Personne : Lapointe, Annie.
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École de nutrition, Faculté des sciences de l'agriculture et de l'alimentation, Université Laval
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- PublicationAccès libreDevelopment of a web-based 24-h dietary recall for a french-canadian population(MDPI Pub., 2016-11-15) Jacques, Simon; Tessier-Grenier, Maude; Lapointe, Annie.; Corneau, Louise; Lamarche, Benoît; Laramée, Catherine; Lemieux, Simone; Robitaille, JulieTwenty-four-hour dietary recalls can provide high-quality dietary intake data, but are considered expensive, as they rely on trained professionals for both their administration and coding. The objective of this study was to develop an automated, self-administered web-based 24-h recall (R24W) for a French-Canadian population. The development of R24W was inspired by the United States Department of Agriculture (USDA) Automated Multiple-Pass Method. Questions about the context of meals/snacks were included. Toppings, sauces and spices frequently added to each food/dish were suggested systematically. A list of frequently forgotten food was also suggested. An interactive summary allows the respondent to track the progress of the questionnaire and to modify or remove food as needed. The R24W prototype was pre-tested for usability and functionality in a convenience sample of 29 subjects between the ages of 23 and 65 years, who had to complete one recall, as well as a satisfaction questionnaire. R24W includes a list of 2865 food items, distributed into 16 categories and 98 subcategories. A total of 687 recipes were created for mixed dishes, including 336 ethnic recipes. Pictures of food items illustrate up to eight servings per food item. The pre-test demonstrated that R24W is easy to complete and to understand. This new dietary assessment tool is a simple and inexpensive tool that will facilitate diet assessment of individuals in large-scale studies, but validation studies are needed prior to the utilization of the R24W.
- PublicationAccès libreMénopause, obésité et profil de risque métabolique : effets d'une intervention nutritionnelle visant l'augmentation de la consommation de fruits et de légumes(2009) Lapointe, Annie.; Lemieux, Simone; Weisnagel, JohnLa transition vers la ménopause est associée à une modification de la composition corporelle chez la femme menant à une détérioration du profil métabolique et à une augmentation du risque de développer le diabète de type 2, d'où l'importance chez la femme de limiter le gain de poids pendant cette période de la vie. Plusieurs lignes directrices en matières de prévention et de traitement de l'obésité et du diabète de type 2 recommandent la réduction de la consommation de lipides comme principale cible alimentaire. Toutefois, le poids perdu à l'aide des approches de perte de poids axées sur la diminution de la consommation des aliments riches en lipides s'avère difficile à maintenir. De plus, les approches de perte de poids restrictives ont été associées à une augmentation des épisodes d'hyperphagie boulimique et à des symptômes dépressifs, d'où la pertinence de développer de nouvelles interventions de perte de poids non axées sur la restriction et efficaces pour le maintien du poids à long terme. Dans un premier temps, nos travaux ont permis d'approfondir les associations entre le tissu adipeux viscéral et le profil métabolique chez la femme ménopausée et ont démontré que la combinaison d'un tissu adipeux viscéral élevé et d'une faible sensibilité à l'insuline avaient des effets délétères sur les acides gras libres. De plus, l'adiponectine était fortement associée aux composantes du syndrome métabolique et plus particulièrement au métabolisme des triglycérides. Ces résultats soulignent l'importance d'évaluer la répartition du tissu adipeux chez la femme ménopausée ayant un surplus de poids puisqu'une obésité viscérale mène à une détérioration métabolique. Dans un deuxième temps, nos travaux ont démontré qu'une intervention nutritionnelle de perte de poids axée sur des messages positifs et non restrictifs visant l'augmentation de la consommation de fruits et de légumes sans mettre d'emphase sur la restriction en énergie/lipides chez la femme ménopausée n'entraînait pas de perte de poids significative à long terme. Ces résultats suggèrent que ce type d'intervention nutritionnelle de perte de poids ne s'adresse pas à tous et convient probablement mieux aux femmes ayant de bons signaux de satiation.
- PublicationRestreintA comparative content analysis of vegetarian food blogs written by registered dietitians and non- registered dietitians(Dietitians of Canada = Diététistes du Canada., 2017-03-23) Dugrenier, Marilyn; Lapointe, Annie.; Lemieux, Simone; Dumas, Audrée-Anne; Desroches, SophieThis purpose of this study was to compare the nutritional content of vegetarian recipes published in food blogs written by registered dietitians (RDs) and by non-registered dietitians (non-RDs). Twelve food blogs written by RDs and 12 written by non-RDs were selected using a systematic approach. For each food blog, 2 vegetarian entrée recipes per season were selected (n = 192 recipes). Descriptive analyses were performed using Fisher’s exact test. Median nutritional values per serving between RDs’ and non-RDs’ recipes were compared using Wilcoxon–Mann–Whitney tests. RDs’ recipes were significantly lower in energy, non-heme iron, vitamin C, and sodium, contained significantly more vitamin D and had a higher protein proportion than non-RDs’ recipes. Disparities were also observed across type of entrée and vegetarian dietary pattern. In conclusion, this study showed that RD and non-RD food bloggers provided vegetarian recipes with few nutritional differences. Whether expanding the comparative analysis between RDs and non-RDs’ blogs targeting different nutrition-related topics would yield different results remains to be investigated.
- PublicationAccès libreAssessing patients' involvement in decision making during the nutritional consultation with a dietitian(John Wiley & Sons Ltd, 2014-07-17) Lapointe, Annie.; Vaillancourt, Hugues; Desroches, Sophie; Deschênes, Sarah-Maude; Légaré, FranceBackground Shared decision making (SDM) represents an interesting approach to optimize the impact of dietary treatment, but there is no evidence that SDM is commonly integrated into diet-related health care. Objective To assess the extent to which dietitians involve patients in decisions about dietary treatment. Methods We audiotaped dietitians conducting nutritional consultations with their patients, and we transcribed the tapes verbatim. Three trained raters independently evaluated the content of the nutritional consultations using a coding frame based on the 12 items of the French-language version of the OPTION scale, a validated and reliable third-observer instrument designed to assess patients’ involvement by examining specific health professionals’ behaviours. Coding was facilitated by the qualitative research software NVivo 8. We assessed internal consistency with Cronbach’s alpha and inter-rater reliability with the intraclass correlation coefficient (ICC). Results Of the 40 dietitians eligible to participate in the study, 19 took part. We recruited one patient per participating dietitian. The overall mean OPTION score was 29 ± 8% [range, 0% (no patient involvement in the decision] to 100% [high patient involvement)]. The mean duration of consultations was 50 ± 26 min. The OPTION score was positively correlated with the duration of the consultation (r = 0.65, P < 0.01). Internal consistency and inter-rater reliability were both good (Cronbach’s alpha = 0.72; ICC = 0.65). Conclusion This study is the first to use a framework based on the OPTION scale to report on dietitians’ involvement of patients in decisions about patients’ dietary treatment. The results suggest that involvement is suboptimal. Interventions to increase patients’ involvement in diet-related decision making are indicated.
- PublicationRestreintPostmenopausal women with abdominal obesity choosing a nutritional approach for weight loss: A decisional needs assessment(Elsevier, 2016-08-19) Lapointe, Annie.; Poirier, Nadine; Stacey, Dawn; Lemieux, Simone; Desroches, Sophie; Bégin, Catherine; Légaré, FranceObjectives: To identify the decisional needs of postmenopausal women with abdominal obesity choosing between two nutritional approaches for weight loss: a low-fat diet or a diet rich in fruit and vegetables. Study design: Our descriptive qualitative study was based on the Ottawa Decision Support Framework. Main outcome measures: Four focus groups were conducted with postmenopausal women. A thematic content analysis was performed to determine the decisional needs influencing the choice of a low-fat diet or a diet rich in fruit and vegetables. Results: Seventeen postmenopausal women participated in the study (median age 59 years). Most frequently reported decisional needs for each nutritional approach were sufficient levels of nutritional skills and knowledge, consideration of the physiological impacts and the sensory aspect of approaches, food availability, social support, finances and motivation. Partners, friends and daughters were considered as the most important individuals involved in the decision. Conclusions: We identified several decisional needs influencing postmenopausal women when choosing between a low-fat diet and a diet rich in fruit and vegetables. These findings could inform the design of decision support interventions that address the decisional needs of women for making and implementing informed decisions about a nutritional approach for weight loss.
- PublicationAccès librePsychosocial factors of dietitians’ intentions to adopt shared decision making behaviours : a cross-sectional survey(Public Library of Science, 2013-05-20) Deschênes, Sarah Maude; Lapointe, Annie.; Turcotte, Stéphane; Gagnon, Marie-Pierre; Desroches, Sophie; Légaré, FranceObjectives While shared decision making (SDM) promotes health-related decisions that are informed, value-based and adhered to, few studies report on theory-based approaches to SDM adoption by healthcare professionals. We aimed to identify the factors influencing dietitians' intentions to adopt two SDM behaviours: 1) present dietary treatment options to patients and 2) help patients clarify their values and preferences. Methods We conducted a cross-sectional postal survey based on the Theory of Planned Behaviour among 428 randomly selected dietitians working in clinical practice across the Province of Quebec, Canada. We performed descriptive analyses and multiple regression analyses to determine the variables that explained the variance in intention to perform the behaviours. Results A total of 203 dietitians completed the questionnaire. Their ages were from 23 to 66 and they had been practising dietetics for 15.4±11.1 years (mean ± SD). On a scale from 1 to 7 (from strongly disagree to strongly agree), dietitians' intentions to present dietary treatment options and to clarify their patients' values and preferences were 5.00±1.14 and 5.68±0.74, respectively. Perceived behavioural control (ß¿=¿0.56, ¿<0.0001), subjective norm (ß¿=¿0.16, ¿<0.05), and moral norm (ß¿=¿0.22, ¿<0.0001), were the factors significantly predicting the intention to present dietary treatment options, while perceived behavioural control (ß¿=¿0.60, ¿<0.0001), attitude (ß¿=¿0.20, ¿<0.05), and professional norm (ß¿=¿0.22, ¿<0.001), significantly predicted the intention to help patients' clarify their values and preferences.
- PublicationAccès libreExploration of shared decision‐making processes among dieticians and patients during a consultation for the nutritional treatment of dyslipidaemia(Blackwell Science, 2014-08-18) Lapointe, Annie.; Vaillancourt, Hugues; Gagnon, Marie-Pierre; Desroches, Sophie; Deschênes, Sarah-Maude; Légaré, FranceBackground: Shared decision making (SDM) holds great potential for improving the therapeutic efficiency and quality of nutritional treatment of dyslipidaemia by promoting patient involvement in decision making. Adoption of specific behaviours fostering SDM during consultations has yet to be studied in routine dietetic practice. Objective: Using a cross-sectional study design, we aimed to explore both dieticians’ and patients’ adoption of SDM behaviours in dietetic consultations regarding the nutritional treatment of dyslipidaemia. Methods: Twenty-six dieticians working in local health clinics in the Quebec City metropolitan area were each asked to identify one dyslipidaemic patient they would see in an upcoming consultation. Based on the Theory of Planned Behaviour (TPB), questionnaires were designed to study two targeted SDM behaviours: ‘to discuss nutritional treatment options for dyslipidaemia’ and ‘to discuss patients’ values and preferences about nutritional treatment options for dyslipidaemia’. These questionnaires were administered to the dietician–patient dyad individually before the consultation. Associations between TPB constructs (attitude, subjective norm and perceived behavioural control) towards behavioural intentions were analysed using Spearman’s partial correlations. Results: Thirteen unique patient-dietician dyads completed the study. Perceived behavioural control was the only TPB construct significantly associated with both dieticians’ and patients’ intentions to adopt the targeted SDM behaviours (P < 0.05). Conclusions: As perceived behavioural control seems to determine dieticians’ and patients’ adoption of SDM behaviours, interventions addressing barriers and reinforcing enablers of these behaviours are indicated. This exploratory study highlights issues that could be addressed in future research endeavours to expand the knowledge base relating to SDM adoption in dietetic practice.
- PublicationRestreintPsychosocial factors and intention to use the nutrition care process among dietitians and dietetic interns(Diététistes du Canada, 2014-05-21) Lapointe, Annie.; Galibois, Isabelle; Gagnon, Pierre.; Desroches, Sophie; Deschênes, Sarah-MaudePurpose The theory of planned behaviour was used to explore the factors (i.e., attitude, subjective norm, and perceived behavioural control) affecting the intention of dietetic internship educators, new dietetic graduates, and dietetic interns to use the nutrition care process (NCP) in their clinical practice. Methods Participants (n=55) were recruited from the Bachelor of Science in Nutrition program at Université Laval. They completed an online quantitative questionnaire assessing their intention to use the NCP in their clinical practice, as well as associated psychosocial factors. Open-ended questions were also used to gain a further understanding of the salient beliefs underlying participants’ intention to use the NCP. Results Intention to use the NCP in practice and associated psychosocial factors were similar and favourable within the three participant groups. Subjective norm and perceived behavioural control were the psychosocial factors that significantly predicted an intention to use the NCP. The most cited perceived barrier to use of the NCP was a lack of knowledge, while the most cited facilitator was training opportunities. Conclusions Our results indicate that successful implementation of the NCP will likely require the development of theoretical and practical training activities for both pre-licensure students and experienced dietitians.
- PublicationRestreintA systematic review of the effect of yogurt consumption on chronic diseases risk markers in adults(Springer, 2016-11-02) Dugrenier, Marilyn; Lapointe, Annie.; Lamarche, Benoît; Dumas, Audrée-Anne; Desroches, Sophie; Provencher, VéroniquePurpose: We reviewed randomised controlled trials (RCTs) that have assessed the effects of yogurt containing Lactobacillus bulgaricus and Streptococcus thermophilus (LBST) on metabolic risk markers of chronic diseases in adults. Methods: We performed a systematic search in July 2016 in the scientific databases PubMed, EMBASE and The Cochrane Library. Included studies were RCTs that assessed the impact of consuming yogurt containing LBST as a treatment, and that evaluated at least one metabolic risk marker for chronic diseases compared with a control diet or a diet supplemented in another food/ingredient in healthy or chronically ill adults. Results: Seven RCTs involving 278 participants were included in the review. Studies were conducted in the USA, France, Spain, Iran and Canada. Five studies were undertaken in healthy adults, and two were conducted among lactose malabsorbers. All studies investigated changes in blood lipids and glucose homoeostasis, with different doses of yogurt, durations of the supplementation and risks markers assessed. Consumption of LBST yogurt significantly reduced total cholesterol concentrations, ratio of total cholesterol to HDL-C and plasma glucose compared to a control yogurt-free diet or diet supplemented in another food/ingredient in two out of the seven studies. The majority of included RCTs presented high to unclear methodological risks of bias, which raises questions about the validity of their findings. Conclusions: Data from this systematic review indicate that the consumption of LBST yogurt shows either favourable or neutral effects on metabolic risk markers when compared with a control treatment in controlled research settings. RCTs investigating the effect of LBST yogurt consumption on metabolic risk markers of chronic diseases are scarce and presented considerable variation in methodologies making comparison between studies difficult. Further large-scale, well-designed studies assessing the impact of LBST yogurt, in particular in comparison with a control yogurt-free diet, are warranted to effectively evaluate the effect of yogurt consumption per se on risk markers of chronic diseases.
- PublicationRestreintWomen’s perceptions of usefulness and ease of use of four healthy eating blog characteristics : a qualitative study of 33 French-Canadian women(Elsevier, 2017-10-26) Dugrenier, Marilyn; Lapointe, Annie.; Bissonnette-Maheux, Véronique; Gagnon, Marie-Pierre; Dumas, Audrée-Anne; Straus, Sharon; Desroches, Sophie; Provencher, VéroniqueBackground Healthy eating blogs are knowledge translation tools used by nutrition and dietetics practitioners for helping people improve their health behaviors and food choices. Objective Our aim was to explore women’s perceptions of the usefulness and ease of use of healthy eating blog (HEB) characteristics that might increase potential users’ intention to use them as tools to improve their dietary habits. Design We conducted qualitative research using semi-structured individual interviews. Participants Thirty-three women (mean age of 44 years; range=27 to 61 years) living in the Quebec City, Canada, metropolitan area were studied. Intervention Four existing HEBs, written by French-Canadian registered dietitians (RDs) whose main objective was the promotion of a healthy diet, were explored by women during individual interviews. A standardized open-ended interview questionnaire based on the Technology Acceptance Model was used to identify women's perceptions about characteristics of type of blog content delivery, RD blogger's delivery of information, blog layout, and blog design. Main outcome measures Women's perceptions toward the contribution of HEB characteristics to the usefulness and ease of use of those tools to improve their dietary habits were measured. Analyses performed Interviews were audiorecorded, transcribed verbatim, coded, and analyzed through an inductive content analysis using NVivo software. Results The most useful characteristics of type of blog content delivery identified by women were recipes, hyperlinks, and references. Among characteristics of RD blogger's delivery of information, most women reported that interaction between blog readers and the RD blogger created a sense of proximity and of connection that was helpful for improving their dietary behaviors. Women's perceptions toward various characteristics of blog layout and design were also discussed. Conclusions Incorporating specific characteristics when designing HEBs should be considered by RDs and future research to promote the use of those tools to support dietary behavior change efforts of internet users.