Publications

Purpose To extend the surveillance of physical activity (PA) in Canada to include the influence of time since immigration within and between ethnic groups. Methods Pooled data from cycles 1.1 (2000/01) and 2.1 (2003) of the cross-sectional Canadian Community Health Survey (ages 20–64 y; N=174,600) were used for this study. Weighted prevalences of self-reported leisure-time PA (≥3 kcal/kg/day (kkd)) were calculated, and unadjusted and adjusted (age, income and education) multiple logistic regression models were used to quantify the odds of being physically active (≥ .3 kkd) by time since immigration (recent ≤10 yrs, long-term > 10 yrs, non-immigrant) within and between ethnic groups (White referent group). Results The rank order of prevalence of recent immigrants (≤10 yrs) being physically active (≥3 kkd) by ethnicity was: White (21%), Other (19%), Black (19%), Latin American (17%), West Asian/Arab (16%), East/Southeast Asian (14%), South Asian (11%). Recent immigrant Black men and White women had the highest prevalence of being physically active at > 3 kkd (M=27%, F=18%) while South Asian men and women had the lowest prevalence of being physically active (M=14%, F=9%). Overall, recent immigrants (0–10 y) exhibit lower prevalences of being physically active (16%) compared to nonimmigrants (24%), however over time (> 10 yrs) there is an increase in the prevalence of immigrants who are physically active (20%). Some but not all ethnic groups follow this trend. Compared to White immigrants, East/Southeast Asian and South Asian recent immigrants have reduced odds of being physically active independent of age, household income and education (OR=0.5–0.7, p < 0.05). Long-term East/Southeast Asian, South Asian, and Black immigrants demonstrate significantly lower odds of being physically active compared to Whites (OR=0.6–0.7, p < 0.05) whether controlling for covariates or not. Ethnic differences in the prevalence of being physically active, by time since immigration, show similar patterns for men and women. Controlling for age, income and education had only small effects on PA prevalences across ethnicities and immigrant status. Conclusion These results suggest that PA levels vary according to immigrant status and self-ascribed ethnicity in Canadian adults. Accordingly, strategies to promote PA and prevent physical inactivity should consider both ethnicity and time since immigration.

This article represents the deliberations that took place at the June 2011 meeting of the World Confederation for Physical Therapy (WCPT) during a panel that was convened to discuss ‘Evidence-based Exercise Prescription: Raising the Standard of Delivery’. The panel consisted of five physical therapists and one exercise physiologist. After introductory remarks by the panel chair, each of the other participants was given the opportunity to do an opening presentation. Several questions (Should physical therapists be exercise experts? Are physical therapists truly the exercise experts they should be? Has physical therapist education prepared them to be exercise experts?) were then posed to the panelists for their response. After those responses, the floor was opened up to the audience for response and input. A verbatim transcript of the proceedings enabled audience participation to be reflected.

This study aimed to explore the association between meeting 24‐h movement guidelines and academic performance among Chinese children and adolescents. Cross‐sectional data on 67,281 Chinese children and adolescents were used for the analyses. Adherence to 24‐h movement guidelines and academic performance (i.e., grades in Chinese, Math, and English), as well as sociodemographic information, were measured using a self‐reported questionnaire. 24‐h movement guidelines recommend at least 60 min/day of moderate to vigorous physical activity (MVPA), no more than 2 h/day of recreational screen time (ST), and 9–11 h/night of sleep for ages 11–13 years or 8–10 h/night for ages 14–17 years. Multilevel generalized linear models were used to explore the associations between 24‐h movement guidelines and academic performance. Results indicated that compared to not meeting any of the three 24‐h movement guidelines, participants meeting one or more guidelines were more likely to report better academic performance in Chinese, Math, and English. Meeting all the three guidelines was associated with better academic performance in Chinese (odds ratio [OR] = 1.56), Math (OR = 1.51), and English (OR = 1.73). Additionally, meeting the physical activity (PA) guidelines only was associated with better academic performance in Chinese; meeting only the ST guidelines, both ST and sleep guidelines, and both ST and PA guidelines were associated with better academic performance in Chinese, Math, and English. Subgroup analyses indicated that the associations between 24‐h movement guidelines and academic performance varied across grade groups and course subjects. As such, in general, adherence to 24‐h movement guidelines was related to better self‐reported academic performance. Healthy movement behaviors should be promoted for health and academic achievement in Chinese children and adolescents.

The objective of this study was to examine the combined associations between time spent in moderate- to vigorous-intensity physical activity (MVPA) and time spent sedentary in relation to cardiometabolic risk factors in a cohort of Canadian children. A cross-sectional study was conducted on 536 white children aged 8-10 years with at least 1 obese biological parent. Time spent in MVPA and sedentary behaviour over 7 days was measured using accelerometry and participants were stratified by tertiles. Daily screen time over 7 days was also self-reported by the child. Outcomes included waist circumference, systolic and diastolic blood pressure, fasting triglycerides, high-density lipoprotein cholesterol, and glucose concentrations. Analyses of covariance comparing tertiles of sedentary time/MVPA showed that higher levels of MVPA were associated with lower waist circumference, fasting triglycerides and diastolic blood pressure, and higher high-density lipoprotein (HDL) cholesterol, irrespective of sedentary time. In linear regression, MVPA was inversely associated with waist circumference and diastolic blood pressure and positively associated with HDL cholesterol, independent of covariates including sedentary time. In contrast, sedentary time was positively associated with diastolic blood pressure but after adjustment for MVPA the association was no longer statistically significant. Self-reported screen time was positively associated with waist circumference and negatively associated with HDL cholesterol independent of covariates including MVPA. Overall, a high level of MVPA was associated with reduced cardiometabolic risk in this sample of children, regardless of their amount of sedentary behaviour. The type of sedentary behaviour (i.e., screen time) might be more important than overall sedentary time in relation to cardiometabolic risk.

Physical inactivity is identified as the fourth leading risk factor for global mortality. Consequently, surveillance of physical activity/inactivity is important for understanding the scope and distribution of the public health impact, and informing and assessing future strategies and interventions. Physical activity surveillance relies on objective and subjective measurement methods for the assessment of physical activity among children and youth. Objective methods of assessing physical activity include measures based on energy expenditure or oxygen uptake, heart rate monitoring, and motion sensors using accelerometry, or pedometers measuring step counts. The surveillance of the physical activity of children and youth at the population level is challenged by this trade-off between accuracy and feasibility. Questionnaires are today the most commonly used tools to evaluate physical activity at the population level. Insufficient levels of physical activity have been observed internationally among children and youth raising concerns for their general health and for the future prevalence of non-communicable diseases.

Summary Background The relationship between children's adiposity and lifestyle behaviour patterns is an area of growing interest. Objectives The objectives of this study are to identify clusters of children based on lifestyle behaviours and compare children's adiposity among clusters. Methods Cross‐sectional data from the International Study of Childhood Obesity, Lifestyle and the Environment were used. Participants : the participants were children (9–11 years) from 12 nations ( n = 5710). Measures : 24‐h accelerometry and self‐reported diet and screen time were clustering input variables. Objectively measured adiposity indicators were waist‐to‐height ratio, percent body fat and body mass index z‐scores. Analysis : sex‐stratified analyses were performed on the global sample and repeated on a site‐wise basis. Cluster analysis (using isometric log ratios for compositional data) was used to identify common lifestyle behaviour patterns. Site representation and adiposity were compared across clusters using linear models. Results Four clusters emerged: (1) Junk Food Screenies , (2) Actives , (3) Sitters and (4) All‐Rounders . Countries were represented differently among clusters. Chinese children were over‐represented in Sitters and Colombian children in Actives . Adiposity varied across clusters, being highest in Sitters and lowest in Actives . Conclusions Children from different sites clustered into groups of similar lifestyle behaviours. Cluster membership was linked with differing adiposity. Findings support the implementation of activity interventions in all countries, targeting both physical activity and sedentary time.

The purpose of this study was to investigate the potential long-term association of motor skill proficiency at 6 years of age and self-reported physical activity (PA) at age 26. Direct motor performance data were collected in 1991 with a follow-up study occurring in 1996, and then indirect questionnaires (self-report) administered in 2001 and 2011. In 2011, 17 participants who were identified as either having high motor proficiency (HMP) or low motor proficiency (LMP) in 1991 completed a series of 4 questionnaires. Analyses were conducted to determine whether there were differences between groups for motor skill proficiency, PA, or sedentary behavior, and whether these outcomes were related across ages. Motor skill proficiency at age 6 was related to self-reported proficiency at age 16 (r = .77, p = .006), and self-reported proficiency between 16 and 26 years (r = .85, p = .001). Motor skill proficiency at age 6 was positively associated with leisure time PA at age 26 in females and participants in the HMP group. The results may provide preliminary evidence about the importance of how early motor skill proficiency relates to long-term PA. More research with larger sample sizes is needed to investigate the importance of motor skills over time.

After publication of the article [1], it has been brought to our attention that an incorrect reference has been used in this article, both in the main body and additional file 2. The reference in question is #105 in the main body and #74 in additional file 2. Here it is cited as "Lindsay H, Brussoni M. Injuries and helmet use related to non-motorized wheeled activities among pediatric patients. Chronic Dis Inj Canada. 2014;34(2–3):74–81".

BACKGROUND: To promote regular physical activity (PA), health promotion campaigns must be relevant to the intended audience based on the process of developing, enacting, or maintaining their PA intentions. Previous research has identified 4 major PA persona profiles of campaign audiences based on intention, behavior, habit, and identity: "nonintenders," "unsuccessful adopters," "successful adopters," and "successful maintainers." To maximize uptake, PA promotion campaigns must also be tailored to the sociodemographic characteristics of the intended audiences. The purpose of this study was to assess sociodemographic differences across these persona profiles. METHODS: Secondary cross-sectional analyses were conducted on a pooled sample of 3 survey data sets (ntotal = 8122): a national poll of the Canadian population and audience feedback from 2 Canada-wide PA promotion campaigns. Participants were classified into persona profiles using an existing classification. Univariate and multivariate logistic regression analyses assessed whether persona profiles differed on sociodemographic variables: age category, gender, sexual orientation, duration lived in Canada, race, education, and income. RESULTS: With univariate analyses, persona profiles could be characterized by age, gender, sexual orientation, disability, race, and income; odds ratios ranged from very small to small. With multivariate analysis, disability (odds ratio: 1.68-2.51) and sexual orientation (odds ratio: 1.90-2.14) were the most distinct of other persona profiles compared with "successful maintainers." CONCLUSIONS: Participants with disability or who identified as 2SLGBTQIA+ (Two-Spirit, Lesbian, Gay, Bisexual, Transgender, Queer or Questioning, Intersex, and Asexual) were the least likely to enact or maintain PA intentions. These audiences with lower societal privilege are most likely to need tailored PA promotion campaign content addressing unique barriers and facilitators to becoming "successful maintainers."

In Canada, there is limited research examining the associations between objectively measured neighborhood environments and physical activity (PA) and obesity. The purpose of this study was to determine the relationships between variables from built and social environments and PA and overweight/obesity across 86 Ottawa, Canada neighborhoods. Individual-level data including self-reported leisure-time PA (LTPA), height, and weight were examined in a sample of 4,727 adults from four combined cycles (years 2001/03/05/07) of the Canadian Community Health Survey (CCHS). Data on neighborhood characteristics were obtained from the Ottawa Neighbourhood Study (ONS); a large study of neighborhoods and health in Ottawa, Canada. Binomial multivariate multilevel models were used to examine the relationships between environmental and individual variables with LTPA and overweight/obesity using survey weights in men and women separately. Within the sample, ~75% of the adults were inactive (<3.0 kcal/kg/day) while half were overweight/obese. Results of the multilevel models suggested that for females greater park area was associated with increased odds of LTPA and overweight/obesity. Greater neighborhood density of convenience stores and fast food outlets were associated with increased odds of females being overweight/obese. Higher crime rates were associated with greater odds of LTPA in males, and lower odds of male and female overweight/obesity. Season was significantly associated with PA in men and women; the odds of LTPA in winter months were half that of summer months. Findings revealed that park area, crime rates, and neighborhood food outlets may have different roles with LTPA and overweight/obesity in men and women and future prospective studies are needed.

Following the first 1000 days of life that span from conception to two years of age, the next 1000 days of a child's life from 2–5 years of age offer a window of opportunity to promote nurturing and caring environments, establish healthy behaviours, and build on early gains to sustain or improve trajectories of healthy development. This Series paper, the first of a two-paper Series on early childhood development and the next 1000 days, focuses on the transition to the next 1000 days of the life course, describes why this developmental period matters, identifies the environments of care, risks, and protective factors that shape children's development, estimates the number of children who receive adequate nurturing care, and examines whether current interventions are meeting children's needs. Paper 2 focuses on the cost of inaction and the implications of not investing in the next 1000 days. In low-income and middle-income countries (LMICs), only 62 million children aged 3 and 4 years (25·4%) currently receive adequate nurturing care during the next 1000 days, leaving 181·9 million children exposed to risks that jeopardise their healthy development. Inputs across nurturing care dimensions of health, nutrition, protection, responsive care, and learning vary substantially across countries. In LMICs, although 86·2% of children have a healthy weight in this period, less than one in three children have access to developmental stimulation or are protected from physical punishment, and only 38·8% have access to early childhood care and education services. Intervention research in LMICs in the next 1000 days is scarce. The continuity of developmentally appropriate nurturing care, coordination across health, education, and protection sectors, and the implementation of interventions to support caregivers and improve the quality of education and care remain top priorities in this period. These sectors play key roles in promoting quality early care and education for this age group, which will help maximise developmental potential and opportunities of children globally and help progress towards the achievement of the Sustainable Development Goals.