Publications

Background Children and youth who meet the physical activity, sedentary, and sleep behaviour recommendations in the Canadian 24-Hour Movement Guidelines are more likely to have desirable physical and psychosocial health outcomes. Yet, few children and youth actually meet the recommendations. The family is a key source of influence that can affect lifestyle behaviours. The purpose of this paper is to describe the process used to develop the Consensus Statement on the Role of the Family in the Physical Activity, Sedentary, and Sleep Behaviours of Children and Youth (0–17 years) and present, explain, substantiate, and discuss the final Consensus Statement. Methods The development of the Consensus Statement included the establishment of a multidisciplinary Expert Panel, completion of six reviews (three literature, two scoping, one systematic review of reviews), custom data analyses of Statistics Canada’s Canadian Health Measures Survey, integration of related research identified by Expert Panel members, a stakeholder consultation, establishment of consensus, and the development of a media, public relations, communications and launch plan. Results Evidence from the literature reviews provided substantial support for the importance of family on children’s movement behaviours and highlighted the importance of inclusion of the entire family system as a source of influence and promotion of healthy child and youth movement behaviours. The Expert Panel incorporated the collective evidence from all reviews, the custom analyses, other related research identified, and stakeholder survey feedback, to develop a conceptual model and arrive at the Consensus Statement: Families can support children and youth in achieving healthy physical activity, sedentary and sleep behaviours by encouraging, facilitating, modelling, setting expectations and engaging in healthy movement behaviours with them. Other sources of influence are important ( e.g. , child care, school, health care, community, governments) and can support families in this pursuit . Conclusion Family is important for the support and promotion of healthy movement behaviours of children and youth. This Consensus Statement serves as a comprehensive, credible, and current synopsis of related evidence, recommendations, and resources for multiple stakeholders.

Background Mental wellbeing in adolescents has declined considerably during past decades, making the identification of modifiable risk factors important. Prolonged screen time and insufficient physical activity appear to operate independently and synergistically to increase the risk of poor mental wellbeing in school-aged children. We aimed to examine the gender-stratified dose-dependent and joint associations of screen time and physical activity with mental wellbeing in adolescents. Methods We used data from three rounds of Health Behaviour in School-aged Children cross-sectional surveys (2006, 2010, and 2014) from 42 European and North American countries. Survey participants, aged 11 years, 13 years, and 15 years, provided self-reported information by completing an anonymous questionnaire that included items on health indicators and related behaviours. We used the self-reported variables of life satisfaction and psychosomatic complaints as indicators of adolescents' mental wellbeing, combining these with the self-reported discretionary use of screens and engagement in physical activity. We used generalised additive models and multilevel regression modelling to examine the gender-stratified relationships between mental wellbeing and screen time and physical activity. Findings Our sample included 577 475 adolescents (mean age 13·60 years, SD 1·64), with 296 542 (51·35%) girls and 280 933 (48·64%) boys. The mean reported life satisfaction score (on a scale of 0–10) was 7·70 (95% CI 7·69–7·71) in boys and 7·48 (7·46–7·50) in girls. Psychosomatic complaints were more common among girls (mean 9·26, 95% CI 9·23–9·28) than boys (6·89, 6·87–6·91). Generalised additive model analyses showed slightly non-linear associations of screen time and physical activity with life satisfaction and psychosomatic complaints for girls and boys. Detrimental associations between screen time and mental wellbeing started when screen time exceeded 1 h per day, whereas increases in physical activity levels were beneficially and monotonically associated with wellbeing. Multilevel modelling showed that screen time levels were negatively associated with life satisfaction and positively associated with psychosomatic complaints in a dose-dependent manner. Physical activity levels were positively associated with life satisfaction and negatively associated with psychosomatic complaints in a dose-dependent manner. Joint associations of screen time–physical activity with mental wellbeing showed that, compared with the least active participants with more than 8 h per day of screen time and no physical activity, most of the other screen time–physical activity groups had considerably higher life satisfaction and lower psychosomatic complaints. Interpretation Higher levels of screen time and lower levels of physical activity were associated with lower life satisfaction and higher psychosomatic complaints among adolescents from high-income countries. Public health strategies to promote adolescents' mental wellbeing should aim to decrease screen time and increase physical activity simultaneously. Funding None.

No abstract is provided for this article.

BACKGROUND: Build Your Best Day! (BYBD) is an interactive website developed to assist in the dissemination of the Canadian 24-Hour Movement Guidelines for Children and Youth (Guidelines) to children, parents, and educators. Guided by Diffusion of Innovations Theory, the current study examined youth's perceptions of the Guidelines before and after interacting with BYBD. METHOD: Youth aged 10-14 years participated in a mixed-methods interview, answering questions regarding the Guidelines before and after trialing BYBD. Outcomes included the perceived advantage of the Guidelines, complexity, compatibility, and intention to adopt the Guidelines. Qualitative data was analyzed with deductive content analysis. Pre-/post-BYBD changes in quantitative variables were assessed with t-tests and Cohen's effect sizes. RESULTS: Seventeen youth participated. Prior to BYBD, youth rated the Guidelines as helpful (M=5.73/7, SD=1.36), not overwhelming (M=6.07/7, SD=0.96), and expressed intent to follow the Guidelines (M=5.67/7, SD=1.68). Ratings remained constant or improved following BYBD, with a significant increase in youth's understanding of the guidelines, p

The objective of the study was to describe objectively measured physical activity (PA) and sedentary time of infants, toddlers, and preschoolers and determine the proportion meeting Canadian age-specific PA guidelines. Ninety children (47 girls, 43 boys; mean age 32 (range, 4–70) months) attending scheduled health supervision visits and in the TARGet Kids! (The Applied Research Group for Kids) cohort wore an Actical accelerometer for 7 days. Participants with 4 or more valid days were included in the analysis. Time, in mean minutes per day (min/day), spent sedentary and in light PA, moderate to vigorous PA (MVPA), and total PA was determined using published cut-points; age groups were compared using ANOVA. Twenty-three percent of children <18 months (n = 28) and 76% of children aged 18–59 months (n = 45) met the guideline of 180 min/day of total PA; 13% of children ≥60 months (n = 17) met the guideline of 60 min/day of MVPA. Children <18 months spent more of their waking time per day engaged in sedentary behaviours (79%; ∼7.3 h) compared with children aged 18–59 months (63%; ∼6.6 h) and children ≥60 months (58%; ∼6.6 h). In conclusion, most children aged 18–59 months met the Canadian PA guidelines for children aged 0–4 years, whereas few younger than 18 months met the same guidelines. Only 13% of children ≥5 years met their age-specific PA guidelines. Further research is needed to develop, test, and implement effective strategies to promote PA and reduce sedentary behaviour in very young children.

This study aimed to examine the association between breastfeeding and childhood obesity. A multinational cross‐sectional study of 4,740 children aged 9–11 years was conducted from 12 countries. Infant breastfeeding was recalled by parents or legal guardians. Height, weight, waist circumference, and body fat were obtained using standardized methods. The overall prevalence of obesity, central obesity, and high body fat were 12.3%, 9.9%, and 8.1%, respectively. After adjustment for maternal age at delivery, body mass index (BMI), highest maternal education, history of gestational diabetes, gestational age, and child's age, sex, birth weight, unhealthy diet pattern scores, moderate‐to‐vigorous physical activity, sleeping, and sedentary time, exclusive breastfeeding was associated with lower odds of obesity (odds ratio [OR] 0.76, 95% confidence interval, CI [0.57, 1.00]) and high body fat (OR 0.60, 95% CI [0.43, 0.84]) compared with exclusive formula feeding. The multivariable‐adjusted ORs based on different breastfeeding durations (none, 1–6, 6–12, and > 12 months) were 1.00, 0.74, 0.70, and 0.60 for obesity ( P trend = .020) and 1.00, 0.64, 047, and 0.64 for high body fat ( P trend = .012), respectively. These associations were no longer significant after adjustment for maternal BMI. Breastfeeding may be a protective factor for obesity and high body fat in 9‐ to 11‐year‐old children from 12 countries.

Background This study preliminarily examined the relationship between physical activity, sedentary time, and social emotional functioning in children aged 4–6 years. Methods Eighty children attending kindergarden classes in Ottawa, Canada wore Actical accelerometers for 1-week to directly assess their physical activity and sedentary time. Physical activity was quantified as minutes per day in light intensity or moderate intensity, and steps per day, while sedentary time was quantified as minutes per day. Social emotional functioning attributes were assessed by teachers using the Devereux Students Strengths Assessment. Results After controlling for age, sex, household-income and school clustering using multilevel regression models, steps per day were positively associated with social awareness β = 1.537, CI = 0.115–2.959) self-awareness (β = 1.285, CI = 0.014–2.555), relationship skills (β = 1.729, CI = 0.238–3.219), personal responsibilities (β = 1.689, CI = 0.101–3.276), and optimistic thinking (β = 1.091, CI = 0.251–2.157). Moderate physical activity was positively associated with relationship skills (β = 1.598, CI = 0.065–3.131) and optimistic thinking (β = 1.515, CI = 0.069–2.234). Time spent in light physical activity and sedentary time were not associated with social emotional functioning indicators. Conclusions Physical activity as measured by steps per day and time spent in moderate physical activity was associated with better social emotional functioning. Future research is needed to verify these preliminary findings and determine the directionality of relationships observed, and experimental studies are needed to determine whether promoting either increased steps per day or intensity of physical activity can improve social emotional functioning in the early years.

No abstract is provided for this article.

PURPOSE: To examine the associations between participation in Physical Education (PE) classes and objective measures of physical activity (PA) and sedentary behavior (SB) in children from 12 countries at different levels of human and socioeconomic development. METHODS: This multinational, cross-sectional study included 5874 children aged 9-11 years from sites in Australia, Brazil, Canada, China, Colombia, Finland, India, Kenya, Portugal, South Africa, the United Kingdom, and the United States. PA and SB were measured over 7 consecutive days using a waist-worn accelerometer. Participation in PE classes was determined by questionnaire. Multilevel modeling analyses were used to account for the hierarchical nature of the data. RESULTS: PE classes were not attended by 6.6% of the total sample, and in low- and middle-income countries this prevalence was higher than in high-income countries (8.4% vs. 4.7%, respectively, p<0.01). After adjusting for age, sex, parental education, and BMI z-score, results showed that children from low- and middle-income countries who participated in PE classes at least once a week were more likely to meet the moderate-to-vigorous physical activity (MVPA) recommendations (male - OR: 1.80; 95%CI: 1.17- 2.77; female - OR: 2.17; 95%CI: 1.44-3.27), to spend more time at different PA intensities, and to have shorter SB time (male - OR: 1.61; 95%CI: 1.01-2.60; female - OR: 2.20; 95%CI: 1.38-3.50) than those who did not attend PE classes. In high-income countries, boys that participated in PE classes were more likely to meet the recommendations for PA (OR: 2.20; 95%CI: 1.29-3.76) and to have shorter SB time (OR: 2.42; 95%CI: 1.22-4.81). For girls in high-income countries, attending PE classes increased the likelihood of spending more time in MVPA, especially if they attended three or more classes per week (OR: 2.42; 95%CI: 1.22-4.80). CONCLUSION: Attending PE classes is associated with a higher level of PA and lower level of SB in children from countries at various levels of human and socioeconomic development. PE classes should be compulsory in all countries as an important contributor to healthy movement behaviors of children.

This paper explores patterns of increased/ decreased physical activity, sedentary and sleep behaviours among Canadian children and youth aged 5-17 years during the COVID-19 pandemic, and examines how these changes are associated with the built environment near residential locations. A cluster analysis identified two groups who were primarily distinguished by the changes in outdoor activities. Compliance to 24-hour movement guidelines was low among both groups. For children, houses (versus apartments) was correlated with increased outdoor activities; proximity to major roads was a barrier. For youth, low dwelling density, and access to parks in high-density neighbourhoods, increased the odds of increased outdoor activities during the pandemic. Our findings can inform future urban and health crisis planning practices by providing new insights into the desirable public health messaging and characteristics of healthy and resilient communities.

The unequivocal link between physical activity and health has prompted researchers and public health officials to search for valid, reliable, and logistically feasible tools to measure and quantify free-living physical activity. Accelerometers hold promise in this regard. Recent technological advances have led to decreases in both the size and cost of accelerometers while increasing functionality (e.g., greater memory, waterproofing). A lack of common data reduction and standardized reporting procedures dramatically limit their potential, however. The purpose of this article is to expand on the utility of accelerometers for measuring free-living physical activity. A detailed example profile of physical activity is presented to highlight the potential richness of accelerometer data. Specific recommendations for optimizing and standardizing the use of accelerometer data are provided with support from specific examples. This descriptive article is intended to advance and ignite scholarly dialogue and debate regarding accelerometer data capture, reduction, analysis, and reporting.