Applied Human Nutrition -- Graduate Theses

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https://hdl.handle.net/10587/590
Completed Graduate theses from the Master of Science in Applied Human Nutrition program.

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Browsing Applied Human Nutrition -- Graduate Theses by Title

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    A cross-cultural assessment of the feeding environment and maternal-child interactions during breastfeeding in the first 6 months
    (2022-06-22) Hillary Fry
    Human milk is the sole recommended food for infants for the first 6 months of life. Despite this, little is known about whether breastfeeding practices, such as feeding responsiveness, differ across cultures. Responsive feeding practices are based on the cues and responses of a caregiver and infant and are associated with more intuitive eating patterns later in life. However, economic, cultural, and sociodemographic differences between high- and lowand middle-income countries may result in differing responsiveness of caregivers. However, there is a lack of cross-cultural research on responsiveness, particularly among infants under six months.
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    A mixed-methods exploration of peripartum food taboos and food additions in rural Cambodia
    (Mount Saint Vincent University, 2022-08-25) Labonté, Jocelyne
    Food taboos are culturally driven food avoidances that go beyond personal taste or preference. These avoidances are particularly prevalent throughout pregnancy and lactation. In Southeast Asia, common peripartum food taboos include seafood, meats, and various vegetables. Such avoidances could negatively impact the health of women and children if foods of similar nutritional value do not replace avoided foods. There is a paucity of information on dietary modifications during pregnancy and lactation in Cambodia.
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    Accessing Nutritious Food: The Realities of Lone Senior Women in Urban Nova Scotia
    (2008-03) Green, Rebecca; Williams, Patty
    This is the first qualitative study in Canada specifically focused on food insecurity in the senior population. Food insecurity is associated with poverty, increased risk of chronic disease, and poor physical and mental health. With the Canadian population steadily aging, and food security being recognized as one of the social determinants of health, it is imperative decision makers understand how food insecurity affects the growing number of senior citizens so that appropriate programs and policies can be implemented to ensure access to food for this vulnerable population. This thesis had three research objectives, to 1) explore how lower income senior women living alone in urban HRM experience food insecurity and uncover the meanings embedded in their experiences; 2) discover participant- and researcher-identified enablers and barriers to accessing nutritious foods; and, 3) explore how accurately hypothetical household scenarios detailing senior’s public pension incomes and monthly expenses to assess the affordability of a nutritious diet reflects the realities of the participants. To address the above objectives, in-depth semi-structured interviews were conducted. Interviews were transcribed verbatim and data were managed using NVIVO 7 software. The data were analyzed using a phenomenological approach to arrive at a structural description of the experience of food insecurity and expose the underlying and precipitating factors that account for what is being experienced. Bronfenbrenner’s Ecological Systems Theory was used to examine the environment shaping the seniors’ lives at various levels of influence. Eight women meeting study criteria (over 65 years of age, living alone in Halifax Regional Municipality and in receipt of the Guaranteed Income Supplement (GIS)) were interviewed to inform the results of this study. These women were recruited using sitebased recruitment methods through community organizations and a governmental housing program. All women rented their dwellings and seven lived in income-geared housing. Four of the women received a personal pension from the Canada Pension Plan (CPP) while two received a survivor’s benefit. Only one woman reported income from a private pension. Seven themes emerged as the women talked about their experiences with accessing food, including: 1) World View, 2) Health and Health Problems, 3) Use of Community Programs, 4) Transportation, 5) Adequacy of Income, 6) Other Food Management Strategies and, 7) Availability of Family & Friends. World view and health appeared to have the most influencial role on their food security status. Bronfenbrenner’s Ecological Systems Theory provided a model to examine the enablers and barriers to accessing food in relation to the fiver layers of the environment (micro-, meso-, exo-, macro- and chronosystems) influencing the participants’ individual food-related behaviours. Enablers and barriers were both participant and researcher identified
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    Achieving Healthy Body Weights in the Teenage Years: Evidence-based Practice Guidelines for Community Nutrition Interventions
    (2007-10) Rudd, Brenna; Glanville, Theresa
    Background: Adolescent obesity has become a significant public health problem. Conservative estimates, based on self-reported data, indicate overweight and obesity rates among Canadian adolescents aged 12 to 17 soared from 14% in 1978/79 to 29% in 2004. This persistent upward trend has serious long-term implications on the physical and psychological well being of adolescents and accounts for billions of dollars in health care costs. For this reason, prevention has been recognized as a priority health issue. While interventions have begun to target school-aged children and adults in clinical settings, few advances have been made to halt the escalating problem among adolescents. This population has unique needs with increasing independence transitioning into adulthood. Reversing the trend requires comprehensive interventions that mitigate personal, social and environmental barriers to healthy lifestyle choices. There is currently little consensus on best practices for dietetic adolescent obesity prevention and management. Community strategies are recommended as the most efficacious and feasible way to reach the greatest number of youth and support healthy lifestyle development. Evidence based guidelines are currently not available and are needed to guide nutrition practice in this area. Methods: A thorough systematic review and evidence analysis yielded 48 prevention and treatment interventions meeting the studies inclusion criteria. The evidence was graded and drafted into recommendations and an algorithm guideline displaying how each recommendation relates to nutrition intervention. A panel of independent, national experts assessed the guidelines for validity, acceptability and applicability with a tool adapted from the AGREE Collaborations Appraisal of Guidelines for Research and Evaluation Instrument. These experts covered different areas of expertise, including community nutrition, public health, adolescent health, academia and endocrinology. Results: The research findings confirm the need for comprehensive strategies, which include components of nutrition education and physical activity, address social and environmental influences and use schools as delivery vehicles for health promotion and health education. For obesity treatment interventions, promising strategies incorporated diet plans, family involvement and behaviour modification techniques in multidisciplinary interventions. Computer based strategies and peer modelling may also be developmentally appropriate strategies for health promotion health in the adolescent population. Conclusions: The results of this study indicate several interventions conducted over the past 10 years have had a positive effect in preventing or reducing adolescent obesity over the short and/or long term. The findings support the development of comprehensive, multi-disciplinary obesity prevention and treatment interventions and the use of peer modeling, family based and computer based strategies.
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    Activism: Does it fall within the roles and responsibilities of all physicians? Perspectives of Atlantic Canadian physician-activists
    (Mount Saint Vincent University, 2023-08) Bromley, Alexandra E
    Health advocacy is an expectation of all Canadian physicians according to the CanMEDS framework, which defines necessary competencies for medical practice in Canada. Whether advocacy work specifically as activism is a professional responsibility is debated by physicians and is not adequately addressed in previous literature.
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    An exploration of the knowledge, attitudes, and practices of infant and young child feeding and labour laws among Cambodian factory workers
    (Mount Saint Vincent University, 2023-04) Meier, Emily
    Human milk is the ideal food for infants up to six months of age and continues to provide essential nutrients for two years and beyond. Rates of exclusive breastfeeding in Cambodia are currently declining, and at the same time, women are increasingly engaged in the paid labour force, particularly factory work. Cambodian Labour law allows 90 days of maternity leave, and evidence suggests that this early return to work and living away from children may impede breastfeeding. While limited research has been conducted on mother employees’ knowledge, attitudes, and practices of nutrition and infant and young child feeding in Cambodian workplaces, little is known about the perspectives of other workers.
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    The Assessment of Food Management Behaviours that Influence the Diet Quality of Mother-led Families in Nova Scotia
    (2010-04-14T13:44:29Z) Currie, Kristin; Glanville, Theresa
    We have shown in previous research that food management strategies adopted by lowincome families may account for the difference in diet quality within households that have similar economic and structural characteristics. By studying these familial food policies we can better understand how internal and external factors influence diet quality, particularly for vulnerable populations, which may help to develop successful programs and health initiatives aimed at achieving and maintaining diet changes that reflect the recommendations in Eating Well with Canada's Food Guide. The objective of this research was to validate the Food Management Assessment Tool; a tool designed to assess diet quality and food management strategies used by low-income households. The goal was to design a tool that could be implemented and interpreted by a health care practitioner with little or no nutrition background. This required three methodological objectives to develop and validate estimation tools to assess, 1) if a meal contains 30% of food energy from fat; 2) if a food item is a limiting food; and, 3) if a non limiting food item is high in fat. Participants included 48 low-income mother-led families with at least two children between the ages of 2-14 living in Nova Scotia. The mothers completed one 20-60 minute face-to face interview in which they described the supper meal consumed by each family member and completed an interview administered questionnaire designed to assess Food Management Strategies. The data was interpreted using Family Systems Theory. Results found that low-income families that use healthy food management strategies were 13 times more likely to have good diet quality than those that do not use healthy food management strategies. The overall Food Management Score includes components on healthy eating, formal meal structuring, meal planning and on whether or not the family is mother driven, as opposed to child driven. This research was the first to develop an index score able to identify and classify families based on the functionality of their environment in relation to diet quality. Practitioners can use the tool we developed to assess clients and to develop, monitor and evaluate programs.
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    Body esteem, eating attitudes, and adherence in adolescents with cystic fibrosis from Atlantic Canada.
    (Mount Saint Vincent University, 2006-09) Faulkner, Colleen
    A study was conducted to investigate the influence of body esteem, nutritional status, nutritional intake, and eating attitudes on adherence to dietary therapy and enzymes in adolescents and young adults with cystic fibrosis. Nine adolescents aged 12.5 to 18 years from the CF clinics at the IWK (Halifax, NS) and the Janeway (St. John’s, NL) participated in the study. The participants completed the following surveys/tools: a Three-Day Food Diary, The Eating Attitudes Test-26 (EAT-26), The Body Esteem Scale for Adolescents and Adults (BBS), and The Adherence Survey. Nutritional analysis determined that study participants had an average caloric intake of 2174 Cal. Only one participant met the adjusted Estimated Energy Requirement (EER + 20%), and was classified as being adherent to dietary therapy. The average Body Mass Index (BMIp) was at the 52"‘' percentile, and the average percent Ideal Body Weight (%IBW) was 100. None of the participants were classified as stunted, according to their height-for-age, but one was classified as wasted, according to his/her BMIp value. BBS scores determined that participants have a relatively positive body esteem, with a mean score of 52.67, 57.25% of the highest possible score. Eating attitudes were also positive, for the most part. However, EAT-26 scores did reveal that one participant was at risk of developing an eating disorder, having a score over 20. In the study, adherence was defined as taking the same dose, or more, of a treatment as prescribed by a doctor and/or dietitian. Adherence to vitamins and nutritional supplements, when prescribed, was extremely poor, at 0%. Adherence to enzymes taken with meals and snacks was similar to rates in the literature, with 56% being adherent. Common reasons cited for non-adherence included forgetfulness, an absence of positive results, time and effort consuming, and a dislike of taking the treatment in front of others. Due to the small sample size, two-tailed independent sample t-tests revealed no statistical significance between adherence, body esteem, eating attitudes, caloric intake, BMIp, and %IBW. Therefore, results of the study indicate that in the population of all adolescents with CF, based on the results of this study, one cannot predict differences in BBS, EAT-26, EER, BMIp, or %IBW based on the individuals’s adherence category.
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    Body esteem, eating attitudes, and adherence in adolescents with cystic fibrosis from Atlantic Canada.
    (2009-04-21T13:58:20Z) Faulkner, Colleen; Taper, Janette
    A study was conducted to investigate the influence of body esteem, nutritional status, nutritional intake, and eating attitudes on adherence to dietary therapy and enzymes in adolescents and young adults with cystic fibrosis. Nine adolescents aged 12.5 to 18 years from the CF clinics at the IWK (Halifax, NS) and the Janeway (St. John’s, NL) participated in the study. The participants completed the following surveys/tools: a Three-Day Food Diary, The Eating Attitudes Test-26 (EAT-26), The Body Esteem Scale for Adolescents and Adults (BES), and The Adherence Survey. Nutritional analysis determined that study participants had an average caloric intake of 2174 Cal. Only one participant met the adjusted Estimated Energy Requirement (EER + 20%), and was classified as being adherent to dietary therapy. The average Body Mass Index (BMIp) was at the 52nd percentile, and the average percent Ideal Body Weight (%IBW) was 100. None of the participants were classified as stunted, according to their height-for-age, but one was classified as wasted, according to his/her BMIp value. BES scores determined that participants have a relatively positive body esteem, with a mean score of 52.67, 57.25% of the highest possible score. Eating attitudes were also positive, for the most part. However, EAT-26 scores did reveal that one participant was at risk of developing an eating disorder, having a score over 20. In the study, adherence was defined as taking the same dose, or more, of a treatment as prescribed by a doctor and/or dietitian. Adherence to vitamins and nutritional supplements, when prescribed, was extremely poor, at 0%. Adherence to enzymes taken with meals and snacks was similar to rates in the literature, with 56% being adherent. Common reasons cited for non-adherence included forgetfulness, an absence of positive results, time and effort consuming, and a dislike of taking the treatment in front of others. Due to the small sample size, two-tailed independent sample t-tests revealed no statistical significance between adherence, body esteem, eating attitudes, caloric intake, BMIp, and %IBW. Therefore, results of the study indicate that in the population of all adolescents with CF, based on the results of this study, one cannot predict differences in BES, EAT-26, EER, BMIp, or %IBW based on the individuals’s adherence category.