Publications

Low levels of brain derived-neurotrophic factor (BDNF) and excessive screen exposure are risk factors for neurocognitive deficits and obesity in youth, but the relationship between screen time and BDNF remains unknown. This study examined whether duration and/or type of sedentary screen time behaviour (TV viewing, video games, recreational computer use) are associated with serum BDNF levels in youth with obesity. The sample consisted of 250 inactive, postpubertal adolescents with obesity (172 females/78 males, aged 15.5 ± 1.4 years) at the baseline assessment of the Healthy Eating, Aerobic, Resistance Training in Youth Study. After controlling for self-reported age, sex, race, parental education, puberty stage, physical activity, and diet, higher total screen exposure was significantly associated with lower serum BDNF levels (β = -0.21, p = 0.002). TV viewing was the only type of screen behaviour that was associated with BDNF levels (β = -0.22, p = 0.001). Higher exposure to traditional forms of screen time was independently associated with lower serum BDNF levels, and this association appears to be driven primarily by TV viewing. Future intervention research is needed to determine whether limiting screen time is an effective way to increase BDNF and associated health benefits in a high-risk population of youth with obesity. Trial Registration: ClinicalTrials.Gov NCT00195858. Novelty: This study is the first to show that recreational screen time is inversely associated with serum BDNF levels. The inverse association between screen time and BDNF is driven primarily by TV viewing, indicating the type of screen might matter.

Abstract Background and objectives Temperament may be associated with eating behaviors over the lifespan. This study examined the association of toddlerhood temperament with dietary behavior and dietary intervention outcomes across 18 years. Methods The study comprised 660 children (52% boys) from The Special Turku Intervention Project (STRIP), which is a longitudinal randomized controlled trial from the age of 7 months until the age of 20 years (1990–2010). Temperament was assessed using Carey temperament scales when the participants were 2 years of age. Latent profile analysis yielded three temperament groups, which were called negative/low regulation (19% of the children), neutral/average regulation (52%) and positive/high regulation (28%). Dietary behavior was examined from 2 to 20 years of age using food records, which were converted into a diet score (mean = 15.7, SD 4.6). Mixed random-intercept growth curve analysis was the main analytic method. Results Dietary behavior showed a significant quadratic U-shaped curve over time (B for quadratic association = 0.39, P Conclusion Children with a temperament profile characterized by high negative mood, high irregularity and high intensity in emotion expression constitute a risk group for less healthy eating over the lifespan.

Evidence-based 24-h movement behavior (24-HMB) guidelines have been developed to integrate recommendations for the time spent on physical activity, sedentary behavior, and sleep. For children and adolescents, these 24-HMB guidelines recommend a maximum of two hours of recreational screen time (as part of sedentary behavior), a minimum of 60 min per day of moderate to vigorous physical activity (MVPA), and an age-appropriate sleep duration (9-11 h for 5 to 13-year-olds; 8-10 h for 14 to 17-year-olds). Although adherence to the guidelines has been associated with positive health outcomes, the effects of adhering to the 24-HMB recommendations have not been fully examined in children and adolescents with attention eficit/hyperactive disorder (ADHD). Therefore, this study examined potential associations between meeting the 24-HMB guidelines and indicators of cognitive and social difficulties in children and adolescents with ADHD.Cross-sectional data on 3470 children and adolescents with ADHD aged between 6 and 17 years was extracted from the National Survey for Children's Health (NSCH 2020). Adherence to 24-HMB guidelines comprised screen time, physical activity, and sleep. ADHD-related outcomes included four indicators; one relating to cognitive difficulties (i.e., serious difficulties in concentrating, remembering, or making decisions) and three indicators of social difficulties (i.e., difficulties in making or keeping friends, bullying others, being bullied). Logistic regression was performed to determine the associations between adherence to 24-HMB guidelines and the cognitive and social outcomes described above, while adjusting for confounders.In total, 44.8% of participants met at least one movement behavior guideline, while only 5.7% met all three. Adjusted logistic regressions further showed that meeting all three guidelines was associated with lower odds of cognitive difficulties in relation to none of the guidelines, but the strongest model included only screen time and physical activity as predictors (OR = 0.26, 95% CI 0.12-0.53, p < .001). For social relationships, meeting all three guidelines was associated with lower odds of difficulty keeping friends (OR = 0.46, 95% CI 0.21-0.97, p = .04) in relation to none of the guidelines. Meeting the guideline for screen time was associated with lower odds of being bullied (OR = 0.61, 95% CI 0.39-0.97, p = .04) in relation to none of the guidelines. While screen time only, sleep only and the combination of both were associated with lower odds of bullying others, sleep alone was the strongest predictor (OR = 0.44, 95% CI 0.26-0.76, p = .003) in relation to none of the guidelines.Meeting 24-HMB guidelines was associated with reduced likelihood of cognitive and social difficulties in children and adolescents with ADHD. These findings highlight the importance of adhering to healthy lifestyle behaviors as outlined in the 24-HMB recommendations with regard to cognitive and social difficulties in children and adolescents with ADHD. These results need to be confirmed by longitudinal and interventional studies with a large sample size.

Background: Healthy child and youth development is fostered through sufficient physical activity (PA; including time outdoors), limiting sedentary behaviours (SB), and adequate sleep; collectively known as movement behaviours. Though the COVID-19 virus outbreak has changed the daily lives of children and youth, it is unknown to what extent related restrictions may compromise the ability to play and meet movement behaviour recommendations. This study examined the immediate impacts of COVID-19 restrictions on movement and play behaviours in children and youth. Methods: A national sample of Canadian parents (n=1,472) of children (5-11 years) or youth (12-17 years) (54% girls) completed an online survey that assessed immediate changes in child movement and play behaviours during the COVID-19 outbreak. Behaviours included PA and play, SB, and sleep. Family demographics and parental factors that may influence movement behaviours were assessed. Correlations between behaviours and demographic and parental factors were determined. For open-ended questions, word frequency distributions were reported. Results: Only 4.8% (2.8% girls, 6.5% boys) of children and 0.8% (1.1% girls, 0.5% boys) of youth were meeting combined movement behaviour guidelines during COVID-19 restrictions. Children and youth had lower PA levels, less outside time, higher SB (including screen time), and more sleep during the outbreak. Parental encouragement and support, parental engagement in PA, and family dog ownership were positively associated with healthy movement behaviours. Although families spent less time in PA and more time in SB, several parents reported adopting new hobbies or accessing new resources. Conclusions: This study provides evidence of immediate collateral consequences of the COVID-19 outbreak, demonstrating an adverse impact on the movement and play behaviours of Canadian children and youth. These findings can guide efforts to preserve and promote child health during the COVID-19 outbreak and crisis recovery period, and to inform strategies to mitigate potential harm during future pandemics.

Summary of studies included in the systematic review sorted by (whenever possible) outcome indicator, study design, age group, and sleep assessment (objective, then subjective). (DOC 254 kb)

The associations between cardiorespiratory fitness (CRF) and physical literacy in children are largely unknown. The aim of this study was to assess the relationships between CRF, measured using the 20-m shuttle run test (20mSRT), and components of physical literacy among Canadian children aged 8-12 years.A total of 9393 (49.9% girls) children, with a mean (SD) age of 10.1 (±1.2) years, from a cross-sectional surveillance study were included for this analysis. The SRT was evaluated using a standardized 15 m or 20 m protocol. All 15 m SRTs were converted to 20mSRT values using a standardized formula. The four domains of physical literacy (Physical Competence, Daily Behaviour, Motivation and Confidence, and Knowledge and Understanding) were measured using the Canadian Assessment of Physical Literacy. Tertiles were identified for 20mSRT laps, representing low, medium, and high CRF for each age and gender group. Cohen's d was used to calculate the effect size between the low and high CRF groups.CRF was strongly and favourably associated with all components of physical literacy among school-aged Canadian children. The effect size between low and high CRF tertile groups was large for the Physical Competence domain (Cohen's d range: 1.11-1.94) across age and gender groups, followed by moderate to large effect sizes for Motivation and Confidence (Cohen's d range: 0.54-1.18), small to moderate effect sizes for Daily Behaviour (Cohen's d range: 0.25-0.81), and marginal to moderate effect sizes for Knowledge and Understanding (Cohen's d range: 0.08-0.70).This study identified strong favourable associations between CRF and physical literacy and its constituent components in children aged 8-12 years. Future research should investigate the sensitivity and specificity of the 20mSRT in screening those with low physical literacy levels.

Purpose The purpose of this paper is to empirically test O’Reilly and Madill’s (2012) process model to assess social marketing elements of a multi-year partnership between Coca-Cola Canada and a physical activity microgrant program, known as Teen Challenge, managed by ParticipACTION, a Canadian not-for-profit organization that champions sport and physical activity participation. ParticipACTION’s Teen Challenge is a multi-year initiative that was developed in 2008 and involves over 5,800 community organizations (COs) and over 500,000 Canadian teens across the nation (ParticipACTION, 2016). Design/methodology/approach A series of ten hypotheses related to the evaluation are tested using longitudinal data from event participants over a five-year period from 2009 to 2013. Findings The study revealed that sponsor and sponsee shared objectives around sport participation, including the three found in this study. Practically, this is a positive result for sport participation properties who might now consider this as part of a sponsorship sales strategy. The research found that both Coca-Cola Canada and ParticipACTION have the following shared objectives in this particular sponsorship: motivate and support youth to get active and live a healthy life; remove barriers that youth face in getting physically active; and encourage more COs to be involved in the program. Conceptually, this finding extends the discussion of shared social marketing objectives in sponsorship proposed by Madill and O’Reilly (2010). Research limitations/implications The findings support the sponsorship literature, in suggesting that shared objectives among sponsorship partners are important for the sponsorship to achieve successful outcomes (Cornwell et al. , 2001). Shared sponsorship objectives can be utilized as a strategic tool for the sponsee to demonstrate the effectiveness of the program and to build a long-term relationship. The results of the logistic regression analysis indicate that COs which viewed partners’ collaboration as positive agreed that the Teen Challenge program made physical activity more accessible and affordable for youth. Practical implications This study provides several important implications for non-profit organizations that aim to establish an effective social marketing campaign. One way for non-profit organizations to build a strong relationship with sponsors was through positive collaboration where the two partners work together (e.g. activation) to maximize the sponsorship’s effectiveness. First, it increased youth participation in the Teen Challenge program and made it affordable for teens to participate in other physical activity programs. Second, it enhanced Coca-Cola’s image as supporters of active lifestyle in the eyes of COs. Finally, it affected the likelihood that COs would recommend the program. Social implications Results of the survey of COs that are registered with the program provides us with another important finding that positive partner collaboration is only one component of overall effectiveness. Another component would be to take action to communicate to COs that positive collaboration indeed took place in the sponsorship. One way to achieve this goal is to demonstrate to COs the importance of funding that the sponsor provides as well as the impact of sponsorship partners’ positive collaboration on the overall program. The authors also found that sponsorship partners’ positive collaboration in the delivery of the Teen Challenge program played an important role in whether COs recommend the program to others. Originality/value The results of this research contribute to the evaluation of the sponsorship of a health-oriented social marketing sponsorship of a sport participation property or sponsee (ParticipACTION) and a major brand as sponsor (Coca-Cola).

Purpose Framed by nostalgia marketing, this research draws upon lessons from ParticipACTION, a Canadian non-profit health promotion organization, to examine one of their most well-known campaigns, Body Break with ParticipACTION, in order to assess the potential role for nostalgia-based marketing campaigns in sport participation across generational cohorts. Design/methodology/approach Exploratory sequential mixed methods involving two studies were completed on behalf of ParticipACTION, with the authors developing the research instruments and the collection of the data undertaken by research agencies. Study 1 was the secondary analysis of qualitative data from five focus groups with different demographic compositions that followed a common question guide. Study 2 was a secondary data analysis of a pan-Canadian online survey with a sample ( n = 1,475) representative of the overall adult population that assessed awareness of, and attitudes toward, ParticipACTION, Body Break, physical activity and sport participation. Path analysis tested a proposed model that was based on previous research on attitudes, brand and loyalty. Further, multi-group path analyses were conducted to compare younger generations with older ones. Findings The results provide direction and understanding of the importance of nostalgia in marketing sport participation programs across generational cohorts. For instance, in the four parent-adult focus groups, unaided references as well as frequent and detailed comments regarding Body Break were observed. Similarly, Millennials reported that Body Break was memorable, Canadian and nostalgic, with a mix of positive and negative comments. The importance of nostalgia was supported sequentially via results from the national survey. For example, while 54.1% of the 40–54 age-group associated ParticipACTION positively with Body Break, so did 49.8% of the 25–39-year age group, most of whom were not born when the promotion ran. Further, brand resonance was found to explain 4% more variance in moderate-to-vigorous physical activity (MVPA), the proxy for sport participation, for younger people compared to older people. Practical implications Results provide direction to brands, properties and agencies around the use of nostalgia in sport marketing campaigns and sponsorship efforts. For brands seeking to sponsor sport properties to alter their image with potential consumers in a new market, associating with a sport property that many view as nostalgic could improve the impact of the campaign. On the sport property side, event managers and marketers should both identify existing assets that members or fans are nostalgic about, as well as consider building nostalgia into current and new properties they develop. Originality/value This research is valuable to the sport marketing and sponsorship literature through several contributions. First, the use of nostalgia marketing, and nostalgia in general, is novel in the sport marketing and sponsorship literature, with future research in nostalgia and sponsorship recommended. Second, the potential to adopt or adapt Body Break to other sport participation and physical activity properties is empirically supported. Finally, the finding that very effective promotions can have a long-lasting effect, both on those who experienced the campaigns as well as younger populations who only heard about it, is notable.

No abstract is provided for this article.

Background Approximately 17% of Canadians with high blood pressure were unaware of their condition, and of Canadians aware of having the condition, approximately 1 in 5 have uncontrolled high blood pressure despite high rates of pharmacotherapy. The objectives of the current study are to estimate the prevalence of resistant hypertension and examine factors associated with (1) lack of awareness and (2) uncontrolled hypertension despite pharmacotherapy. Methods Using the 2007-2009 Canadian Health Measures Survey (N = 3473, aged 20-79 years) and logistic regression, we quantified relationships between characteristics and (1) presence of hypertension, (2) lack of awareness (among those with hypertension), and (3) uncontrolled high blood pressure (among those treated for hypertension). Results Older age, lowest income, and less than high school education were associated with presence of hypertension. Men (odds ratio [OR], 1.6; 95% confidence interval [CI], 1.1-2.2) and adults < 60 years (OR, 1.7; 95% CI, 1.1-2.6) were more likely than others to be unaware. Among those aged 60+ years, women were more likely than men to have uncontrolled high blood pressure (OR, 2.4; 95% CI, 1.1-5.2) despite treatment. Elevated systolic blood pressure was the issue in over 90% of women and 80% of men with uncontrolled hypertension. Depending on the definition employed, 4.4% (95% CI, 2.4-6.4) to 7.8% (95% CI, 6.0-9.6) of the population with hypertension had resistant hypertension. Conclusions Messaging or interventions encouraging screening may be helpful for all younger Canadian adults and men; programs encouraging blood pressure control may help older women.

Background : To determine if children’s moderate to vigorous physical activity (MVPA) and sedentary time varied across levels of household income in countries at different levels of Human Development Index (HDI), consistent with the theory of epidemiological transition. Methods : Data from 6548 children (55% girls) aged 9–11 years from 12 countries at different HDI levels are used in this analysis to assess MVPA and sedentary time (measured using ActiGraph accelerometers) across levels of household income. Least-square means are estimated separately for boys and girls at the estimated 10th, 50th, and 90th percentiles of HDI for the sample. Results : For boys, time in MVPA is negatively associated with income at the 10th and 50th percentiles of HDI (both P &lt; .002). For girls, time in MVPA is negatively associated with income at the 10th and 50th percentiles of HDI (all P &lt; .01) and positively related with income at the 90th percentile ( P = .04). Sedentary time is positively associated with income at the 10th percentile of HDI for boys ( P = .03), but not for girls. Conclusions : Results support the possibility of an epidemiological transition in physical activity, with lower levels of MVPA observed at opposite levels of income depending on the HDI percentile. This phenomenon was not observed for sedentary time.

&lt;p&gt;&lt;strong&gt;Introduction&lt;/strong&gt; School readiness is a multidimensional construct that includes cognitive, behavioural and emotional aspects of a child’s development. School readiness is strongly associated with a child’s future school success and well-being. The Early Development Instrument (EDI) is a reliable and valid teacher-completed tool for assessing school readiness in children at kindergarten age. A substantial knowledge gap exists in understanding how early child growth, health behaviours, nutrition, cardiometabolic risk and development impact school readiness. The primary objective was to determine if growth patterns, measured by body mass index trajectories in healthy children aged 0–5 years, are associated with school readiness at ages 4–6 years (kindergarten age). Secondary objectives were to determine if other health trajectories, including health behaviours, nutrition, cardiometabolic risk and development, are associated with school readiness at ages 4–6 years. This paper presents the Fit for School Study protocol.&lt;/p&gt; &lt;p&gt;&lt;strong&gt;Methods and analysis&lt;/strong&gt; This is an ongoing prospective cohort study. Parents of children enrolled in the The Applied Health Research Group for Kids (TARGet Kids!) practice-based research network are invited to participate in the Fit for School Study. Child growth, health behaviours, nutrition, cardiometabolic risk and development data are collected annually at health supervision visits and linked to EDI data collected by schools. The primary and secondary analyses will use a two-stage process: (1) latent class growth models will be used to first determine trajectory groups, and (2) generalised linear mixed models will be used to examine the relationship between exposures and EDI results.&lt;/p&gt; &lt;p&gt;&lt;strong&gt;Ethics and dissemination&lt;/strong&gt; The research ethics boards at The Hospital for Sick Children, Unity Health Toronto and McMaster University approved this study, and research ethics approval was obtained from each school board with a student participating in the study. The findings will be presented locally, nationally and internationally and will be published in peer-reviewed journals.&lt;/p&gt;

ABSTRACT Background The evidence on associations between sedentary behaviour (SB) and motor skills in 3‐ to 4‐year‐olds is unclear and mostly from high‐income countries. Objective The objective of this study is to examine associations between (1) screen time (h/day) and total daily SB (h/day), and gross and fine motor skills, and (2) meeting the restraint, screen time and overall SB (restraint and screen time) guidelines and fine and gross motor skills. Methods Cross‐sectional study of 1394 3‐ to 4‐year‐olds from the pilot phase of the SUNRISE International study. Time spent in SB was measured using the activ PAL accelerometer, whereas screen time and restraint were measured using a parent questionnaire. Fine and gross motor skills were measured using parent‐reported Ages and Stages Questionnaire (ASQ‐3). Associations between SB and motor skills were determined using linear and logistic regression, adjusting for sex and socioeconomic status. Results Every additional 1 h of screen time was associated with 0.50‐point reduction in gross motor skills scores ( p = 0.008). More screen time was associated with decreased odds of being on track for fine and gross motor skill development ( p &lt; 0.001 and p = 0.017, respectively). Meeting the screen time ( p = 0.009) and overall SB guidelines ( p = 0.006) were favourably associated with fine motor skills scores. Meeting the screen time, restraint and overall SB guidelines were favourably associated with gross motor skills scores ( p = 0.007, p &lt; 0.001 and p &lt; 0.001, respectively), higher odds of being on track for fine ( p = 0.033, p = 0.015 and p &lt; 0.001, respectively) and gross motor skills ( p = 0.006, p &lt; 0.001 and p &lt; 0.001, respectively) development. Conclusion The present study adds to the evidence on the importance of sedentary behaviour for the motor development of 3‐ to 4‐year‐olds. It is important that policy makers and health educators develop strategies that will encourage and promote adherence to sedentary behaviour guidelines among 3‐ and 4‐year‐olds.