Louise W. McEachern

Inadequate dietary intake among postsecondary students can negatively impact academic achievement, mental health and the development of chronic disease later in life. Mobile health (mHealth) interventions offer a unique opportunity to improve dietary behaviours in this population, who report frequent use of mobile devices. This systematic review evaluated the impact of mHealth diet interventions on postsecondary students' dietary behaviours. A literature search was conducted in January 2025 using six electronic databases (Web of Science, Scopus, CINAHL, EMBASE, Medline and PsycINFO). Eligible intervention studies included randomized controlled trials (RCTs) and pre‐post studies, with or without a control group. The interventions had to include at least one dietary behaviour outcome variable and involve only enroled postsecondary students. Sample and intervention characteristics, intervention results, as well as equity and behaviour change theory use and reporting, were extracted. Findings were reported as a narrative synthesis. Eleven studies met the inclusion criteria and were included in this review. Of the studies reviewed, 10 reported a positive and significant impact on at least one dietary behaviour in the postsecondary student population. Notably, 5 of the 6 studies assessing fruit and/or vegetable intake found significant improvements following the mHealth interventions. However, the clinical significance of these should be noted: some reported dietary changes were relatively small. Overall, mHealth interventions show promise in improving postsecondary students' dietary behaviours. However, further research is necessary, and future interventions should ensure the use of validated dietary assessment tools and longer follow‐up periods to evaluate long‐term effectiveness.

Background/Objectives: Accurate dietary assessment is crucial for nutritional epidemiology, but tools like 24 h recalls (24HRs) face challenges with missing or implausible data. The Automated Self-Administered 24 h Dietary Assessment Tool (ASA24) facilitates large-scale data collection, but its lack of interviewer input may lead to implausible dietary recalls (IDRs), affecting data integrity. Multiple imputation (MI) is commonly used to handle missing data, but its effectiveness in high-variability dietary data is uncertain. This study aims to assess MI’s accuracy in estimating nutrient intake under varying levels of missing data. Methods: Data from 24HRs completed by 743 adolescents (ages 13–18) in Ontario, Canada, were used. Implausible recalls were excluded based on nutrient thresholds, creating a cleaned reference dataset. Missing data were simulated at 10%, 20%, and 40% deletion rates. MI via chained equations was applied, incorporating demographic and psychosocial variables as predictors. Imputed values were compared to actual values using Spearman’s correlation and accuracy within ±10% of true values. Results: Spearman’s rho values between the imputed and actual nutrient intakes were weak (mean ρ ≈ 0.24). Accuracy within ±10% was low for most nutrients (typically < 25%), with no clear trend by missingness level. Diet quality scores showed slightly higher accuracy, but values were still under 30%. Conclusions: MI performed poorly in estimating individual nutrient intake in this adolescent sample. While MI may preserve sample characteristics, it is unreliable for accurate nutrient estimates and should be used cautiously. Future studies should focus on improving data quality and exploring better imputation methods.

Food retail businesses experienced a pronounced increase in sales when food hospitality outlets closed in the early stages of the COVID-19 pandemic in Canada. This study investigates how pandemic-related modifications to food retail businesses in Ontario, Canada affected the well-being of workers. Semi-structured interviews were conducted with 17 food retail employees between June 2020 and May 2021 as part of the Food Retail Environment Study for Health and Economic Resiliency (FRESHER). Transcripts were analyzed inductively, and themes were refined using the Effort Reward Imbalance Model. Themes were connected to the main components of this model: extrinsic effort, intrinsic effort, money, esteem, status control, and burnout. Results indicate that, for food retail employees, the presence of an imbalance between efforts and rewards threatens well-being via symptoms of burnout. Further study is needed to examine how this inequality and burnout among this population might be measured and addressed.

Context: Adolescence is a critical stage for improving nutrition. The popularity of smartphones makes them an ideal platform for administering interventions to adolescents. A systematic review has yet to assess the impact of smartphone app–based interventions exclusively on adolescents’ dietary intake. Furthermore, despite the impact of equity factors on dietary intake and the claim for mobile health of increased accessibility, there is minimal research on the reporting of equity factors in the evaluation of smartphone app–based nutrition-intervention research. Objectives: This systematic review examines the effectiveness of smartphone app–based interventions on adolescents’ dietary intake and the frequency with which equity factors and statistical analyses specific to equity factors are reported in these intervention studies. Data Sources: Databases (ie, Scopus, CINAHL, EMBASE, MEDLINE, PsycINFO, ERIC, and Cochrane Central Register for Randomized Control Trials) were searched for studies published from January 2008 to October 2022. Smartphone app–based intervention studies that were nutrition focused, evaluated at least 1 dietary intake variable, and included participants with a mean age between 10 and 19 years were included. All geographic locations were included. Data Extraction and Analysis: Study characteristics, intervention results, and reported equity factors were extracted. Because of the heterogeneity of dietary outcomes, findings were reported as a narrative synthesis. Conclusion: In total, 3087 studies were retrieved, 14 of which met the inclusion criteria. Eleven studies reported a statistically significant improvement in at least 1 dietary outcome because of the intervention. Reporting of at least 1 equity factor across articles’ Introduction, Methods, Results, and Discussion sections was minimal (n = 5), and statistical analyses specific to equity factors were rare, occurring in only 4 of the 14 included studies. Future interventions should include a measurement of intervention adherence and report the impact of equity factors on the effectiveness and applicability of interventions for equity-deserving groups.

Youth health, long-term food sovereignty and the reclamation of traditional food-related knowledge are areas of concern within Indigenous communities in Canada. Learning Circles: Local Healthy Food to School (LC:LHF2S) built on an exemplar program in four predominantly Indigenous communities. In each, the initiative worked with interested community members to plan, implement and evaluate a range of activities aimed at enhancing access to local, healthy and traditional foods for schools and youth. This case study describes the context, process, outcomes and perceptions of implementation in one of the communities, Hazelton/Upper Skeena, located in northern British Columbia. Data were collected between 2016–2019 and included semi-directed interviews with community members and LCEF (n = 18), process reporting (e.g., LCEF reports, emails, conference calls and tracking data), photographs and video footage, and photovoice. Data were analyzed thematically. Hazelton/Upper Skeena has an active local and traditional food culture. Indigenous governance was supportive, and community members focused on partnership and leadership development, gardens, and food skills work. Findings point to strengths; traditional food, knowledge and practices are valued by youth and were prioritized. LC:LHF2S is a flexible initiative that aims to engage the broader community, and exemplifies some of the best practices recommended for community-based initiatives within Indigenous communities. Results indicate that a LC is a feasible venture in this community; one that can facilitate partnership-building and contribute to increased access to local and traditional food among school-aged youth. Recommendations based on community input may help the uptake of the model in similar communities across Canada, and globally.

Integrated knowledge translation (IKT) and community-based participatory research (CBPR) are recognized as effective approaches when Indigenous and non-Indigenous partners work together to focus on a common goal. The “Learning Circles: Local Healthy Food to School” (LC:LHF2S) study supported the development and implementation of Learning Circles (LC) in 4 Canadian Indigenous communities with the goal of improving local, community-based healthy food systems. Critical to the research process were annual gatherings (AG) where diverse stakeholders (researchers, Indigenous community members, and partners) visited each community to share knowledge, experiences, and provide support in the research process. Using a qualitative, descriptive method, this paper explores how the AG supported IKT across partners. Yearly interviews involving 19 total participants (with some participating multiple times across the 4 gatherings) elicited their AG experiences in supporting local LC:LHF2S. Three themes with multiple sub-themes were identified: (a) setting the stage for IKT (importance of in-person gatherings for building relationships across partners, learning from each other), (b) enabling meaningful engagement (aligning research with Indigenous values, addressing tensions and building trust over time, ensuring flexibility, and Indigenous involvement and leadership), and (c) supporting food system action at the local level (building local community engagement and understanding, and integrating support for implementation and scale-up of LC). This paper provides useful and practical examples of the principles of Indigenous-engaged IKT and CBPR in action in healthy, local, and traditional food initiatives. AG are a valuable IKT strategy to contribute to positive, transformative change and ethical research practice within Indigenous communities.

Interventions to improve dietary quality and intake of fruits and vegetables (FV) among Canadian children have had modest success, and it has been suggested that food knowledge could be key to improvement. Programs have been criticized for insufficiently connecting food knowledge with food skills and decision making about dietary intake. The objective of this study was to investigate factors associated with FV consumption by elementary school children, aged 9–14 years, in Ontario, Canada, including food knowledge, socioeconomic status, sociodemographic characteristics, and the food environment. In 2017–2019, a cross-sectional survey was administered to 2443 students at 60 elementary schools across Southwestern Ontario (SWO), Canada. A parent survey was used to validate self-reported sociodemographic variables. The mean intake of FV reported by these participants was 2.6 (SD 1.1) and 2.4 (SD 1.2) servings/day, respectively. A FV intake below WHO guidelines was reported by 40.7% of respondents. Knowledge score, child age, and parent employment status significantly predicted higher reported intake of FV. This study shows that FV intake among this population group is low, and increased intake is associated with higher food knowledge. To encourage healthy eating, school-based food and nutrition programs that incorporate multiple components and emphasize food literacy are needed.

Indigenous communities in Canada are concerned about the health of their youth and the reclamation of traditional food-related skills amongst their people. Food sovereignty has an integral role in food and nutrition security, and the path to Indigenous self-determination. Learning Circles: Local Healthy Food to School (LC:LHF2S) was a community engagement model that aimed to enhance access to local, healthy, and traditional foods for youth. In each of four First Nations communities, a Learning Circle Evaluation Facilitator worked to plan and implement activities, build on community strengths, and promote partnerships. This paper describes how the model was perceived to support food sovereignty. Data included interviews, process reporting, and school surveys, and was analyzed according to pillars effective for the development of food sovereignty in Indigenous communities. Goals set by two communities incorporated food sovereignty principles, and in each community capacity-building work furthered the development of a more autonomous food system. There were many examples of a transition to greater food sovereignty, local food production, and consumption. Indigenous governance was an important theme and was influential in a community’s success. The model appears to be an adaptable strategy to support the development of food sovereignty in First Nations communities. Novelty: LC:LHF2S was a community engagement model that aimed to enhance access to local, healthy, and traditional foods for youth. The model is an adaptable strategy to support the development of food sovereignty in First Nations communities. There were many examples of a transition to greater food sovereignty, local food production, and consumption.