Transcript Presentation

Canadian Community Health Survey
– Cycle 2.2 (2004) –
Nutrition
Larry MacNabb
Health Statistics Division
Statistics Canada
APHEO - 2005
1
CCHS 2.2 - Goal

Provide reliable, timely information
about dietary intake, nutritional
wellbeing and their key determinants
to inform and guide programs,
policies and activities of federal and
provincial governments as well as
local health agencies.
2
CCHS 2.2 - Objectives




Estimate the distribution of usual dietary intake in terms of
foods, food groups, dietary supplements, nutrients and
eating patterns among a representative sample of Canadians
at national and provincial levels.
Measure the prevalence of household food insecurity among
various population groups in Canada.
Gather some anthropometric measurements for body weight
measurement.
Collect data on selected health conditions and socioeconomic and demographic characteristics of respondents.
3
Sample Design

Objectives

estimate the distribution of usual dietary intake in terms of
food, food groups, dietary supplements, nutrients and
eating patterns for the following 15 key domains of
interest (Dietary Reference Intakes age groupings X sex):
– <1
All
–
–
–
–
–
–
–
–
1-3
4-8
9-13
14-18
19-30
31-50
51-70
71 +
All
All
M/F
M/F
M/F
M/F
M/F
M/F
4
Target Population

Target population for the survey



individuals living in private occupied dwellings in the ten
provinces
Exclusions: those living on Indian Reserves and Crown
Lands, residents of institutions, full-time members of the
Canadian Armed Forces and residents of some remote
areas
The Nutrition survey component covers
approximately 98% of the Canadian population
living in the provinces
5
Sample Allocation




Total sample size: 30,000 responding units
Two-step approach
Step 1

1,120 units for each province (80 for each of the 14
DRI/sex groupings)

Note: the minimum 0f 80 units is not a requirement for the < 1
Step 2

The remaining 18,800 units are allocated to the provinces
using a power allocation scheme with a power q=0.70
6
Frames

Area Frame
 CCHS 2.1 Frame
 Buy-ins
Aboriginals – National – CCHS 2.1
 PEI (top-up) – PEI Health Registry
 Ontario (7 Regions) – CCHS 2.1
 Manitoba (Children in 4 regions) – MB Health
Registry
 Off-Reserve
7
Data Collection


Four quarterly samples from January 2004 - December 2004
60-minute CAPI interview including the 24-hour recall and
physical measures for half the sample


Anticipated response rate: 80%
• (85% for fresh sample and 75% for 2.1 sample of households)
To allow for the calculation of the intra-individual variability

A second 24-recall for a subsample of 10,000 units (CATI) 3 to 10
days after the first interview preferably a different day of the
week
 A minimum of 125 individuals for each of the 15 DRI/sex
groupings by Region (Atlantic, Quebec, Ontario, Prairies, BC)
8
Content

24 – Hour Dietary Recall
 USDA Automated
Multiple Multiple Pass
Methodology

General Health Questionnaire
9
24 Hour Dietary Recall

All foods eaten from midnight to midnight
for the previous day
 Details
 Amounts

Computer application developed by United
States Department of Agriculture
 In conjunction with Health Canada modified
to represent Canadian marketplace
 Translated into French
10
Automated Multiple Pass
Methodology

5 step method designed to improve a
respondents’ chances of recalling all foods
eaten during the previous 24 hour period:
Quick List
2. Forgotten Foods
3. Time and Occasion
4. Detail Cycle
5. Final Probe
1.
11
General Health
Questionnaire
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

*General Health (age 12+)
*Physical Activity (age 12+)
Sedentary Activity (age 12 –
17)
Measured Height and
Weight (age 2+)
Self Reported Height and
Weight (10% sample, age
18+)
Vitamin and Mineral
Supplements (all)
Household Food Security
(all)









Children’s Physical Activity
(age 6 to 11)
Fruit and Vegetable
Consumption (age 6 mo.+)
Women’s Health (women
age 9+)
*Chronic Conditions (all)
*Smoking (age 12+)
*Alcohol Consumption (age
12+)
*Socio-Demographics (all)
*Labour Force (age 15 – 75)
Income (all)
12
Age-Specific Interview
Protocols
12+ - Non-Proxy
 6 to 11 – Assisted-Proxy (parent and
respondent)
 5 and Under – Proxy (parent only)

13
Data Quality – Response
Rates
1st Interview
2nd Interview
Overall
Area
Frame
Other
Frames
Overall
Area
Frame
Other
Frames
Canada
76.5
75.9
77.2
72.8
72.3
72.8
NL
83.3
84.6
80.5
79.9
81.7
79.9
PE
79.2
80.4
78.3
84.3
82.8
84.3
NS
78.6
78.6
78.6
77.5
75.8
77.5
NB
75.7
75.0
77.2
81.4
81.4
81.4
PQ
75.8
74.8
77.1
80.3
79.2
80.3
ON
72.7
71.6
73.9
67.1
64.8
67.1
MB
82.7
82.1
83.5
70.0
70.5
70.0
SK
77.1
75.5
79.5
70.7
70.0
70.7
AB
77.4
76.6
78.6
72.8
73.2
72.8
BC
77.1
76.2
78.3
61.9
60.4
61.9
14
Data Quality – Number of
Respondents
First Interview
Second Interview
Canada
35107
10786
NL
1734
752
PE
1430
860
NS
1705
704
NB
1633
683
PQ
4780
1964
ON
10921
1647
MB
4194
921
SK
2041
894
AB
3021
767
BC
3648
1564
15
Total Respondents by Age, 1st Interview,
Canada and Provinces – CCHS 2.2
Total
<1
1-3
4-8
Canada
35107
289
NL
1734
16
85
132
PE
1430
9
63
NS
1705
15
NB
1633
QC
9-13
14-18 19-30 31-50
51-70
71+
4766
3984
5689
6142
4382
211
223
182
331
406
148
113
175
173
188
247
290
172
118
179
219
245
192
272
321
144
15
104
147
174
216
188
292
341
156
4780
34
325
505
579
685
517
846
913
376
ON
10921
84
705
988
1208
1325
1070
1557
1799
2185
MB
4194
46
349
443
560
623
478
669
632
394
SK
2041
12
135
218
231
300
238
316
343
248
AB
3021
26
183
295
366
430
474
542
481
224
BC
3648
32
235
339
471
546
457
617
616
335
2302 3359 4194
16
Total Respondents by Age, 1st Interview
Ontario – CCHS 2.2
Total
<1
1-3
4-8
9-13
14-18 19-30 31-50
51-70
71+
Ontario
10921
84
705
988
1208
1325
1070
1557
1799
2185
Southwest
1660
16
101
144
186
192
163
220
257
381
Central South
1351
17
98
103
155
159
110
166
238
305
Central West
1712
14
108
183
198
238
223
234
242
272
Central East
1591
6
99
150
209
197
114
249
266
301
Toronto
1383
6
105
148
139
165
158
221
196
245
East
1526
14
95
116
158
186
140
241
249
327
North
1698
11
99
144
163
188
162
226
351
354
17
Total Respondents by Age, 2nd Interview,
Canada and Provinces – CCHS 2.2
Total
<1
1-3
4-8
9-13
14-18 19-30 31-50
51-70
71+
10786
65
768
755
1546
1569
1463
1512
1617
1491
NL
782
6
43
58
133
102
89
140
110
101
PE
860
2
51
50
131
103
137
132
137
117
NS
704
4
60
48
93
117
96
123
84
79
NB
683
1
46
53
87
95
110
80
109
102
QC
1964
13
140
142
290
290
270
269
289
261
ON
1647
9
96
123
211
198
207
238
269
296
MB
921
9
79
47
110
167
110
141
154
104
SK
894
2
88
73
146
155
99
89
106
136
AB
767
7
47
49
84
108
123
120
112
117
BC
1564
12
118
112
261
234
222
180
247
178
Canada
18
Total Respondents by Age, 2nd Interview
Ontario – CCHS 2.2
Total
<1
1-3
4-8
9-13
14-18 19-30 31-50
51-70
71+
Ontario
1647
9
96
123
211
198
207
238
269
296
Southwest
247
1
16
14
30
27
26
33
44
56
Central South
190
1
12
16
27
20
20
18
35
41
Central West
263
1
18
31
36
29
48
35
34
31
Central East
236
2
13
10
35
41
19
38
25
53
Toronto
203
1
15
20
18
26
29
36
29
29
East
233
3
11
17
32
22
31
37
39
41
North
275
0
11
15
33
33
34
41
63
45
19
Data Quality – Measured
Height and Weight (%)
Total
NL
PE
NS
NB
PQ
ON
MB
SK
AB
BC
Measured – H/W
63
71
68
73
62
68
55
68
62
61
62
Refused
11
14
11
10
13
7
11
11
9
18
12
Respondent Not Available
6
4
4
4
5
5
6
7
4
6
6
Resp. too Tall
5
5
6
5
12
5
5
2
10
4
7
Equipment (NA, batteries)
5
0
0
1
1
8
11
0
4
0
0
Phone Interview
4
3
4
3
3
1
3
6
5
4
5
Interview Setting
2
1
2
2
1
1
3
2
2
3
4
Physical/Mental Condition
2
2
3
1
2
1
3
2
1
1
2
Data not stated
2
1
1
2
1
2
2
2
2
2
2
Other
0
0
0
0
0
0
1
0
0
0
0
20
Phase 1 Release – July 6, 2005

Internet Publication
 Nutrition:
Findings from the Canadian
Community Health Survey
• Adult Obesity
• Childhood Obesity

CANSIM tables
 Adult
Measured BMI
 Child Measured BMI
 Food Insecurity
 Children’s Physical Activity
 Teenage Sedentary Activity
21
Measured Obesity Rates by Age
Canada Health Survey - 1978/79, CCHS - 2004
35
*
30
1978/79
2004
percent
25
*
*
20
15
*
10
*
*
*
*
5
0
F
F
2-5
6-11 12-17 18-24 25-34 35-44 45-54 55-64 65-74
75+
22
Adult (aged 18+) Self-reported Chronic
Condition Prevalence by Weight Class
CCHS - 2004
Normal Weight
Overweight
Obese Class I
Obese Class II
Obese Class III
35
* *
30
*
percent
25
20
*
15
*
10
*
*
*
5
F
0
High Blood Pressure
Diabetes
* *
F
Heart Disease
23
Percent
Adult Percentage Distribution of BMI (age 18+)
1978/79 and 2004
10
9
8
7
6
5
4
3
2
1
0
1978/79
2004
14 16 18 20 22 24 26 28 30 32 34 36 38 40 42 44
BMI (kg/m2)
25
Adult Obesity Rates (Age 18+) by Fruit and Vegetable
Consumption and Leisure Time Physical Activity
CCHS - 2004
35
percent
30
25
Fruits and Vegetables
Physical Activity
*
*
*
20
15
10
5
0
Less than 3 to less 5+ times a
3 times per than 5
day
day
times per
day
High
Moderate Sedentary
26
Teenage Percentage Distribution of BMI (age 12-17)
1978/79 and 2004
14
1978/79
2004
12
8
6
4
2
39
37
35
33
31
29
27
25
23
21
19
17
15
13
11
0
9
Percent
10
BMI (kg/m2)
28
Childhood Overweight and Obesity Rates (Age 2 to
17) by Fruit and Vegetable Consumption
CCHS - 2004
35
30
*
*
percent
25
20
15
10
5
0
Less than 3 times per day
3 to less than 5 times per
day
5+ times a day
30
Childhood Overweight and Obesity Rates (Age 6 to 17) by Daily
(Age 6 to 11) and Weekly (Age 12 to 17) Hours of Screen Time
CCHS - 2004
40
35
Daily Screen Time
*
Weekly Screen Time
*
*
percent
30
25
20
15
10
5
0
<= 1
1 to 2
2+
< 10
10 to
19.9
20 to
29.9
30+
31
Ontario Measured Obesity Rates by Age and Region, 2004
CCHS 2.2
50%
45+
45%
18 to 44
40%
35%
Overall
30%
2 to 17
25%
20%
15%
10%
5%
0%
ON SW C S C W C E T O
E
N
ON SW C S C W C E T O
E
N
ON SW C S C W C E T O
E
N
ON SW C S C W C E T O
E
N
32
Phase 2 Release

Currently assigning food codes to ~ 750,000
records




In colloboration with Health Canada coding to Canadian
Nutrient File
Nutritional profiles for each food will then be calculated
using a processing system designed by Health Canada for
provincial nutrition surveys
Plan on releasing early 2006
Release approach will be similar to phase 1


Articles
CANSIM Tables
33
Microdata Outputs

4 files
 General
Health and Nutritional Summary data
 Vitamin and Mineral supplement details
• 1 record per supplement reported
 Food
details file
• 1 record per food reported
 Day
1 and 2 Intake summary file
• 1 record per intake day
• 1 record for 2/3 of respondents, 2 records for 1/3 of
respondents
34
General Health and Nutrition Summary File
Sample ID
1111
1112
1113
GEN
x
x
x
VMD
Day 1 Food Detail
Summary (A) summary (B)
2
1
3
40
0
15
Day 1 plus usual daily vitamin
and mineral details (A + B)
x
x
x
Vitamin and Mineral Details
Sample ID
1111
1111
1112
1112
1112
#
1
2
1
2
3
VMD
x
x
x
x
x
Food Details
Sample ID
1111
1112
1112
1112
1112
1112
1112
1113
1113
1113
#
1
1
…
40
1
…
25
1
…
15
Intake Day Summary
Day
1
1
1
1
2
2
2
1
1
1
Details
x
x
x
x
x
x
x
x
x
x
Roll Up
Sample ID
1111
1112
1112
1113
Day
1
1
2
1
Details
1
40
25
15
Nutrition Variables

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












Protein
Fat (total lipids)
Carbohydrate, total
Energy (kilocalories)
Alcohol
Mositure
Caffeine
Energy (kilojoules)
Sugars (total)
Fibre, total dietary
Calcium
Iron
Magnesium
Phosphorous
Potassium
Sodium
Zinc
Vitamin D (IU)
Vitmin D (MCG)

















Vitamin C
Thiamin
Riboflavin
Total Niacin Equivalent
Vitamin B6
Total Folacin
Vitamin B12
Folic Acid
Cholesterol
Fatty Acids, Saturated, Total
Fatty Acids, Polyunsaturated, 18:2,
Linoleic
Fatty Acids, Polyunsaturated, 18:3,
Linolenic
Fatty Acids, Monounsaturated, Total
Fatty Acids, Polyunsaturated, Total
Naturally Occuring Folate
Retinol Activity Equivalents
Dietary Folate Equivalent
36
Intake Adjustment – Total Calories Consumed, Males
Age 31 to 50
United States , CSFII (1994-86, 1998)
0.0008
0.0008
σTotal = σInter Individual + σIntra Individual
0.0007
0.0007
0.0006
0.0006
0.0005
0.0005
0.0004
0.0004
0.0003
0.0003
0.0002
0.0002
0.0001
0.0001
00
0
0
1000
1000
2000
2000
3000
3000
4000
4000
5000
5000
6000
6000
7000
7000
37
Proportion of Males Age 31 to 50 Consuming 3500+
Calories
United States , CSFII (1994-86, 1998)
Unadjusted – 15.1%
 Adjusted – 4.6%

38
Training/Support/Other





Proper use of files
Use of intake distribution software
Health Canada – interpretation guide
Working with CIHR on an RFA process to
fund researchers to analyse the data
Working with STC Agriculture Division to
compare data with consumption data
39
Questions
?
40
Contact Information
Larry MacNabb
Project Manager
Canadian Community Health Survey
Phone: (613) 951-4269
Email: [email protected]
41