Vicky Drapeau

Introduction: Obesity is a complex and multifactorial condition. For children living with overweight and obesity (OW/OB), family- and home-based intervention is a recommended approach to support weight management. We evaluated changes in eating behaviors and diet quality after a 1-year home-based intervention targeting families with at least 1 child living with OW/OB. Methods: Eating behaviors (cognitive restriction [CR], emotional eating [EE], uncontrolled eating [UE]) were assessed using the DEBQ (caregivers) and the CTFEQ-r17 (children). Diet quality was measured using a brief questionnaire based on France's nutritional guidelines. Linear mixed models assessed intervention effects. Results: Among 142 families (n = 194 children [53% girls] with OW/OB, n = 223 caregivers [60% female]), overall diet quality improved ( P < .04), except male caregivers with OW/OB. Children showed reduction in UE ( P < .001) and caregivers in EE and UE ( P < .02). Reduced zBMI among children with OW/OB was associated with decreased CR, whereas an increased in zBMI was associated with increased CR ( r = 0.65; P = .04). Conclusion: This 1-year intervention improved overall diet quality and UE across and reduced zBMI in children with OW/OB. However, children responded differently: some reduced zBMI and CR, whereas others experienced an increase in CR and zBMI.

Mediation analysis identifies variables that explain the causal pathways linking an exposure (here genetic susceptibility to obesity) to an outcome (here obesity‐related traits), offering potential targets for weight management interventions. This review followed the PRISMA guidelines and systematically searched the literature up to August 2024 in four databases (Web of Science, Embase, Medline, CINAHL) to identify studies using mediation analysis with genetic or polygenic risk scores of obesity as exposure and body mass index (BMI) as outcome. Twenty‐nine studies focusing on eating behaviors, diet quality, physical activity, and other lifestyle factors were included. Eating behaviors traits emerged as the most influential mediators of genetic susceptibility to obesity. Mediation explained 23%–56% of the genetic effect on BMI for disinhibition, 6%–23% for uncontrolled eating, 4%–19% for susceptibility to hunger, 4%–15% for emotional eating and 8%–10% for satiety responsiveness. For diet quality, fat intake mediated 4%–5% of the effect, while whole grain intake explained 1%–2%. Physical activity accounted for 0.3%–23% of mediation, whereas sedentary time explained 5%–43%. These findings highlight that behavioral and lifestyle factors substantially mediate genetic risk for obesity. Interventions targeting disinhibition, uncontrolled eating, susceptibility to hunger, fat intake, whole grain consumption, physical activity and sedentary behavior could improve obesity prevention and management, particularly for individuals with higher genetic susceptibility.

Background: Nutrition care is a first-line strategy for preventing and managing many health conditions. Understanding healthcare professionals’ (HCPs) educational experiences and learning preferences is essential to strengthening nutrition care and supporting timely referrals to dietitians. This study aimed to assess previous nutrition education, nutrition guidance practices, self-perceived nutrition competence, and perceived learning needs among Canadian HCPs and trainees. Methods: A cross-sectional online survey was conducted between July and October 2025 among Canadian HCPs and trainees, excluding dietitians and dietetic students. The survey included a sociodemographic questionnaire, a nutrition education needs assessment, and the Nutrition Competence Questionnaire (NUTCOMP). Descriptive statistics summarized participant characteristics. Independent t-tests compared NUTCOMP scores between groups of professionals. Open-ended responses were analyzed inductively to identify themes related to nutrition education needs and preferred learning formats. Results: A total of 168 HCPs completed the survey. Participants were predominantly women (79%), with most practicing in British Columbia. Over half (51%) of participants reported receiving ≤15 hours of nutrition education during pre-licensure training, and 25% had engaged in nutrition education within the previous two years. Two-thirds (67%) reported a need for further nutrition education. Attitudes toward nutrition care were higher than perceived knowledge and skills, and allied HCPs reported lower nutrition competence than physicians, nurses, and dentists (p<0.05). Participants emphasized the importance of referrals to dietitians and preferred online, self-guided modules that incorporated case studies, downloadable resources, and certificates of completion. Conclusion: Canadian HCPs report limited nutrition education and a demand for accessible, continued, and practice-focused nutrition education and training.

It is difficult to imagine that an individual living with obesity may gain body weight in response to a diet and physical activity program aiming at a negative energy balance. However, this type of case is a matter of usual occurrence in obesity clinics and has been traditionally explained by a lack of adherence to guidelines. While a link between adherence to a weight loss intervention and its outcome has been demonstrated, there is growing evidence showing that unsuccessful response to weight-reducing programs may happen in some individuals despite adequate adherence, be it imposed experimentally or spontaneously expressed in a free-living context. As described in this paper, the response to a weight loss program may range from a weight gain to a greater than expected weight loss. Based on our research findings and available literature, an unsuccessful body-weight response is seen in 5% to 20% of individuals and is attributable to behavioral and metabolic changes affecting appetite control and thermogenesis. Experimental evidence also shows that the response to a negative-energy balance is genetically determined. Globally, these observations emphasize the importance of future research in precision medicine to develop treatment approaches that progressively become more individualized.

Background: Chronic diseases are the leading global cause of death, largely driven by Western lifestyles characterized by poor diets and physical inactivity. Digital interventions offer promising tools to support health behavior change. Interactive conversational agents (CAs) provide real-time, personalized meal planning and dietary advice. Their interactive nature and adaptability make them valuable for promoting healthy dietary behaviors in the context of diet-related chronic diseases. However, evidence of their effectiveness remains limited. Systematic evaluations of their impact, features, and user acceptability are needed to clarify their role in public health strategies for improving dietary behaviors and preventing chronic diseases. Objective: This review aimed to evaluate the effectiveness of CAs in improving dietary behaviors, to describe their features, functions, conversational capabilities, and impact on nutritional knowledge, usability, acceptability, user experience, and engagement. Methods: Five electronic databases were searched: MEDLINE, CINAHL, Embase, Web of Science, and PsycINFO. We only included sources that focused on the use of CAs to change dietary behavior. Eligible studies were published since 2013 in English, French, or Spanish. Two independent reviewers screened studies, with a third resolving disagreements. The quality of studies was appraised using the Mixed Methods Appraisal Tool (McGill University). Quantitative and qualitative findings were synthesized narratively. Results: In total, 2200 references were identified, and after screening and eligibility assessment, 11 references (10 studies with approximately 20‐480 participants) were included. Among the included studies, improvements in fruit and vegetable intake were reported in 2 studies ( P =.04 and P =.005). One study found significant increases in adherence to the Mediterranean diet at 6 weeks with gains maintained at 12 weeks. Two additional studies reported enhanced nutritional knowledge (eg, nutrition label use). Effects on protein, whole grains, sugar, sodium, and caffeine intake were mixed or nonsignificant. Some studies reported increased physical activity (+109.8 min/wk) and reduced alcohol use for stress management. One randomized controlled trial showed modest but significant weight loss and decrease in waist circumference (−2.1 cm, 95% CI −3.5 to 0.7; P =.003). Engagement varied between studies. Usability and user experience were generally positive; goal setting, feedback, and tailored recommendations were linked to higher satisfaction. Reported challenges included unnatural conversation style, simplistic content, and limited perceived usefulness. Conclusions: CAs show promising potential to improve dietary behaviors, with evidence of gains in fruit and vegetable intake, Mediterranean diet adherence, nutritional knowledge, physical activity, and modest weight loss. Overall usability was favorable, but variability in outcomes, high attrition, and limited impact on social support highlight areas for refinement. Future research should use larger samples, longer follow-up, standardized outcomes, and strategies to enhance sustained engagement and inclusivity. Systematic evaluations and refined designs are essential to establish the role of CAs as scalable, evidence-based tools in chronic disease prevention.

Background: Calcium is essential for maintaining bone health, facilitating muscle contractions, regulating body temperature, and supporting aerobic metabolism. While the relationship between physical activity and calcium metabolism is well established, the impact of calcium intake on cardiorespiratory fitness (CRF) remains underexplored. The main aim of this study was to assess the effects of calcium intake on CRF and the mediation effect of calcium intake on the relationship between vigorous physical activity participation and CRF. Methods: Analyses were performed on a sample of 576 adult participants (257 males and 319 females) from the Quebec Family Study (QFS) for whom data were available for calcium intake, CRF, and body composition. The effects of calcium intake on CRF and body composition were analyzed by comparing subjects classified into sex-specific tertiles of calcium intake using general linear mixed models. Pearson correlations were also used to document the associations between calcium intake, CRF, and body composition. A mediation analysis was used to determine the effect of calcium intake as a mediator of the association between vigorous physical activity and CRF. Results: The comparison of calcium-based tertiles revealed that low calcium consumers had lower CRF, especially in males. In both males and females, correlation analysis showed that calcium intake was positively associated (p < 0.05) with CRF. Mediation analyses revealed that calcium intake explains an insignificant fraction of the physical activity–CRF relationship. Between-tertile comparisons showed reduced body fat and increased fat-free mass levels when increasing calcium intake, although some of these effects were not statistically significant. Conclusions: The results of this study suggest that low calcium intake is associated with reduced aerobic capacity in adult males and females. While the positive relationship observed between calcium and aerobic fitness aligns with calcium’s known physiological roles, further research is needed to clarify the exact mechanisms by which this micronutrient may influence aerobic capacity.

Background: Insufficient adherence to dietary guidelines underscores the need for effective interventions promoting healthy eating, including dairy consumption, among Canadian families. Research suggests that web-based interventions grounded in user research and behavior change theories can effectively support dietary improvements. However, few theory-driven digital interventions specifically target dairy consumption in families. Objective: This study aims to describe the development of a web-based nutrition intervention, Dairyathlon, designed to promote dairy consumption among families using the IDEAS (Ideate, Design, Assess, and Share) framework. In addition, it evaluates user experience (UX) with the web-based platform. Methods: Following the IDEAS framework, family perspectives and beliefs regarding dairy consumption were explored through ethnographic research and interviews. Behavior change techniques, based on the theory of planned behavior, were integrated to enhance attitudes and perceived behavioral control toward dairy intake. These techniques underwent iterative design, prototype testing, and refinement. UX was assessed with the AttrakDiff questionnaire, comparing families using Dairyathlon to those using the Canadian Food Guide (CFG). Children and parents completed the questionnaire after the presentation of the platform (PRE) and following 8 weeks of use (POST). AttrakDiff evaluates pragmatic quality (PQ), hedonic stimulation (HSQ), hedonic identity (HIQ), and attractiveness dimension (ATT) on a scale from –3 to +3, with >1 considered optimal, 0–1 acceptable, and < 0 suboptimal. Results: Between April 2019 and August 2020, Dairyathlon was developed to enhance families’ attitudes and perceived control over dairy consumption, adhering to the IDEAS framework. Users' experience assessments were conducted among 29 families and showed significantly higher scores for Dairyathlon compared to the reference platform (CFG) at both pre- and postassessments (P<.001). Although both platforms were initially rated as optimal, UX ratings decreased after use: PRE (1.7, SD 0.6) to POST (1.4, SD 0.8) in the Dairyathlon group (mean difference of 0.4, 95% CI 0.2-0.7; P=.002), and (1.4, SD 0.6) to (0.9, SD 0.6) in the CFG group (mean difference = 0.6, 95% CI 0.5-0.6; P<.001). After using Dairyathlon, children (n=45) rated all UX dimensions as optimal, with scores of PQ (1.4, SD 1.0), HSQ (1.6, SD 1.0), HIQ (1.4, SD 1.1), and ATT (1.7, SD 0.9). Parents (n=50) also rated most dimensions as optimal, with scores of 1.2 (SD 1.0) for PQ, 1.4 (SD 0.8) for HIQ, and 1.6 (SD 0.8) for ATT. However, the HSQ dimension received a slightly lower rating of 0.9 (SD 0.8), indicating a need for improvement in adult stimulation. Conclusions: This study highlights the effectiveness of the IDEAS framework in developing a web-based intervention to promote dairy consumption. The Dairyathlon platform’s UX was rated as optimal, especially for visual attractiveness, though the stimulation dimension requires improvement for adults. Future research will evaluate its impact on dairy consumption, diet quality, and family health status.