Publications

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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 study determined if meeting the Canadian 24-Hour Movement Guidelines recommendations are associated with all-cause mortality. Participants were 3471 adults from the 2005-2006 U.S. National Health and Nutrition Examination Survey followed for mortality over 11 years. They were classified as meeting or not meeting recommendations for sleep duration, sedentary behaviour, and moderate-to-vigorous physical activity (MVPA). A total of 63.8%, 35.3%, and 41.5% of participants met recommendations for sleep, sedentary behaviour, and physical activity while 12.3% met all 3 recommendations. The hazard ratio (HR) for all-cause mortality in participants meeting the recommendations relative to those not meeting the recommendations were 0.91 (0.72, 1.16) for sleep, 0.92 (0.61, 1.40) for sedentary behaviour, and 0.42 (0.24, 0.74) for MVPA. The HR for meeting none, any 1, any 2, and all 3 recommendations were 1.00, 0.86 (0.65, 1.14), 0.49 (0.28, 0.86), and 0.72 (0.34, 1.50). When the cut-point used to denote acceptable sedentary time was changed from ≤8 to ≤10 hours/day, the HR for meeting none, any 1, any 2, and all 3 recommendations were 1.00, 0.83 (0.59, 1.15), 0.57 (0.34, 0.96), and 0.43 (0.20, 0.93). These findings provide some support of the ability of the 24-hour Movement Guidelines to predict mortality risk. Novelty: The 24-Hour Movement Guidelines provide recommendations for sleep, sedentary behaviour, and physical activity. The findings of this study provide some support of the ability of these new guidelines to predict mortality risk.

We review the evidence that supports cardiorespiratory fitness (CRF) as an important indicator of current and future health among school-aged children and youth, independent of physical activity levels. We discuss the merit of CRF measurement for population health surveillance and propose the development of CRF guidelines to help support regional, national, and international surveillance efforts.

Search strategy for the systematic review. (DOC 175 kb)

Optimal maternal folate status is associated with a reduction in the occurrence of neural tube defects (NTD). Socio‐demographic and lifestyle factors collected as part of the Canadian Health Measures and the National Health and Examination Surveys account for less than 30% of the variation in RBC folate concentration, a measure of tissue stores. Using a comprehensive literature‐derived list of potential predictors of folate status, our aim was to re‐evaluate maternal socio‐demographic, dietary and lifestyle factors associated with a RBC folate maximally protective against NTD (≥906 nmol/L) to determine the feasibility of developing a tool that could be used by health clinicians to predict RBC folate ≥906 nmol/L. A Block food frequency questionnaire, and detailed additional questions on: dietary sources of folate; folic acid and B12 supplement intake; education; ethnicity; income; birth status; age, smoking; and alcohol use were collected from 101 women of reproductive age. Mean RBC folate was 849.9±264.6 nmol/L as determined by microbial assay; 39% had RBC folate concentrations ≥906 nmol/L. Only higher folic acid supplement intake had a positive association (OR=2.6; 95% CI 1.38, 4.9) with RBC folate ≥906 nmol/L while low alcohol intake was negatively associated (OR=0.3; 95% CI 0.09, 1.0). We conclude that use of a comprehensive list of factors did not improve the prediction of RBC folate protective against NTD. Grant Funding Source : CIHR (218776), NSERC (46513), and Hospital for Sick Children RTC Matching Funds Program (BH)

Background: Childhood is a critical period for brain development, and the behaviours that comprise a typical 24-hour day contribute to cognitive performance in children. This study investigated the relationship between cognition and meeting the 24-hour movement behaviour guidelines of ≥60 minutes of physical activity, ≤2 hours of recreational screen time, and 9-11 hours of sleep per day in 9-10 year olds.

It is unknown if young children's parent-reported physical activity and sedentary time are correlated with direct measures. The study objectives were to compare parent-reported physical and sedentary activity versus directly measured accelerometer data in early childhood. From 2013 to 2014, 117 healthy children less than 6 years of age were recruited to wear Actical accelerometers for 7 days. Accelerometer data and questionnaires were available on 87 children (74 %). Average daily physical activity was defined as the sum of activity ≥100 counts per minute, and sedentary time as the sum of activity <100 counts per minute during waking hours. Parents reported daily physical activity (unstructured free play in and out of school, and organized activities) and selected sedentary behaviors (screen time, stroller time, time in motor vehicle). Spearman correlation coefficients and Bland–Altman plots were used to assess the validity of parent-reported measures compared to accelerometer data. Total physical activity was significantly greater when measured by accelerometer than parent-report; the median difference was 131 min/day (p < 0.001). Parent-reported child physical activity was weak to moderately correlated with directly measured total physical activity (r = 0.39, 95 % CI 0.19, 0.56). The correlations between types of physical activity (unstructured free play in and outside of school/daycare, and organized structured activity) and accelerometer were r = 0.30 (95 % CI 0.09, 0.49); r = 0.42 (95 % CI 0.23, 0.58); r = 0.26 (95 % CI 0.05, 0.46), respectively. There was no correlation between parent-reported and accelerometer-measured total sedentary time in children (r = 0.10, 95 % CI −0.12, 0.33). When the results were stratified by age group (<18, 18–47, and 48–70 months of age) no statistically significant correlations were observed and some inverse associations were observed. The correlation between parent-report of young children's physical activity and accelerometer-measured activity was weak to moderate depending on type of activity and age group. Parent-report of children's sedentary time was not correlated with accelerometer-measured sedentary time. Additional validation studies are needed to determine if parent-reported measures of physical activity and sedentary time are valid among children less than 6 years of age and across these young age groups.

Self-reported screen time is associated with elevated health risk in children and youth; however, research examining the relationship between accelerometer-measured sedentary time and health risk has reported mixed findings. The purpose of this study was to examine the association between accelerometer-measured patterns of sedentary time and health risk in children and youth. The results are based on 1,608 children and youth aged 6 to 19 years from the Canadian Health Measures Survey (2007–2009). Sedentary time was measured using the Actical accelerometer. Breaks in sedentary time and prolonged bouts of sedentary time lasting 20 to 120 minutes were derived for all days, weekend days and during the after-school period (i.e., after 3 pm on weekdays). Regression analyses were used to examine the association between patterns of sedentary time and body mass index (BMI), waist circumference, blood pressure and non-HDL cholesterol. Boys accumulated more sedentary time on weekdays after 3 pm and had a higher number of breaks in sedentary time compared to girls. Overweight/obese boys (aged 6–19 years) accumulated more sedentary time after 3 pm on weekdays (282 vs. 259 min, p < .05) and as prolonged bouts lasting at least 80 minutes (171 vs. 133 min, p < .05) compared to boys who were neither overweight nor obese. Prolonged bouts of sedentary time lasting at least 80 minutes accumulated after 3 pm on weekdays were positively associated with BMI and waist circumference in boys aged 11–14 years (p < .006). Each additional 60 min of sedentary time after 3 pm on weekdays was associated with a 1.4 kg·m-2 higher BMI and a 3.4 cm higher waist circumference in 11–14 year old boys. No sedentary pattern variables differed between girls who were not overweight or obese and those who were overweight/obese and none of the sedentary pattern variables were associated with any health markers in girls. The findings confirm results of other studies that reported accelerometer-measured sedentary time was not associated with health risk in children and youth. Even when the pattern and timing of sedentary time was examined relative to health markers, few associations emerged and were limited to boys aged 11–14 years.

Meeting the 24-Hour Movement Guidelines (physical activity, screen time, and sleep duration) has been associated with positive health indicators. However, there are no previous meta-analyses that have examined the overall adherence to the 24-Hour Movement Guidelines from pre-school to adolescence across the world. Therefore, the main purpose of this systematic review and meta-analysis was to examine the overall (non)adherence to the 24-Hour Movement Guidelines among preschoolers, children, and adolescents worldwide.

Background A recent dialogue in the field of play, learn, and teach outdoors (referred to as “PLaTO” hereafter) demonstrated the need for developing harmonized and consensus-based terminology, taxonomy, and ontology for PLaTO. This is important as the field evolves and diversifies in its approaches, contents, and contexts over time and in different countries, cultures, and settings. Within this paper, we report the systematic and iterative processes undertaken to achieve this objective, which has built on the creation of the global PLaTO-Network ( PLaTO-Net ). Methods This project comprised of four major methodological phases. First, a systematic scoping review was conducted to identify common terms and definitions used pertaining to PLaTO. Second, based on the results of the scoping review, a draft set of key terms, taxonomy, and ontology were developed, and shared with PLaTO members, who provided feedback via four rounds of consultation. Third, PLaTO terminology, taxonomy, and ontology were then finalized based on the feedback received from 50 international PLaTO member participants who responded to ≥ 3 rounds of the consultation survey and dialogue. Finally, efforts to share and disseminate project outcomes were made through different online platforms. Results This paper presents the final definitions and taxonomy of 31 PLaTO terms along with the PLaTO-Net ontology model. The model incorporates other relevant concepts in recognition that all the aspects of the model are interrelated and interconnected. The final terminology, taxonomy, and ontology are intended to be applicable to, and relevant for, all people encompassing various identities (e.g., age, gender, culture, ethnicity, ability). Conclusions This project contributes to advancing PLaTO-based research and facilitating intersectoral and interdisciplinary collaboration, with the long-term goal of fostering and strengthening PLaTO’s synergistic linkages with healthy living, environmental stewardship, climate action, and planetary health agendas. Notably, PLaTO terminology, taxonomy and ontology will continue to evolve, and PLaTO-Net is committed to advancing and periodically updating harmonized knowledge and understanding in the vast and interrelated areas of PLaTO.