicators and an environmental scan was conducted to identify the best possible data sources. The Canadian Community Health Survey (CCHS) was identified as being the most comprehensive data source, and the annual core component of the 2014 CCHS was used, in addition to the Rapid Response Food Skills Modules from the 2012 and 2013 CCHSs. Selected indicators were stratified by socio-demographic characteristics (e.g. age, sex, household income and Aboriginal status, when available) to gain a greater understanding of how these determinants vary among these subgroups.
Specific indicators considered for healthy eating behaviours included fruits and vegetable consumption, self-perceived diet quality and adjusting a recipe to make it healthier. For food literacy and skills, the indicators selected were personal cooking skills; using Canada’s Food Guide to learn about healthy eating and grocery shopping; participation of children in shopping for groceries; and helping with meal preparation or cooking. Data was not available for food literacy and skills indicators at the provincial level, so Canadian data was used as a proxy. For food insecurity, self-reported health and physical activity data from the 2014 CCHS was used.
II A Summary of Key Findings
While the majority of Canadians report good or excellent eating habits, less than half (38.5%) consume fruits and vegetables more than five times or more per day. In Ontario, adults report the lowest prevalence of fruit and vegetable consumption compared to youth and older adults. Females report a higher prevalence of fruit and vegetable consumption than males and are also more likely to report adjusting a recipe to make it healthier. Adults report having more advanced cooking skills than youth, who report having more basic or intermediate cooking skills. A very small proportion of Canadians (8.9%) report using Canada’s Food Guide to learn about healthy eating— and its use is highest among youth. More Canadians (31.1%), especially females and older adults, report using the food guide to shop for groceries. The majority of Canadian households report children participating in shopping for groceries and preparing meals. Moderate and severe food insecurity impacts 9% of households in Ontario, with a much higher prevalence in Aboriginal households (18%) and the lowest income households (27%). While the majority of Ontarians report their self-rated health as “very good or excellent”, a significantly lower proportion of older adults and people with Aboriginal status or low income report this. Over half of Ontarians report being moderately active or active, with the younger population (12-17 year olds) and those in higher income quintiles reporting being more active.
IIa Healthy Eating
- Almost half of Canadians, over the age of 12, report their eating habits as very good or excellent. Despite this, just 38% of Ontarians report consumption of fruits and vegetables five times or more per day. In Ontario, adults (18-65 years old, 37%) reported the lowest prevalence of fruit and vegetable consumption compared to youth (12-17 years old, 43%) and older adults (over 65 years old, 44%). Females (45%) report significantly higher prevalence of fruits and vegetable consumption compared to males (32%). Consuming fruits and vegetables five or more times per day increases across income quintiles, with the lowest quintile having significantly lower consumption compared to the highest quintile. There is no significant difference between Aboriginal populations and non-Aboriginal households with regards to fruits and vegetables consumed five or more times per day.
- Almost two-thirds (63%) of Canadians self-report adjusting a recipe to make it healthier, with adults having the highest prevalence for adjusting recipes, while only about one-third of youth report this behaviour. In Canada, a significantly higher proportion of females (75%) compared to males (51%) report adjusting a recipe to make it healthier.
- Almost half of Canadians report adjusting a recipe to make it healthier by reducing fat content or adding more fruits and vegetables. Canadians also make efforts to reduce salt and sugar content, while few make a recipe healthier by adding whole grains. Less than one-third of Canadian youth report they adjust a recipe to make it healthier by reducing fat, sugar and salt content or by choosing whole grains; however, almost half of youth report adding more fruits and vegetables to a recipe to make it healthier. Similarly, almost half of Canadian females and males report adjusting a recipe to make it healthier by adding more fruits and vegetables. A greater proportion of females than males report adjusting a recipe to make it healthier by reducing fat or sugar content and by increasing whole grains. A greater proportion of males report adjusting a recipe to make it healthier by reducing salt content.
IIb Food Literacy and Skills
- The majority of adults (18-65 years old) report having more advanced cooking skills (81%), while a large portion of older adults ( >65 years old) report having more advanced (73%) and average (22%) cooking skills. Canadian youth report having basic or intermediate food skills (90%), such as preparing a simple meal or following a recipe.
- Most Canadians (92%) report good or very good skills in “peeling, chopping or slicing vegetables or fruits”. Across age groups, youth report the lowest percentage of good or very good self-perceived skills in peeling, chopping or slicing vegetables and fruits, compared to adults and older adults. While a high percentage of the Canadians surveyed report good or very good skills in “cooking a raw piece of meat, chicken or fish”, there is a significant lower percentage of youth compared to adults and older adults (52% versus 92% and 89%, respectively) who report good or very good meat, chicken or fish preparation skills. While the majority of both females and males report a good or very good skill level for “peeling, chopping or slicing vegetables and fruits” and for “cooking a raw piece of meat, chicken or fish”, percentages are significantly higher among females than males. There is no significant difference in self- perceived food skills between Aboriginal and non-Aboriginal households.
- Overall, Canada’s Food Guide (CFG) is not well utilized by Canadians to learn about healthy eating or to aid with grocery shopping. A very small proportion of Canadians (9%) report consulting CFG to learn about healthy eating. The prevalence of consulting CFG to learn about healthy eating is higher among females compared to males, and decreases across age groups with youth having the highest prevalence compared to adults and older adults. A greater proportion of Canadians (31%) report using CFG while shopping for groceries rather than consulting it to learn about healthy eating, with a significantly higher proportion of older adults using CFG for grocery shopping compared to adults. Canadian females also show a significantly higher prevalence of consulting CFG for grocery shopping compared to males. There is no significant difference between Aboriginal and non-Aboriginal households with regards to using CFG to learn about healthy eating or using CFG to shop for groceries.
- A high percentage of Canadian households report the participation of children in shopping for groceries (68%) and helping to prepare meals or cook food (60%). Aboriginal households report significantly more children involved in preparing meals (76%) compared with non-Aboriginal households (59%).
IIc Food Insecurity
- In Ontario, 6% of children and 8% of adults (>18 years old) are living in households with moderate or severe food insecurity (based on 2014 CCHS data). The percentage of older adults (> 65 years old) living in households with moderate or severe food insecurity is significantly lower (3.5%) compared to adults (18-65 years old) (9%) and children (6%). Overall, 9% of households in Ontario experience moderate or severe food insecurity. Households in the lowest income quintile have a significantly higher prevalence of food insecurity (27%) compared to households in highest income quintile (1%). The prevalence of food insecurity is significantly higher in Aboriginal households (18%) compared to non- Aboriginal households (9%).
IId Self-Reported Health and Physical Activity
- The majority (60%) of Ontarians report their self-rated health as very good or excellent. A significantly lower proportion of older adults (46%), people with Aboriginal status (50%) and individuals in the lowest income quintile (45%) report very good or excellent health status compared to their respective socio- demographic counterparts.
- Over half (53%) of the total population of Ontario self-report being moderately active or active for leisure time physical activity. The prevalence of being moderately active or active was significantly higher in the younger age group (12-17 year olds) compared to adults and older adults and for those in higher income quintiles compared to lower income quintiles. There is no statistically significant difference found in self-reported physical activity between males and females or between Aboriginal and non-Aboriginal populations.
III Limitations of this Study
Overall, the data available to assess the determinants of healthy eating and dietary intake in Ontario is very limited. For this study, we were only able to access data on vegetable and fruit intake, self-rated eating habits, and adjusting recipes to make them healthier to measure eating behaviours. Furthermore, we were only able to access data on the food literacy and skills of Canadians, not Ontarians. While we had data on moderate and severe (not marginal) food insecurity for Ontario, data on other important determinants of healthy eating—such as dietary intake, the food environment, and geographic or cultural influences—is not available. The lack of data on these important determinants of dietary intake makes it difficult to paint a complete picture of healthy eating among Ontarians. Moreover, the gap in dietary intake data from the CCHS nutrition component spans more than a decade in Canada, and this lack of data limits the authors’ ability to assess the dietary intake of Ontarians and draw relationships between the determinants of healthy eating and diet quality or dietary intake. While data collected in the 2015 CCHS Nutrition survey became available in July 2017, it was not be considered in this report due to timing.
IV Future Recommendations
Future initiatives should address developing and administering standardized indicators and surveys within the province of Ontario that provide population- representative estimates of important determinants of healthy eating. This includes, but is not limited to: eating behaviours, including food and nutrient intake (such as fat, sugar, sugar-sweetened beverages, sodium etc.); food literacy; food insecurity (including marginal); the food environment; and geographic and cultural influences, as well as more regular reporting on the dietary intakes and nutritional status of Ontarians.
More importantly, such determinants of healthy eating should be analyzed in relation to current measures of diet quality and dietary intakes to determine which factors have the most impact among various sub-sets of the Ontario population. This would enable planning and assessing the impact of evidence-informed and targeted interventions and policies to improve population nutrition status; preventing and reducing obesity and other non-communicable chronic diseases; and reducing health inequities and associated health care costs in Ontario. Additionally, this data should be centrally housed to be more easily accessed and utilized by public health policy and program decision makers and others as benchmarks and indicators for provincial program and policy planning.