Canadian Community Health Survey – Cycle 2.2 (2004) – Nutrition

1. Canadian Community Health Survey – Cycle 2.2 (2004) – Nutrition Larry MacNabb Health Statistics Division Statistics Canada APHEO - 2005

2. CCHS 2.2 - Goal • Provide reliable, timely information about dietary intake, nutritional wellbeing and their key determinants to inform and guideprograms, policies and activities of federal and provincial governments as well as local health agencies.

3. 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 socio-economic and demographic characteristics of respondents.

4. 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 All • 4-8 All • 9-13 M/F • 14-18 M/F • 19-30 M/F • 31-50 M/F • 51-70 M/F • 71 + M/F

5. 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

6. 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 powerallocation scheme with a power q=0.70

7. Frames • Area Frame • CCHS 2.1 Frame • Buy-ins • Off-Reserve 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

8. 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)

9. Content • 24 – Hour Dietary Recall • USDA Automated Multiple Multiple Pass Methodology • General Health Questionnaire

10. 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

11. 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 • Forgotten Foods • Time and Occasion • Detail Cycle • Final Probe

12. *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) General Health Questionnaire

13. Age-Specific Interview Protocols • 12+ - Non-Proxy • 6 to 11 – Assisted-Proxy (parent and respondent) • 5 and Under – Proxy (parent only)

14. Data Quality – Response Rates

15. Data Quality – Number of Respondents

16. Total Respondents by Age, 1st Interview, Canada and Provinces – CCHS 2.2

17. Total Respondents by Age, 1st Interview Ontario – CCHS 2.2

18. Total Respondents by Age, 2nd Interview, Canada and Provinces – CCHS 2.2

19. Total Respondents by Age, 2nd Interview Ontario – CCHS 2.2

20. Data Quality – Measured Height and Weight (%)

21. 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

22. Measured Obesity Rates by AgeCanada Health Survey - 1978/79, CCHS - 2004 * * * * * * * * F F

23. Adult (aged 18+) Self-reported Chronic Condition Prevalence by Weight ClassCCHS - 2004 * * * * * * * * * * F F

24. Adult Percentage Distribution of BMI (age 18+)1978/79 and 2004

25. Adult Obesity Rates (Age 18+) by Fruit and Vegetable Consumption and Leisure Time Physical ActivityCCHS - 2004 Fruits and Vegetables Physical Activity * * *

26. Teenage Percentage Distribution of BMI (age 12-17)1978/79 and 2004

27. Childhood Overweight and Obesity Rates (Age 2 to 17) by Fruit and Vegetable ConsumptionCCHS - 2004 * *

28. Childhood Overweight and Obesity Rates (Age 6 to 17) by Daily (Age 6 to 11) and Weekly (Age 12 to 17) Hours of Screen TimeCCHS - 2004 Daily Screen Time Weekly Screen Time * * *

29. Ontario Measured Obesity Rates by Age and Region, 2004CCHS 2.2 45+ 18 to 44 Overall 2 to 17

30. 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

31. 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

32. Roll Up

33. 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 Nutrition Variables

34. Intake Adjustment – Total Calories Consumed, Males Age 31 to 50United States , CSFII (1994-86, 1998) σTotal = σInter Individual + σIntra Individual

35. Proportion of Males Age 31 to 50 Consuming 3500+ CaloriesUnited States , CSFII (1994-86, 1998) • Unadjusted – 15.1% • Adjusted – 4.6%

36. 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

37. Questions ?

38. Contact Information Larry MacNabb Project Manager Canadian Community Health Survey Phone: (613) 951-4269 Email: larry.macnabb@statcan.ca