Health associations with meeting new 24-hour movement guidelines for Canadian children and youth

Carson V, Chaput JP, Janssen I, Tremblay MS.

Prev Med. 2016 Dec 5;95:7-13.

Abstract

The study objective was to examine whether meeting the new Canadian 24-hour movement guidelines was associated with health indicators in a representative sample of Canadian children and youth. Cross-sectional findings are based on 4157 (1239 fasting subsample) children and youth aged 6-17years from cycles 1-3 of the Canadian Health Measures Survey (CHMS). Sleep and screen time were subjectively measured while moderate- to vigorous-intensity physical activity (MVPA) was accelerometer-determined. Health indicators in the full sample (body mass index (BMI) z-scores, waist circumference, blood pressure, behavioral strengths and difficulties score (lower=better), and aerobic fitness) and fasting subsample (triglycerides, high-density lipoprotein (HDL)-cholesterol, C-reactive protein, and insulin) were measured. Meeting the overall guidelines was defined as: 9-11 hour/night (5-13years) or 8-10 hour/day (14-17years) of sleep, ≤2 hour/day of screen time, and ≥60 minute/day of MVPA. Compared to meeting all three recommendations, meeting none, one, and two recommendations were associated with a higher BMI z-score, waist circumference, and behavioral strengths and difficulties score and lower aerobic fitness in a gradient pattern (Ptrend<0.05). Additionally, compared to meeting all three recommendations, meeting none and one recommendation were associated with higher systolic blood pressure and insulin (Ptrend<0.05). Finally, compared to meeting all three recommendations, meeting no recommendations was associated with higher triglycerides and lower HDL-cholesterol (Ptrend<0.05). Collectively, meeting more recommendations within the 24-hourmovement guidelines was associated with better overall health. Since a small proportion (17%) of this representative sample was meeting the overall guidelines, efforts to promote adoption are needed.

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Integrating sleep, sedentary behaviour, and physical activity research in the emerging field of time-use epidemiology: definitions, concepts, statistical methods, theoretical framework, and future directions

Pedišić Z, Dumuid D, Olds T.

Kinesiology. 2017 49(2):xxx-xxx.

Abstract

Nearly 70 years of sleep, sedentary behaviour, physical activity, and time-use research has led to the recent development of time-use epidemiology. To conceptualise the emerging research field and provide a framework for its further development, this paper defines its position among the established branches of science, explains its main concepts and defines associated terms, recommends suitable data analysis methods, proposes a theoretical model for future research, and identifies key research questions. Time-use epidemiology is defined as the study of determinants, incidence, distributions, and effects of health-related time-use patterns in populations and of methods for preventing unhealthy time-use patterns and achieving the optimal distribution of time for population health. As a theoretical model for future studies, this paper proposes the Framework for Viable Integrative Research in Time-Use Epidemiology (VIRTUE framework), acknowledging the compositional nature of time-use data and incorporating research on: 1) methods in time-use epidemiology; 2) outcomes of health-related components of time use; 3) optimal time-use balance and its prevalence in populations; 4) determinants and correlates of health-related components of time use; and 5) effectiveness of time-use interventions. It is likely that in total more deaths worldwide can be attributed to unhealthy time use than to smoking or obesity, potentially making it the most relevant modifiable behavioural and lifestyle risk factor of our time. We hope that governments and leading health organisations will recognise enormous importance of healthy time use, and provide adequate support for future research in time-use epidemiology.

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Meeting Canada’s new 24-Hour Movement Guidelines for Children and Youth: Results from the Canadian Health Measures Survey

Roberts KC, Xiaoquan Y, Carson V, Chaput J-P, Janssen I, Tremblay MS.

Health Reports 28(10):3-7, 2017.

Abstract

The Canadian 24-Hour Movement Guidelines for Children and Youth: An Integration of Physical Activity, Sedentary Behaviour, and Sleep, provide specific recommendations on the amount of time over a typical 24-hour day that children and youth aged 5 to 17 should spend in moderate-to-vigorous physical activity (at least 60 minutes), recreational screen time (no more than 2 hours), and sleep (9 to 11 hours for 5- to 13-year-olds; 8 to 10 hours for 14- to 17-year-olds). DATA AND METHODS: Based on combined results of cycles 2 (2009-to-2011) and 3 (2012-to-2013) of the Canadian Health Measures Survey, this analysis examines average daily moderate-to-vigorous physical activity, screen time and sleep duration of 5- to 11-year-olds and 12- to 17-year-olds, and the percentages meeting the 24-Hour Guidelines‘ recommendations. Findings are presented overall and by age group and sex. Differences in average daily times between groups were tested for statistical significance, as were differences between groups in the percentages meeting each recommendation and combination of recommendations. RESULTS: Overall, 17.5% of children and youth met the 24-Hour Guidelines‘ specific time recommendations. Higher percentages of children than youth (29.6% versus 5.5%) and boys than girls (22.9% versus 11.8%) met the recommendations. About a third (36.3%) met two of the three recommendations. INTERPRETATION: Recommendations for moderate-to-vigorous physical activity, sedentary behaviour, and sleep have higher levels of adherence among children than youth.

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Physical activity of Canadian children and youth, 2007 to 2015

Colley RC, Carson V, Garriguet D, Janssen I, Roberts KC, Tremblay MS.

Health Reports 28(10):8-16, 2017.

Abstract

BACKGROUND: This study describes and compares the percentages of Canadian children and youth who adhere to different operational definitions of the moderate-to-vigorous physical activity (MVPA) recommendation of 60 minutes per day. DATA AND METHODS: Data for 6- to 17-year-olds (n = 5,608) were collected from 2007 through 2015 as part of the Canadian Health Measures Survey. MVPA was measured using the Actical accelerometer. The MVPA recommendation was operationalized as accumulating 60 minutes of MVPA every day, on most days, and on average. RESULTS: Data from the most recent cycle of the Canadian Health Measures Survey indicate that 7% of children and youth accumulated at least 60 minutes of MVPA on at least 6 out of 7 days, and 33% achieved a weekly average of at least 60 minutes per day. Boys accumulated more MVPA than did girls, and 6- to 11-year-olds accumulated more MVPA than did 12- to 17-year-olds. Regardless of how adherence to the recommendation is operationalized, MVPA levels among Canadian children and youth did not change over the 9-year period from 2007 to 2015. INTERPRETATION: The majority of Canadian children do not meet the physical activity recommendation, regardless of the operational definition used. However, the discrepancies between results based on different interpretations of the 60-minutes-per-day recommendation highlight the importance of explicitly reporting how recommendations are operationalized to avoid misinterpreting trends and comparisons.

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Proportion of children meeting recommendations for 24-hour movement guidelines and associations with adiposity in a 12-country study

Roman-Viñas B, Chaput JP, Katzmarzyk PT, Fogelholm M, Lambert EV, Maher C, Maia J, Olds T, Onywera V, Sarmiento OL, Standage M, Tudor-Locke C, Tremblay MS; ISCOLE Research Group.

Int J Behav Nutr Phys Act. 2016 Nov 25;13(1):123.

Abstract

BACKGROUND: The Canadian 24-h movement guidelines were developed with the hope of improving health and future health outcomes in children and youth. The purpose of this study was to evaluate adherence to the 3 recommendations most strongly associated with health outcomes in new 24-h movement guidelines and their relationship with adiposity (obesity and body mass index z-score) across countries participating in the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE). METHODS: Cross-sectional results were based on 6128 children aged 9-11 years from the 12 countries of ISCOLE. Sleep duration and moderate-to-vigorous physical activity (MVPA) were assessed using accelerometry. Screen time was measured through self-report. Body weight and height were measured. Body mass index (BMI, kg · m-2) was calculated, and BMI z-scores were computed using age- and sex-specific reference data from the World Health Organization. Obesity was defined as a BMI z-score > +2 SD. Meeting the overall 24-h movement guidelines was defined as: 9 to 11 h/night of sleep, ≤2 h/day of screen time, and at least 60 min/day of MVPA. Age, sex, highest parental education and unhealthy diet pattern score were included as covariates in statistical models. Associations between meeting vs. not meeting each single recommendation (and combinations) with obesity were assessed with odds ratios calculated using generalized linear mixed models. A linear mixed model was used to examine the differences in BMI z-scores between children meeting vs. not meeting the different combinations of recommendations. RESULTS: The global prevalence of children meeting the overall recommendations (all three behaviors) was 7%, with children from Australia and Canada showing the highest adherence (15%). Children meeting the three recommendations had lower odds ratios for obesity compared to those meeting none of the recommendations (OR = 0.28, 95% CI 0.18-0.45). Compared to not meeting the 24-h movement recommendations either independently or combined, meeting them was significantly associated with a lower BMI z-score. Whenever the MVPA recommendation was included in the analysis the odds ratios for obesity were lower. CONCLUSIONS: For ISCOLE participants meeting these 3 healthy movement recommendations the odds ratios of being obese or having high BMI z-scores were lower. However, only a small percentage of children met all recommendations. Future efforts should aim to find promising ways to increase daily physical activity, reduce screen time, and ensure an adequate night’s sleep in children. TRIAL REGISTRATION: The International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) as registered at ClinicalTrials.gov (Identifier NCT01722500) (October 29, 2012).

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The Physical Activity, Sedentary Behaviour and Sleep (PASS) Indicator Framework

Roberts KC, Butler G, Branchard B, Rao DP, Otterman V, Thompson W, Jayaraman G.

Health Promot Chronic Dis Prev Can. 2017 Aug;37(8):252-56.

Abstract

Physical activity surveillance in Canada has traditionally focussed on measuring and reporting on the most active end of the activity spectrum. Emerging research suggests that in addition to insufficient moderate-to-vigorous physical activity (MVPA), sedentary behaviour and inadequate sleep are also important risk factors
for chronic disease. In order to create effective public health policy and program initiatives to target all levels of activity (MVPA, light physical activity, sedentary behaviour and sleep), the demand for reliable,
nationally representative data and information on the patterns of all of these behaviours among Canadians has increased. As a result, the need for a broader, modernized approach to national physical activity surveillance, with the inclusion of sedentary behaviour, sleep and the proximal and distal factors that impact all of these behaviours, was identified as a priority for the Public Health Agency of Canada (PHAC) in 2014.

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