- Email: [email protected]
Multimodal measurement of body composition change with diet- and exercise-induced weight loss in obese women
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cANADIAN JoUrNAL oF DIAbEtEs
Patients were divided into four groups based on smoking status: Never Smokers, Former Smokers, Light Smokers, and Heavy Smokers. This was a prospective study, and weekly visit data were entered for each patient including: weight, weight management class attendance, quantity of meal replacement consumed, and mean number of cigarettes smoked. Using S.A.S. 9.2, statistical analysis was performed on the data, namely one-way ANOVA analysis, followed by Tukey’s HSD post-hoc analysis for the continuous data. Chi-square analysis was employed for the nominal data. results: There were 1,472 Never Smokers, 1,350 Former Smokers, 118 Light Smokers, and 241 Heavy Smokers. Never Smokers were more likely to attend weight-management classes than Heavy Smokers. Former Smokers followed the meal supplement plan more closely than Heavy Smokers. Never Smokers were the least likely of all groups to change their smoking status. Former Smokers were more likely than Never Smokers to smoke during the program. Light Smokers were more likely than Heavy Smokers to make a smoking cessation attempt. Significantly more per cent weight loss over the first eight weeks of the program was observed for Never Smokers, compared to Former Smokers. conclusons: By recognizing the significant differences between weighttreatment-seeking groups based on their smoking status, obesity and combined obesity-smoking cessation interventions could be developed to be more responsive to these different subgroups. 242 Use of Nutritional Information in canada: National trends between 2004 and 2008 S. Goodman1, D. Hammond1, F. Pillo-Blocka2, T. Glanville3, and R. Jenkins4 1 Department of Health Studies, University of Waterloo, Waterloo, Ontario, Canada; 2The Canadian Council of Food and Nutrition, Mississauga, Ontario, Canada; 3Faculty of Applied Human Nutrition, Mount Saint Vincent University, Halifax, Nova Scotia, Canada; 4Jenkins Research Inc., Ottawa, Ontario, Canada Introduction: Obesity is a primary risk factor for a range of chronic diseases, including cancer, type 2 diabetes, cardiovascular disease, and osteoarthritis. Diet is estimated to account for approximately 30% of cancers in industrialized countries. Recent estimates indicate that nearly one-quarter of adult Canadians are obese and 36% are overweight, while more than one-third of Canadian children and youth are either obese or overweight. Nutritional labelling on packaged food products is an important policy tool used to educate consumers and promote the selection of healthy foods. The present study sought to examine longitudinal trends in use of nutrition information among Canadian consumers over a five-year period. Methods: Representative samples of Canadian adults were recruited using Random Digit Dialling sampling in 2004 (n=2,405) and 2006 (n=2,014), and an online commercial panel in 2008 (n=2,001). Data was collected using population-based phone and Internet surveys. Main outcome measures included: socio-demographic predictors of product label use, use of nutrition information sources, and nutrient content information. Linear and logistic regression models were used to examine predictors and changes over time. results: Food product labels were the most common source of nutritional information in 2008, followed by the Internet and magazines/newspapers. The Internet was the only source to significantly increase over the study period; however, the frequency of reading food product labels increased since 2004. Food selection based on trans fat increased significantly in 2006, following mandatory labelling of trans fat on packaged foods. Taste and nutrition were consistently the primary factors guiding food choice. conclusions: Food product labels and the Internet emerged as nutrition information sources with broad reach. Longitudinal analyses revealed that more comprehensive labelling regulations were associated with increased label use and greater use of nutrient information over time.
243 consideration of measurement variability and its implication for feedback effects between body weight and physical activity behaviour P.B. Deck, S. White, C.L. Matteson, L.C. Masse, S.A. Lear, and D.T. Finegood Simon Fraser University, Department of Biomedical Physiology and Kinesiology, Burnaby, British Columbia, Canada background: Current knowledge of the complex interdependencies between physiological and behavioural mechanisms underlying weight regulation is incomplete. Understanding the variability and dynamics of measures used in feedback loops, such as body weight and physical activity levels, has implications for determining which measures are optimal for supporting behaviour change, and choosing the optimal frequency for measurement. approach: Nineteen healthy subjects ages 23-59 wore an Actigraph GTX3 accelerometer every day for 12 weeks. Weekly measurements included body weight, body composition, resting energy expenditure, and hip and waist circumference. Accelerometer data was processed using ActiLife v4.4.1 Software to generate steps, activity counts, and time spent at physical activity intensities. Body composition was measured using a Discovery X-Ray Bone Densitometer. results: Body weight (2.1%), waist circumference (2.9%), and per cent body fat (5.2%) varied by a small amount during the 12-week study. Physical activity measures, including mean daily steps (41.0%), activity counts (44.6%), and time spent in at least moderate intensity activity (62.8%), were highly variable. Despite a fourfold difference between the least active and the most active subject, there was no significant relationship between the level of physical activity (counts) and the weekly coefficient of variation (r=.350; P=0.155). conclusions: Highly variable measures, such as those that reflect activity levels, may demand more frequent measurement to enable integration and improved accuracy to enable use as feedback. Less variable measures such as body weight may help create more effective feedback loops when the time delay between behaviour change and the change in outcome is considered. 244 If I am biased, what am I supposed to do now? M. Vallis Capital Health/Dalhousie University, Halifax, Nova Scotia, Canada Introduction: The professional bias against obesity has become widely acknowledged. The extent of bias has been demonstrated in virtually all health care provider disciplines, including those professionals who provide service to the obese. In contrast to the literature demonstrating the existence of bias, there is very little in the way of effective strategies to reduce bias. This poster will provide a review of the literature on methods to reduce bias. Practical strategies to actively counter bias against obesity will be offered. A toolkit that can be used as an educational intervention will be outlined. The goal of this poster is to empower providers to take action to ensure that implicit bias does not inadvertently impair obesity management. 245 Multimodal measurement of body composition change with diet- and exercise-induced weight loss in obese women A.R. Josse1, S.A. Atkinson2, M.A. Tarnopolsky2, H. Azizian3, J.K.G. Kramer4 and S.M. Phillips1 1 Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada; 2Pediatrics and Medicine, McMaster University Medical Centre, Hamilton, Ontario, Canada; 3NIR Technologies, Oakville, Ontario,
abstract
Canada; 4Agriculture and Agri-Food Canada (retired), Guelph, Ontario, Canada Introduction: Using changes in body mass index or body weight to classify the success of any anti-obesity intervention has inherent flaws. Measuring changes in body composition would be more clinically meaningful since a weight loss profile characterized by the loss of fat mass and maintenance/gain of muscle mass would be associated with greater reductions in disease risk. Methods: We assessed how daily exercise and different hypoenergetic diets varying in dairy (0-1, 2-4, 6-7 servings/d), total protein (% energy intake: 15, 15, 30), and dairy source calcium (~300, ~1000, ~1700 mg), affected changes in the tissue composition of weight loss in 90 premenopausal, obese women over 16 weeks. We compared three different modalities: DXA, MRI, and Fourier Transform Near-Infrared Spectroscopy (FT-NIR), to assess body composition changes before and after a diet- and exercise-based intervention. results: We observed comparable weight loss across all three study groups, however, subjects who consumed higher protein (30%) and high calcium showed the greatest reduction in total and visceral/ abdominal fat mass, and a gain in lean mass. FT-NIR and DXA measures of body fat (kg) were highly correlated (r=0.95, p<0.001), as were direct measures of visceral fat volume by MRI and total abdominal fat by DXA (r=0.76, p<0.001). conclusions: All three modalities provided comparable results in tracking changes in various components of body fat in young, obese women on a weight-loss program. DXA is a more practical and accessible modality than the gold-standard MRI for measuring visceral fat mass. FT-NIR, while still fairly new, is a cheaper and far more accessible method of assessing fat mass loss that is comparable to DXA. Thus, measuring body composition to monitor progress during weight loss interventions can be done using a variety of modalities, but FT-NIR is particularly suited to large-scale clinical trials. supported by: The Dairy Farmers of Canada, The U.S. National Dairy Council and the Dairy Research Institute, CIHR. 246 consumption of high prebiotic fiber or high-protein diet during pregnancy alters gut microbiota in the dams and their offspring M.C. Hallam1 and R.A. Reimer2 1 Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada; 2Faculty of Kinesiology and Faculty of Medicine, Department of Biochemistry and Molecular Biology, University of Calgary, Calgary, Alberta, Canada Introduction: The microbial community of the gastrointestinal tract plays a large role in nutrient harvest and metabolism for the host, and is primed by maternal microbiota at birth. Proportions of Firmicutes and Bacteroidetes have been linked to body weight and can be influenced by diet. Methods: Virgin Wistar dams were given a high prebiotic fiber (HF), high protein (HP), or control (C) diet from one week pre-conception until weaning. Male and female pups were weaned onto AIN-93G at 21d. Fecal samples were collected from dams 14d post partum, and from pups at 35 days. DNA was isolated from samples for qPCR using primers for Lactobacillus, Clostridium leptum, Clostridium coccoides, Bifidobacteria, Bacteroides/Prevotella, Total Eubacteria, and Enterobacteriaceae. results: At week two of pregnancy and at weaning, HF dams weighed less than HP dams (p<0.05). Dams on HF had higher Lactobacillus, Bifidobacteria, and Clostridium coccoides and lower Clostridium leptum 14 days post partum than controls (p<0.05). Offspring mass did not differ at 35 days. Diet affected Clostridium leptum and Clostridium coccoides, which were greater in C than HF, and HF and HP, respectively (p<0.01). HF females also had a greater percentage of Bacteroidetes than all other groups (p<0.001), and lower percentage of Firmicutes than female HF and HP (p<0.001).
conclusions: A maternal high prebiotic fiber diet had beneficial effects on gut microbiota profiles in dams and may have influenced weight gain. While body weight was not affected in offspring at 35 days, strains of bacteria associated with obesity were decreased and may have an effect later in life. 247 coping in an obesogenic environment: the perceptions of women who compulsively overeat A. Cooley and S. Kirk Dalhousie University, Halifax, Nova Scotia, Canada Introduction: Compulsive overeaters are a marginalized group within the realm of disordered eating, and are underserved by health professionals. Those with weight issues may struggle to find the resources they need to overcome their eating behaviours because they may be seen as “failed dieters,” since most traditional approaches to weight loss are not necessarily appropriate. Methods: This qualitative study explored the experiences of overweight and obese Nova Scotian women who compulsively overeat, to better understand environmental determinants influencing their behaviour. Based on social ecological theory, photo-elicitation and semi-structured interviews with six women were used to gather indepth and contextual information about weight-related motivations and obstacles to appropriate support. results: This study identified several environmental barriers these women face in maintaining a healthy weight, such as food retailers (e.g., displaying an abundance of unhealthy food for low prices), food service outlets (e.g., the availability and accessibility of unhealthy food— particularly fast food restaurants), food marketing (e.g., widespread distribution of coupons and abundance of fast food advertising), and their inability to access or take advantage of weight management or prevention services (due to lack of knowledge or unavailability of these resources). conclusion: Participants’ lack of coping skills when dealing with these environmental influences demonstrate a focus on the individual as the problem, i.e., blaming themselves for their weight rather than recognizing how the “obesogenic” environment plays a key role in influencing compulsive overeating behaviours. Increasing awareness of these influences, alongside the provision of supportive environments for healthy food choices may be needed. 248 rester à l’école pour dîner plutôt qu’aller manger dans les restaurants à service rapide : résultats d’une intervention chez les élèves du secondaire D. Beaulieu1,3, and G. Godin1,2,3 1 Faculté des sciences infirmières, Université Laval, Ville de Québec, Québec, Canada; 2Chaire de recherche du Canada sur les comportements et la santé, Université Laval, Ville de Québec, Québec, Canada; 3Unité de recherche en santé des populations, Centre hospitalier affilé de Québec, Hôpital du Saint-Sacrement, Ville de Québec, Québec, Canada Introduction: À ce jour, la majorité des écoles secondaires ont retiré la malbouffe de leur menu pour la remplacer par des aliments santé. Il serait donc avantageux pour leur santé que les élèves consomment un repas acheté à l’école ou apporté du domicile plutôt qu’un repas provenant d’un restaurant à service rapide à proximité de leur école puisque les aliments disponibles dans ces restaurants sont généralement riches en gras, en sucre, en sel et en calories. Le but de cette présentation est de décrire les résultats d’une intervention visant à encourager les élèves du secondaire à rester à l’école pour dîner plutôt que d’aller manger un repas dans les restaurants à service rapide à proximité de leur école. Méthode: Diverses activités ont été élaborées et offertes en 2008 dans une école secondaire de la ville de Québec. Ces activités ont pris la forme de
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cANADIAN JoUrNAL oF DIAbEtEs
Patients were divided into four groups based on smoking status: Never Smokers, Former Smokers, Light Smokers, and Heavy Smokers. This was a prospective study, and weekly visit data were entered for each patient including: weight, weight management class attendance, quantity of meal replacement consumed, and mean number of cigarettes smoked. Using S.A.S. 9.2, statistical analysis was performed on the data, namely one-way ANOVA analysis, followed by Tukey’s HSD post-hoc analysis for the continuous data. Chi-square analysis was employed for the nominal data. results: There were 1,472 Never Smokers, 1,350 Former Smokers, 118 Light Smokers, and 241 Heavy Smokers. Never Smokers were more likely to attend weight-management classes than Heavy Smokers. Former Smokers followed the meal supplement plan more closely than Heavy Smokers. Never Smokers were the least likely of all groups to change their smoking status. Former Smokers were more likely than Never Smokers to smoke during the program. Light Smokers were more likely than Heavy Smokers to make a smoking cessation attempt. Significantly more per cent weight loss over the first eight weeks of the program was observed for Never Smokers, compared to Former Smokers. conclusons: By recognizing the significant differences between weighttreatment-seeking groups based on their smoking status, obesity and combined obesity-smoking cessation interventions could be developed to be more responsive to these different subgroups. 242 Use of Nutritional Information in canada: National trends between 2004 and 2008 S. Goodman1, D. Hammond1, F. Pillo-Blocka2, T. Glanville3, and R. Jenkins4 1 Department of Health Studies, University of Waterloo, Waterloo, Ontario, Canada; 2The Canadian Council of Food and Nutrition, Mississauga, Ontario, Canada; 3Faculty of Applied Human Nutrition, Mount Saint Vincent University, Halifax, Nova Scotia, Canada; 4Jenkins Research Inc., Ottawa, Ontario, Canada Introduction: Obesity is a primary risk factor for a range of chronic diseases, including cancer, type 2 diabetes, cardiovascular disease, and osteoarthritis. Diet is estimated to account for approximately 30% of cancers in industrialized countries. Recent estimates indicate that nearly one-quarter of adult Canadians are obese and 36% are overweight, while more than one-third of Canadian children and youth are either obese or overweight. Nutritional labelling on packaged food products is an important policy tool used to educate consumers and promote the selection of healthy foods. The present study sought to examine longitudinal trends in use of nutrition information among Canadian consumers over a five-year period. Methods: Representative samples of Canadian adults were recruited using Random Digit Dialling sampling in 2004 (n=2,405) and 2006 (n=2,014), and an online commercial panel in 2008 (n=2,001). Data was collected using population-based phone and Internet surveys. Main outcome measures included: socio-demographic predictors of product label use, use of nutrition information sources, and nutrient content information. Linear and logistic regression models were used to examine predictors and changes over time. results: Food product labels were the most common source of nutritional information in 2008, followed by the Internet and magazines/newspapers. The Internet was the only source to significantly increase over the study period; however, the frequency of reading food product labels increased since 2004. Food selection based on trans fat increased significantly in 2006, following mandatory labelling of trans fat on packaged foods. Taste and nutrition were consistently the primary factors guiding food choice. conclusions: Food product labels and the Internet emerged as nutrition information sources with broad reach. Longitudinal analyses revealed that more comprehensive labelling regulations were associated with increased label use and greater use of nutrient information over time.
243 consideration of measurement variability and its implication for feedback effects between body weight and physical activity behaviour P.B. Deck, S. White, C.L. Matteson, L.C. Masse, S.A. Lear, and D.T. Finegood Simon Fraser University, Department of Biomedical Physiology and Kinesiology, Burnaby, British Columbia, Canada background: Current knowledge of the complex interdependencies between physiological and behavioural mechanisms underlying weight regulation is incomplete. Understanding the variability and dynamics of measures used in feedback loops, such as body weight and physical activity levels, has implications for determining which measures are optimal for supporting behaviour change, and choosing the optimal frequency for measurement. approach: Nineteen healthy subjects ages 23-59 wore an Actigraph GTX3 accelerometer every day for 12 weeks. Weekly measurements included body weight, body composition, resting energy expenditure, and hip and waist circumference. Accelerometer data was processed using ActiLife v4.4.1 Software to generate steps, activity counts, and time spent at physical activity intensities. Body composition was measured using a Discovery X-Ray Bone Densitometer. results: Body weight (2.1%), waist circumference (2.9%), and per cent body fat (5.2%) varied by a small amount during the 12-week study. Physical activity measures, including mean daily steps (41.0%), activity counts (44.6%), and time spent in at least moderate intensity activity (62.8%), were highly variable. Despite a fourfold difference between the least active and the most active subject, there was no significant relationship between the level of physical activity (counts) and the weekly coefficient of variation (r=.350; P=0.155). conclusions: Highly variable measures, such as those that reflect activity levels, may demand more frequent measurement to enable integration and improved accuracy to enable use as feedback. Less variable measures such as body weight may help create more effective feedback loops when the time delay between behaviour change and the change in outcome is considered. 244 If I am biased, what am I supposed to do now? M. Vallis Capital Health/Dalhousie University, Halifax, Nova Scotia, Canada Introduction: The professional bias against obesity has become widely acknowledged. The extent of bias has been demonstrated in virtually all health care provider disciplines, including those professionals who provide service to the obese. In contrast to the literature demonstrating the existence of bias, there is very little in the way of effective strategies to reduce bias. This poster will provide a review of the literature on methods to reduce bias. Practical strategies to actively counter bias against obesity will be offered. A toolkit that can be used as an educational intervention will be outlined. The goal of this poster is to empower providers to take action to ensure that implicit bias does not inadvertently impair obesity management. 245 Multimodal measurement of body composition change with diet- and exercise-induced weight loss in obese women A.R. Josse1, S.A. Atkinson2, M.A. Tarnopolsky2, H. Azizian3, J.K.G. Kramer4 and S.M. Phillips1 1 Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada; 2Pediatrics and Medicine, McMaster University Medical Centre, Hamilton, Ontario, Canada; 3NIR Technologies, Oakville, Ontario,
abstract
Canada; 4Agriculture and Agri-Food Canada (retired), Guelph, Ontario, Canada Introduction: Using changes in body mass index or body weight to classify the success of any anti-obesity intervention has inherent flaws. Measuring changes in body composition would be more clinically meaningful since a weight loss profile characterized by the loss of fat mass and maintenance/gain of muscle mass would be associated with greater reductions in disease risk. Methods: We assessed how daily exercise and different hypoenergetic diets varying in dairy (0-1, 2-4, 6-7 servings/d), total protein (% energy intake: 15, 15, 30), and dairy source calcium (~300, ~1000, ~1700 mg), affected changes in the tissue composition of weight loss in 90 premenopausal, obese women over 16 weeks. We compared three different modalities: DXA, MRI, and Fourier Transform Near-Infrared Spectroscopy (FT-NIR), to assess body composition changes before and after a diet- and exercise-based intervention. results: We observed comparable weight loss across all three study groups, however, subjects who consumed higher protein (30%) and high calcium showed the greatest reduction in total and visceral/ abdominal fat mass, and a gain in lean mass. FT-NIR and DXA measures of body fat (kg) were highly correlated (r=0.95, p<0.001), as were direct measures of visceral fat volume by MRI and total abdominal fat by DXA (r=0.76, p<0.001). conclusions: All three modalities provided comparable results in tracking changes in various components of body fat in young, obese women on a weight-loss program. DXA is a more practical and accessible modality than the gold-standard MRI for measuring visceral fat mass. FT-NIR, while still fairly new, is a cheaper and far more accessible method of assessing fat mass loss that is comparable to DXA. Thus, measuring body composition to monitor progress during weight loss interventions can be done using a variety of modalities, but FT-NIR is particularly suited to large-scale clinical trials. supported by: The Dairy Farmers of Canada, The U.S. National Dairy Council and the Dairy Research Institute, CIHR. 246 consumption of high prebiotic fiber or high-protein diet during pregnancy alters gut microbiota in the dams and their offspring M.C. Hallam1 and R.A. Reimer2 1 Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada; 2Faculty of Kinesiology and Faculty of Medicine, Department of Biochemistry and Molecular Biology, University of Calgary, Calgary, Alberta, Canada Introduction: The microbial community of the gastrointestinal tract plays a large role in nutrient harvest and metabolism for the host, and is primed by maternal microbiota at birth. Proportions of Firmicutes and Bacteroidetes have been linked to body weight and can be influenced by diet. Methods: Virgin Wistar dams were given a high prebiotic fiber (HF), high protein (HP), or control (C) diet from one week pre-conception until weaning. Male and female pups were weaned onto AIN-93G at 21d. Fecal samples were collected from dams 14d post partum, and from pups at 35 days. DNA was isolated from samples for qPCR using primers for Lactobacillus, Clostridium leptum, Clostridium coccoides, Bifidobacteria, Bacteroides/Prevotella, Total Eubacteria, and Enterobacteriaceae. results: At week two of pregnancy and at weaning, HF dams weighed less than HP dams (p<0.05). Dams on HF had higher Lactobacillus, Bifidobacteria, and Clostridium coccoides and lower Clostridium leptum 14 days post partum than controls (p<0.05). Offspring mass did not differ at 35 days. Diet affected Clostridium leptum and Clostridium coccoides, which were greater in C than HF, and HF and HP, respectively (p<0.01). HF females also had a greater percentage of Bacteroidetes than all other groups (p<0.001), and lower percentage of Firmicutes than female HF and HP (p<0.001).
conclusions: A maternal high prebiotic fiber diet had beneficial effects on gut microbiota profiles in dams and may have influenced weight gain. While body weight was not affected in offspring at 35 days, strains of bacteria associated with obesity were decreased and may have an effect later in life. 247 coping in an obesogenic environment: the perceptions of women who compulsively overeat A. Cooley and S. Kirk Dalhousie University, Halifax, Nova Scotia, Canada Introduction: Compulsive overeaters are a marginalized group within the realm of disordered eating, and are underserved by health professionals. Those with weight issues may struggle to find the resources they need to overcome their eating behaviours because they may be seen as “failed dieters,” since most traditional approaches to weight loss are not necessarily appropriate. Methods: This qualitative study explored the experiences of overweight and obese Nova Scotian women who compulsively overeat, to better understand environmental determinants influencing their behaviour. Based on social ecological theory, photo-elicitation and semi-structured interviews with six women were used to gather indepth and contextual information about weight-related motivations and obstacles to appropriate support. results: This study identified several environmental barriers these women face in maintaining a healthy weight, such as food retailers (e.g., displaying an abundance of unhealthy food for low prices), food service outlets (e.g., the availability and accessibility of unhealthy food— particularly fast food restaurants), food marketing (e.g., widespread distribution of coupons and abundance of fast food advertising), and their inability to access or take advantage of weight management or prevention services (due to lack of knowledge or unavailability of these resources). conclusion: Participants’ lack of coping skills when dealing with these environmental influences demonstrate a focus on the individual as the problem, i.e., blaming themselves for their weight rather than recognizing how the “obesogenic” environment plays a key role in influencing compulsive overeating behaviours. Increasing awareness of these influences, alongside the provision of supportive environments for healthy food choices may be needed. 248 rester à l’école pour dîner plutôt qu’aller manger dans les restaurants à service rapide : résultats d’une intervention chez les élèves du secondaire D. Beaulieu1,3, and G. Godin1,2,3 1 Faculté des sciences infirmières, Université Laval, Ville de Québec, Québec, Canada; 2Chaire de recherche du Canada sur les comportements et la santé, Université Laval, Ville de Québec, Québec, Canada; 3Unité de recherche en santé des populations, Centre hospitalier affilé de Québec, Hôpital du Saint-Sacrement, Ville de Québec, Québec, Canada Introduction: À ce jour, la majorité des écoles secondaires ont retiré la malbouffe de leur menu pour la remplacer par des aliments santé. Il serait donc avantageux pour leur santé que les élèves consomment un repas acheté à l’école ou apporté du domicile plutôt qu’un repas provenant d’un restaurant à service rapide à proximité de leur école puisque les aliments disponibles dans ces restaurants sont généralement riches en gras, en sucre, en sel et en calories. Le but de cette présentation est de décrire les résultats d’une intervention visant à encourager les élèves du secondaire à rester à l’école pour dîner plutôt que d’aller manger un repas dans les restaurants à service rapide à proximité de leur école. Méthode: Diverses activités ont été élaborées et offertes en 2008 dans une école secondaire de la ville de Québec. Ces activités ont pris la forme de
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