title: Policy outcomes of applying different nutrient profiling systems in recreational sports settings: the case for national harmonization in Canada.
abstract: OBJECTIVE
  To assess agreement among three nutrient profiling systems used to evaluate the healthfulness of vending machine products in recreation and sport settings in three Canadian provinces. We also assessed whether the nutritional profile of vending machine items in recreation and sport facilities that were adhering to nutrition guidelines (implementers) was superior to that of facilities that were not (non-implementers).
  
  
  METHODS
  Trained research assistants audited the contents of vending machines. Three provincial nutrient profiling systems were used to classify items into each province's most, moderately and least healthy categories. Agreement among systems was assessed using weighted κ statistics. ANOVA assessed whether the average nutritional profile of vending machine items differed according to province and guideline implementation status.
  
  
  METHODS
  Eighteen recreation and sport facilities in three Canadian provinces. One-half of facilities were implementing nutrition guidelines.
  
  
  METHODS
  Snacks (n 531) and beverages (n 618) within thirty-six vending machines were audited.
  
  
  RESULTS
  Overall, the systems agreed that the majority of items belonged within their respective least healthy categories (66-69 %) and that few belonged within their most healthy categories (14-22 %). Agreement among profiling systems was moderate to good, with κ w values ranging from 0·49 to 0·69. Implementers offered fewer of the least healthy items (P<0·05) and these items had a better nutritional profile compared with items in non-implementing facilities.
  
  
  CONCLUSIONS
  The policy outcomes of the three systems are likely to be similar, suggesting there may be scope to harmonize nutrient profiling systems at a national level to avoid unnecessary duplication and support food reformulation by industry.
authors.affiliation: 1Centre for Health Promotion Studies,University of Alberta,Edmonton,Alberta,Canada.
authors.forename: Dana Lee
authors.initials: DL
authors.lastname: Olstad
authors.affiliation: 2Atlantic Health Promotion Research Centre,Dalhousie University,PO Box 15000,Halifax,Nova Scotia B3H 4R2,Canada.
authors.forename: Kelly
authors.initials: K
authors.lastname: Poirier
authors.affiliation: 3School of Exercise Science,Physical and Health Education,Victoria,British Columbia,Canada.
authors.forename: Patti-Jean
authors.initials: PJ
authors.lastname: Naylor
authors.affiliation: 2Atlantic Health Promotion Research Centre,Dalhousie University,PO Box 15000,Halifax,Nova Scotia B3H 4R2,Canada.
authors.forename: Cindy
authors.initials: C
authors.lastname: Shearer
authors.affiliation: 2Atlantic Health Promotion Research Centre,Dalhousie University,PO Box 15000,Halifax,Nova Scotia B3H 4R2,Canada.
authors.forename: Sara F L
authors.initials: SF
authors.lastname: Kirk
mesh_terms: D001628:Beverages; D002170:Canada; D002149:Energy Intake; D005509:Food Dispensers, Automatic / Q000592:standards; D005522:Food Services / Q000592:standards; D006801:Humans; D018673:Nutrition Policy; D009753:Nutritive Value; D011998:Recreation; D062410:Snacks; D013177:Sports; D064133:Sports Nutritional Physiological Phenomena
keywords: Food environment; Nutrient profiling system; Nutrition guidelines; Recreational sports settings