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We used a prevalence-based approach to estimate the economic costs associated with low muscle strength, as assessed using handgrip strength, in Canadian adults. We estimated the annual economic burden of low muscle strength at $3.0 billion, representing 2.2% of the 2021 Canadian burden of illness costs. The two most expensive chronic diseases attributable to low muscle strength were cardiovascular disease ($899 million) and type 2 diabetes ($880 million). A 10% decrease in the prevalence of low handgrip strength would save approximately $546 million per year, equivalent to an 18.1% cost reduction. Strategies to increase population-level muscle strength are needed to reduce healthcare costs and improve health. The economic cost associated with low muscle strength in Canadian adults is unknown. The total annual economic burden of low muscle strength in Canadian adults represents 2.2% of the overall burden of illness costs in 2021. We estimated that $546 million per year would be saved if the prevalence of low handgrip strength was reduced by 10%. [ABSTRACT FROM AUTHOR]

The time spent in sleep, sedentary behavior, and physical activity form a 24-hour movement behavior composition. The objective was to identify neighborhood physical environment features associated with multiple components of the movement behavior composition among 10 to 13-year-olds. Twenty-three neighborhood physical environment features were measured in 1 km buffers from the participantsʻ homes and from these walkability, traffic safety, dedicated play spaces, non-dedicated play spaces, noise, and artificial light indices were created. Moderate-to-vigorous physical activity, light physical activity, sedentary time, and sleep duration were measured. Compositional data analysis was used to establish differences in movement behaviors according to neighborhood physical environment features. One hundred and sixteen associations, reflecting four movement behaviors X 29 environment variables and indices, were examined. Only three of these were statistically significant. Therefore, neighborhood physical environment features were not meaningful correlates of 24-hour movement behaviors. [ABSTRACT FROM AUTHOR]

Background: Recent studies report that the health benefits of physical activity differ depending on whether the activity is performed in the morning, afternoon or evening. The purpose of this systematic review was to examine whether the timing of physical activity within the 24-hour day is associated with health. Methods: Five databases were searched for English or French language peer-reviewed studies that examined whether the timing of physical activity within the day is associated with health. No limits were placed on publication year, study population, study design or health outcomes. Studies that examined acute effects of physical activity or timing of physical activity around food intake were excluded. Results: This systematic review examined 35 studies, with 17 259 participants, and the following health outcomes: measures of sleep health, adiposity, fat-free mass and muscle size, cardiometabolic biomarkers, physical function and mobility, mental health, and risk of cardiovascular disease, cancer, and mortality. Heterogeneity across studies precluded meta-analyses, and we present our findings using narrative syntheses. Of the 35 studies, 11 reported that morning physical activity provides greater health benefits than afternoon/evening physical activity, while 12 found that morning physical activity provides fewer health benefits than afternoon/evening physical. In the remaining 12 studies, there was no clear difference in health benefits based on the timing of physical activity. The quality of evidence for the different health outcomes across study designs was very low. Conclusion: There is no consistent evidence that physical activity at one time of day provides more favourable health benefits than physical activity at a different time of day. [ABSTRACT FROM AUTHOR]

Background: The objective was to determine whether time spent in different types of sedentary behavior during adolescence are associated with the risk of developing type 2 diabetes in adulthood.Methods: Participants were 3942 adolescents aged 16 years who were part of the 1970 British Cohort Study. Sedentary behavior was assessed using a questionnaire that asked participants to indicate how much time they spent watching TV and videos, using the computer, reading, and doing homework. Incident cases of type 2 diabetes were determined quadrennially until 46 years of age. The association between adolescent sedentary behaviors and type 2 diabetes was determined using Cox proportional hazards regression that controlled for sex, body mass index, sugary beverage consumption, smoking status, physical activity at baseline, and physical activity in adulthood .Results: There were 91 incident cases of type 2 diabetes with an incidence rate of 9 cases/10,000 person-years. By comparison to those who watched TV and videos for 2 or less hours/day, type 2 diabetes risk was not different in those who watched for 2.1-4.0 h/day (HR = 0.89, 95% CI = 0.54, 1.47) but was increased by 2.06-fold (95% CI = 1.24, 3.43) in those who watched for more than 4 h/day. Time spent using a computer, reading, and doing homework were not significantly associated with type 2 diabetes.Conclusion: Spending more than 4 h/day watching television and videos at age 16 was associated with an increased risk of type 2 diabetes. Conversely, using a computer and non-screen based sedentary behaviors were not associated with type 2 diabetes risk. [ABSTRACT FROM AUTHOR]

Background: Daily time spent in sleep, sedentary behaviour (SED), light intensity physical activity (LIPA), and moderate-to-vigorous intensity physical activity (MVPA) are compositional, co-dependent variables. The objectives of this study were to use compositional data analysis to: (1) examine the relationship between the movement behaviour composition (daily time spent in sleep, SED, LIPA and MVPA) and all-cause mortality risk, and (2) estimate the extent to which changing time spent in any given movement behaviour (sleep, SED, LIPA, or MVPA) within the movement behaviour composition was associated with changes in risk of all-cause mortality. Methods: 2838 adult participants from the 2005–2006 cycle of the U.S. National Health and Nutrition Examination Survey were studied using a prospective cohort design. Daily time spent in SED, LIPA and MVPA were determined by accelerometer. Nightly time spent sleeping was self-reported. Survey data were linked with mortality data through to the end of December 2015. Compositional data analysis was used to investigate relationships between the movement behaviour composition and mortality. Results: The movement behaviour composition was significantly associated with mortality risk. Time spent in MVPA relative to other movement behaviours was negatively associated with mortality risk (HR =.74; 95% CI [.67,.83]) while relative time spent in SED was positively associated with mortality risk (HR = 1.75; 95% CI [1.10, 2.79]). Time displacement estimates revealed that the greatest estimated changes in mortality risk occurred when time spent in MVPA was decreased and replaced with sleep, SED, LIPA or a combination of these behaviours (HRs of 1.76 to 1.80 for 15 min/day displacements). Conclusions: The daily movement behaviour composition was related to mortality. Replacing time in MVPA or SED with equivalent time from any other movement behaviour was associated with an increase and decrease in mortality risk, respectively. [ABSTRACT FROM AUTHOR]

This systematic review determined if the composition of time spent in movement behaviours (i.e., sleep, sedentary behaviour (SED), light physical activity, and moderate-to-vigorous physical activity (MVPA)) is associated with health in adults. Five electronic databases were searched in August 2019. Studies were eligible for inclusion if they were peer-reviewed, examined community-dwelling adults, and used compositional data analysis to examine the associations between the composition of time spent in movement behaviours and health outcomes. Eight studies (7 cross-sectional, 1 prospective cohort) of >12 000 unique participants were included. Findings indicated that the 24-h movement behaviour composition was associated with all-cause mortality (1 of 1 analyses), adiposity (4 of 4 analyses), and cardiometabolic biomarkers (8 of 15 analyses). Reallocating time into MVPA from other movement behaviours was associated with favourable changes to most health outcomes and taking time out of SED and reallocating it into other movement behaviours was associated with favourable changes to all-cause mortality. The quality of evidence was very low for all health outcomes. In conclusion, these findings support the notion that the composition of movement across the entire 24-h day matters, and that recommendations for sleep, SED, and physical activity should be combined into a single public health guideline. (PROSPERO registration no.: CRD42019121641.) Novelty The 24-h movement behaviour composition is associated with a variety of health outcomes. Reallocating time into MVPA is favourably associated with health. Reallocating time out of SED is associated with favourable changes to mortality risk. [ABSTRACT FROM AUTHOR]

Aim: To: (1) explore how young people with epilepsy spend time on physical activity, screen-time, and sleep in a 24-hour period; (2) compare these findings to young people without epilepsy; and (3) evaluate the findings relative to the Canadian 24-hour movement guidelines for children and youth.Method: The study is based on Canadian data from the 2013 to 2014 'Health Behaviour in School-aged Children study' (HBSC), a cross-sectional sample of young people aged 10 to 17 years. Three groups participated: 163 young people with epilepsy, 3613 young people with non-neurological conditions, and 18 339 population norms. Self-reported activity data were compared across groups.Results: Demographics were similar across groups. Young people with epilepsy spent 5.8 hours per week on moderate-to-vigorous physical activity versus 5.6 hours per week in population norms; 32% met the recommended 1 hour or more per day. Screen-time was 8.7 hours per day versus 7.4 hours per day in population norms; only 5.4% met the 2 hours or less per day recommendation. Sleep duration was 10.2 hours per day versus 9.8 hours per day in population norms, and 50.7% met the recommendation. Overall, 25.7% of young people with epilepsy did not meet any of the guidelines, 60.5% met one, 13.5% met two, and 0.3% met all three recommendations; whereas 2.8% of population norms and 2% of young people with non-neurological conditions met all three recommendations.Interpretation: These data could inform future interventions and alert policy-makers, health care professionals, parents, educators, and advocacy-groups to the low adherence of young people with epilepsy with Canadian guidelines and their risk for poor health.What This Paper Adds: Young people with epilepsy adhere poorly to Canadian guidelines for daily sleep duration, physical activity, and sedentary screen time. Young people with epilepsy accumulate more screen-time than those with non-neurological conditions or population norms. [ABSTRACT FROM AUTHOR]

• The movement behavior composition was associated with high polysubstance use. • The strength and direction of this association differed based on grade and gender. • Reallocating time to sleep was associated with reduced polysubstance use in grades 6–8 students. • Decreasing physical activity was associated with increased polysubstance use in grades 9–10 boys. This study of grade 6–10 students used compositional analysis to examine the relationship between the movement behavior composition (time in sleep, screen time, and physical activity) and polysubstance use (frequency of using cigarettes, alternative tobacco products, alcohol, cannabis, and illicit drugs). In grades 6–8 students and grades 9–10 girls: 1) sleep was negatively associated with polysubstance use, 2) screen time was positively associated with polysubstance use, and 3) reallocating physical activity or screen time into sleep was associated with lower polysubstance use. In grades 9–10 boys, reallocating 60 min/day from physical activity into screen time or sleep was associated with greater polysubstance use. [ABSTRACT FROM AUTHOR]

Background: Children participate in four main types of physical activity: organized sport, active travel, outdoor active play, and curriculum-based physical activity. The objective of this study was to develop a valid approach that can be used to concurrently measure time spent in each of these types of physical activity. Methods: Two samples (sample 1: n = 50; sample 2: n = 83) of children aged 10–13 wore an accelerometer and a GPS watch continuously over 7 days. They also completed a log where they recorded the start and end times of organized sport sessions. Sample 1 also completed an outdoor time log where they recorded the times they went outdoors and a description of the outdoor activity. Sample 2 also completed a curriculum log where they recorded times they participated in physical activity (e.g., physical education) during class time. Results: We describe the development of a measurement approach that can be used to concurrently assess the time children spend participating in specific types of physical activity. The approach uses a combination of data from accelerometers, GPS, and activity logs and relies on merging and then processing these data using several manual (e.g., data checks and cleaning) and automated (e.g., algorithms) procedures. In the new measurement approach time spent in organized sport is estimated using the activity log. Time spent in active travel is estimated using an existing algorithm that uses GPS data. Time spent in outdoor active play is estimated using an algorithm (with a sensitivity and specificity of 85%) that was developed using data collected in sample 1 and which uses all of the data sources. Time spent in curriculum-based physical activity is estimated using an algorithm (with a sensitivity of 78% and specificity of 92%) that was developed using data collected in sample 2 and which uses accelerometer data collected during class time. There was evidence of excellent intra- and inter-rater reliability of the estimates for all of these types of physical activity when the manual steps were duplicated. Conclusions: This novel measurement approach can be used to estimate the time that children participate in different types of physical activity. [ABSTRACT FROM AUTHOR]

Introduction: The Canadian 24-Hour Movement Guidelines for Children and Youth were released in 2016. They contain specific recommendations on the daily time that 5- to 17-year-olds should devote to moderate-to-vigorous physical activity, recreational screen time, and sleep. The objective of this study was to estimate the proportion of Canadians aged 10 to 17 years that meet the recommendations contained within the 24-Hour Movement Guidelines for Children and Youth. Methods: A nationally representative sample of 22 115 young people was examined. Movement behaviour data were self-reported. Adherence to the guideline recommendations were based on the following: accumulation of at least 60 minutes per day of moderate- to-vigorous physical activity, no more than 2 hours per day of recreational screen time, and 9 to 11 hours/night of uninterrupted sleep for those aged 10 to 13 years or 8 to 10 hours/night for those aged 14 to 17 years. Results: Only 3% of the sample met all three of the key recommendations contained in the guidelines. Twenty-five percent met two of the recommendations, 51% met one of the recommendations, and 21% met none of the three recommendations. More children and youth met recommendations for sleep duration (66%) than for moderate-to-vigorous physical activity (35%) and screen time (8%). Conclusion: A small minority (< 3%) of Canadians aged 10 to 17 years met all three of the key recommendations contained in the 24-Hour Movement Guidelines for Children and Youth. [ABSTRACT FROM AUTHOR]

Objective:To provide a broad overview of the state of physical activity (PA) research in the form of (1) definitions of PA, (2) health benefits, (3) prevalence, (4) correlates and (5) interventions. Design:A high-level overview of published reviews of the literature. Results:Regular PA is an effective primary and secondary preventative strategy against at least 25 chronic medical conditions with risk reduction typically in the 20–30% range. While approximately 75% of adults meet recommended PA guidelines, the prevalence is slightly lower for women compared to men, and considerably lower for youth, older adults and those in higher income countries. Motivation, self-efficacy and self-regulation remain consistent correlates of PA. Interventions show PA changes in the small effect size range for adults and youth but the heterogeneity is considerable across studies. Only a few (aggregate of behavioural regulation strategies, supervision, high frequency of contact) reliable moderators of intervention success were identified across study quality, sample characteristics, theory/behaviour change techniques and delivery modes/settings. Conclusion:PA research should continue to examine the mechanisms causing health outcomes, the dose that can lead to clinically relevant changes in health status, the scope and validity of PA surveillance and innovative behaviour change techniques, while improving the reach and duration of PA interventions. [ABSTRACT FROM AUTHOR]

The Canadian 24-Hour Movement Guidelines for Children and Youth were released in 2016. These guidelines contained recommendations for moderate to vigorous physical activity, screen time, and sleep duration. The objectives of this study were to determine ( i) if achieving the individual recommendations and combinations of the recommendations within the guidelines is associated with indicators of physical, mental, and social health within children and youth; ( ii) if meeting the recommendation for a specific movement behaviour is associated with larger differences in physical, mental, and social health indicators compared with meeting the recommendations for the other specific movement behaviours; and ( iii) if physical, mental, and social health indicators differ according to different combinations of the guideline recommendations achieved. To address these objectives, we studied a representative sample of over 17 000 Canadians aged 10-17 years. The findings indicated that participants achieving any given recommendation had preferable scores for the health outcomes compared with participants who did not meet the recommendations. There was a dose-response pattern between the number of recommendations achieved and the health outcomes, indicating that the health outcomes improved as more recommendations were achieved. When the number of recommendations achieved was the same, there were no differences in the health outcomes. For instance, health indicators scores were not different in the group who achieved the sleep and screen time recommendations, the group who achieved sleep and moderate to vigorous physical activity recommendations, and the group who achieved screen time and moderate to vigorous physical activity recommendations. [ABSTRACT FROM AUTHOR]

The objective of this study was to estimate health care and health-related productivity costs associated with low cardiorespiratory fitness (CRF) in Canadian adults. We also estimated costs that would be avoided by a 10 percentage point prevalence reduction in low CRF. A prevalence-based approach was used to estimate the economic costs associated with low CRF. Three pieces of information were used: (1) the pooled relative risk estimates of adverse health outcomes consistently associated with low CRF obtained from meta-analyses of prospective cohort studies; (2) the prevalence of low CRF in Canadian men and women obtained from a nationally representative sample; and (3) the direct (health care) and indirect (lost productivity due to premature mortality) costs of the adverse health outcomes based on the Economic Burden of Illness in Canada data. We estimated the total annual economic burden of low CRF in Canadian adults at CAD$3.6 billion, representing 2.7% of the overall Canadian burden of illness costs in 2021. The three most expensive chronic diseases attributable to low CRF were type 2 diabetes (CAD$1.3 billion), heart disease (CAD$701 million), and depression/anxiety (CAD$565 million). Prescription drug expenditures and hospital care expenditures were the main contributors to the total economic burden. An absolute 10% reduction in the prevalence of low CRF (from 45.5% to 35.5%) would save an estimated CAD$644 million per year in costs. In conclusion, low CRF is an important contributor to the economic burden of illness in Canada. Evidence-based and cost-effective strategies that aim to increase CRF at the population level may help alleviate health care costs and improve health. • The economic burden of low cardiorespiratory fitness (CRF) in Canada is estimated at CAD$3.6 billion in 2021. • The economic burden of low CRF represents 2.7% of the overall burden of illness costs for 2021 in Canada. • An absolute 10% reduction in the prevalence of low CRF would save an estimated CAD$644 million per year. [ABSTRACT FROM AUTHOR]

Background: Childrens' outdoor active play is an important part of their development. Play behaviour can be predicted by a variety of physical and social environmental features. Some of these features are difficult to measure with traditional data sources. Methods: This study investigated the viability of a machine learning method using Google Street View images for measurement of these environmental features. Models to measure natural features, pedestrian traffic, vehicle traffic, bicycle traffic, traffic signals, and sidewalks were developed in one city and tested in another. Results: The models performed well for features that are time invariant, but poorly for features that change over time, especially when tested outside of the context where they were initially trained. Conclusion: This method provides a potential automated data source for the development of prediction models for a variety of physical and social environment features using publicly accessible street view images. Highlights: This study describes an automated method for selecting StreetView images in a given area and extracting from them measures of the built and social environment. Measures obtained in this way are benchmarked against publicly available ground truth measures. The effectiveness of this method varies depending on the nature of the variable being measured. [ABSTRACT FROM AUTHOR]

Insufficient sleep is a serious problem in adolescents and school start time is thought to be a key contributor. This study provided the first comprehensive assessment of school start times across Canada and examined whether school start times were associated with sleep duration and tiredness among adolescents. We collected information on school start times from 362 schools that participated in the 2013/2014 Health Behaviour in School-aged Children study. We calculated sleep duration from weekday bedtime and wake time reported by 29 635 students (aged 10-18 years). We classified weekday sleep as sufficient if it met national recommendations, and used data on self-reported tiredness at school in the morning. Random-effects regression models estimated the association of school start time with sleep duration, sleep sufficiency and tiredness. On average, schools started at 08:43 hours. Students slept an average of 8:36 h on weekdays and 69% met sleep duration recommendations, but 60% reported feeling tired in the morning. Every 10-min delay in school start time corresponded with 3.2 [95% confidence interval ( CI): 2.0, 4.5] additional minutes of sleep, a 1.6% (95% CI: 0.5, 2.8) greater probability of sufficient sleep and a 2.1% (95% CI: 1.0, 3.2) smaller probability of feeling tired at school in the morning. Students from schools that started later slept longer, were more likely to meet sleep recommendations and were less likely to report feeling tired in the morning. The study adds weight to the mounting evidence that delaying school start time benefits adolescent sleep. [ABSTRACT FROM AUTHOR]

The objective of this study was to provide contemporary sleep duration estimates of Canadian school-aged children and adolescents and to determine the proportion adhering to the sleep duration recommendations. This study included 24 896 participants aged 10-17 years from the 2013/2014 Canadian Health Behaviour in School-aged Children study ( HBSC), a nationally representative cross-sectional study. Bedtime and wake-up times were reported by participants and their sleep duration was calculated. Participants were then classified as having a sleep duration that met the recommended range (9-11 h per night for 10-13-year-olds or 8-10 h per night for 14-17-year-olds), a sleep duration that was shorter than the recommended range or a sleep duration that was longer than the recommended range. An estimated 68% of children aged 10-13 years and 72% of adolescents aged 14-17 years sleep for the recommended amount per night when averaged across all days of the week. Short sleepers represent 31% of school-aged children and 26% of adolescents. Long sleepers are rare (<2% overall). Children and adolescents sleep ~1 h more at weekends compared to weekdays. Approximately 5% of the participants typically went to bed after midnight on weekdays and 31% did so at weekends; these proportions reached 11 and 45%, respectively, within 16-17-year-olds. In general, differences in sleep times between boys and girls are small and not clinically significant. In conclusion, almost one-third of Canadian children and adolescents sleep less than the recommended amount. Public health efforts should continue to monitor the sleep of Canadian children and adolescents and identify subgroups of the population more likely to be affected by insufficient sleep. [ABSTRACT FROM AUTHOR]

Objectives: Acculturation is a multidimensional process involving changes in behaviour and beliefs. Questionnaires developed to measure acculturation are typically designed for specific ethnic populations and adult experiences. This study developed a questionnaire that measures acculturation among ethnically diverse populations of youth that can be included as a module in population surveys. Methods: Questionnaires measuring acculturation in youth were identified in the literature. The importance of items from the existing questionnaires was determined using a Delphi process and this informed the development of our questionnaire. The questionnaire was then pilot tested using a sample of 248 Canadians aged 18–25 via an online system. Participants identified as East and South East Asian (27.8%), South Asian (17.7%) and Black (13.7%). The majority were 1st (33.5%) or 2nd generation immigrants (52.0%). After redundant items were eliminated, exploratory factor analysis grouped items into domains, and, for each domain, internal consistency, and convergent validity with immigrant generation then age at immigration estimated. A subset of participants re-completed the questionnaire for reliability estimation. Results: The literature review yielded 117 articles that used 13 questionnaires with a total of 440 questions. The Delphi process reduced these to 32 questions. Pilot testing occurred in 248 Canadians aged 18–25. Following item reduction, 16 questions in three domains remained: dominant culture, heritage language, and heritage culture. All had good internal consistency (Cronbach’s alphas > .75). The mean dominant domain score increased with immigrant generation (1st generation: 3.69 (95% CI: 3.49–3.89), 2nd: 4.13 (4.00–4.26), 3rd: 4.40 (4.19–4.61)), and mean heritage language score was higher among those who immigrated after age 12 than before (p = .0001), indicative of convergent validity. Conclusions: This Bicultural Youth Acculturation Questionnaire has demonstrated validity. It can be incorporated into population health surveys to elucidate the impact of acculturation on health outcomes among bicultural youth. [ABSTRACT FROM AUTHOR]

The objectives were to determine whether: (1) playability features differed across walkable and non-walkable school neighborhoods, and (2) physical activity differed in children living in walkable and non-walkable school neighborhoods. A total of 3912 grade 6-8 students from 132 school neighborhoods were studied. There was more developed park space in high walkability neighborhoods than low walkability neighborhoods. Other playability features were more preferable in the low (e.g., undeveloped treed and water areas) and moderate (e.g., physical disorder/esthetics) walkability neighborhoods. Children from low walkability neighborhoods were more likely to engage in free-time physical activity outside of school and to achieve recommended levels of moderate-to-vigorous physical activity than were children from high walkability neighborhoods. [ABSTRACT FROM AUTHOR]

Objective To explore associations between helicopter, little emperor, tiger mom, and concerted cultivation hyper-parenting styles with child physical activity. Methods 724 North American parents of 7-12 year olds completed a survey (May, 2014) that assessed their engagement in the hyper-parenting styles and the frequency that their child played outdoors, walked/bicycled, and played organized sports. Z-scores were generated for each hyper-parenting style and four groups were created: low (<- 1 SD), below average (- 1 to - 0.49 SD), average (- 0.50 to 0.50 SD), above average (0.51 to 0.1.0 SD), and high (> 1 SD). Results Outdoor play, active transportation, and organized sport did not differ across helicopter parenting groups. Children in the low little emperor group had higher (P < 0.005) outdoor play and active transportation scores than children in the average, above average, and high groups (exception: high group for outdoor play). Children in the low tiger mom and concerted cultivation groups had higher (P < 0.005) outdoor play, active transportation, and organized sport scores than children in the average, above average, and high groups (exceptions: average and high tiger mom groups for organized sport). Conclusions Little emperor, tiger mom, and concerted cultivation parenting styles were associated with lower physical activity among 7-12 year olds. [ABSTRACT FROM AUTHOR]

Background: Research on the association between the physical environment and physical activity in children has focused on built and developed features or total green space. The impact of natural, undeveloped green spaces is unknown. The objective of this study was to determine whether the presence of undeveloped green spaces in the home neighborhood are associated with physical activity in 11 to 13-year-olds. Methods: This was a cross-sectional study of grade 6 to 8 urban residing Canadian students who participated in the 2009/10 Health Behaviour in School-Aged Children survey. Children self-reported the frequency they participated in physical activity in their free-time outside of school hours. Geographic Information Systems (GIS) were used to assess the proportion of land area within 1 km of participants' homes that was devoted to publicly accessible meadows (i.e., field vegetated primarily by grass and other non-woody plants) and treed areas (i.e., field vegetated primarily by trees and shrubs). Ordinal logistic regression models were used to examine the relationships between the undeveloped green space areas and free-time physical activity. Several intrapersonal, family, and neighborhood environment factors were controlled for in these regression models. Results: The proportion of neighborhood land covered by meadows was not associated with the physical activity outcome (p > 0.6). However, the proportion of neighborhood land covered by treed areas was independently associated with the physical activity outcome (p = 0.02). For each additional 5% increase in the proportion of neighborhood land covered by treed areas there was a corresponding 5% increase (95% confidence interval: 1-10% increase) in the relative odds of increasing free-time physical activity outside of school hours. Conclusions: The physical activity levels of 11 to 13-year-old children was associated with the amount of space in their home neighborhood devoted to treed areas. [ABSTRACT FROM AUTHOR]

This study analyzed the prospective relationship of community social disorder with sedentary behavior, sport participation, and adiposity in Mexican adults from the National Mexican Family Life Survey (MxFLS). The sample included 8307 adults (aged ≥20 years) from 145 communities. During a three-year follow-up, participants from communities with high social disorder had a 1.36 cm larger increase in waist circumference than participants from communities with low social disorder. However, there were no differences in body mass index, television, or sport participation. These findings emphasize the need to promote healthy social environments in local communities. [ABSTRACT FROM AUTHOR]

Objective To determine whether perceptions of neighborhood safety and measures of neighborhood crime are independently associated within physical activity in youth. Methods The study sample consisted of 14,125 youths in grades 6-10 (ages 11-15) who participated in the nationally representative cross-sectional 2009/10 Canadian Health Behaviour in School-Aged Children Survey. Participants responded to four questions about how safe their home neighborhood is and reported whether or not they accumulated at least 4h/week of physical activity in their free-time outside of school hours. Crimes against persons was assessed in 1km radius buffers around participants' homes. Associations were assessed using logistic regression. Results After controlling for crime and relevant confounders, the relative odds of being physically active outside of school was 0.52 (95% CI: 0.44-0.62) in youth whose perceptions of neighborhood safety were in the lowest quintile. After controlling for perceptions of safety and relevant confounders, the relative odds of being physically active outside of school was 0.75 (0.60-0.95) in youth from neighborhoods with crimes against persons scores in the highest quintile. Conclusions Within this large sample of 11-15year olds, perceptions and objective measures of neighborhood safety and crime were independently associated with physical activity in free-time outside of school. [ABSTRACT FROM AUTHOR]

Background The study objectives were to examine whether: 1) sedentary time is associated with sleep duration, 2) sedentary time predicts the metabolic syndrome (MetS) independent of sleep duration and vice versa, and 3) sedentary time and sleep duration have an interactive effect on the MetS. Methods This cross-sectional study is based on the 2003-2006 National Health and Nutrition Examination Survey. A sample of 1371 adults (aged ⩾20 years) were studied. Average daily sedentary time and sleep duration were determined via 7-day accelerometry. Screen time was determined via questionnaire. The MetS was determined using standard criteria. Analysis of variance was used to examine relationships among sedentary time and screen time with sleep duration. Logistic regression was used to examine associations between sedentary time, screen time, and sleep duration with the MetS after controlling for several confounders. Results Sedentary time and screen time did not vary across sleep duration quartiles. Participants in the highest quartile of sedentary time were more likely to have the MetS than participants in the lowest quartile (odds ratio = 1.60, 95% CI:1.05-2.45). The odds of the MetS was higher in participants in the highest screen time tertile as compared to the lowest tertile (odds ratio = 1.67, 95% confidence interval:1.13-2.48). Sleep duration was not independently related to the MetS. There were no significant sedentary time X sleep duration interactions on the MetS. Conclusion Highly sedentary individuals and individuals with a high screen time are more likely to have the MetS. [ABSTRACT FROM AUTHOR]

The study objective was to estimate the proportion of excessive fast-food consumption by youth that is attributable to living and attending school in a neighbourhood with a moderate or high density of fast-food restaurants. This was a cross-sectional study of 6099 Canadian youths (aged 11-15 years) from 255 school neighbourhoods. All participants lived within 1 km of their school. The density of chain fast-food restaurants within a 1-km circular buffer surrounding each school was determined using geographic information systems. Excessive fast-food consumption (≥2 times per week) was assessed by questionnaire. Multilevel logistic regression analysis was used to examine associations. The population attributable risk estimates of excessive fast-food consumption due to neighbourhood exposure to fast-food restaurants were determined based on the prevalence of exposure and the results from the logistic regression. Eight percent of participants were excessive fast-food consumers. After adjusting for sociodemographic factors (i.e., gender, race, and socioeconomic status), it was found that youths from neighbourhoods with a moderate (odds ratio (OR), 1.68; 95% confidence interval (CI), 1.11-2.54) or high (OR 1.70; 95% CI 1.12-2.56) density of chain fast-food restaurants were more likely to be excessive fast-food consumers than were youths from neighbourhoods with no chain fast-food restaurants. Approximately 31% of excessive consumption was attributable to living in neighbourhoods with a moderate or high density of fast-food restaurants. Thus, the fast-food retail environment within which youth live and go to school is an important contributor to their eating behaviours. [ABSTRACT FROM AUTHOR]

Purpose: Physical activity guidelines recommend that adults accumulate at least 150 min of moderate- to-vigorous physical activity (MVPA) per week in bouts of at least 10 min. However, sporadic MVPA contributes significantly to total physical activity and may also affect health. The study objective was to determine, within adults age 18 to 64 yr, whether MVPA accumulated in bouts is more strongly associated with metabolic syndrome (MetS) than an equivalent volume of MVPA accumulated sporadically. Methods: The study sample included 1119 adults age 18 to 64 yr from the 2007-2009 Canadian Health Measures Survey, a nationally representative cross-sectional study. The energy expenditure from bouted (at least 10 consecutive minutes) and sporadic (<10 consecutive minutes) MVPA was measured for 7 d using Actical accelerometers. The presence of MetS was determined using established criteria. Associations were examined using logistic regression and controlled for covariates (age, sex, education, diet, and smoking). Results: After adjusting for the covariates and each other, bouted and sporadic MVPA were independently associated with the MetS. For each additional MET-hour per week of bouted MVPA, the relative odds of the MetS decreased by 9% (95% confidence interval, 3%- 14%). For each additional MET-hour per week of sporadic MVPA, the relative odds of the MetS decreased by 11% (5%-16%). Overlapping confidence interval indicates no difference in the effect estimates for bouted and sporadic MVPA. Secondary analyses revealed that small bursts of sporadic MVPA (1-3 min) were meaningful when predicting the MetS. Conclusion: Within this representative sample of Canadian adults, sporadic MVPA was associated with the MetS to a similar order of magnitude as an equivalent volume of bouted MVPA. [ABSTRACT FROM AUTHOR]

Background Lifestyles such as unhealthy diets and the lack of physical activity have been contributed to the increased prevalence of obesity. In 2012, the world health organization published the first global recommendation for physical activity and health. People who do not meet at least 150 minutes of moderate-to-vigorous physical activity are considered to be physically inactive. The prevalence of physical inactivity worldwide is 31%, however there is insufficient data from prevalence and trends of physical inactivity in Mexican population. The purposes of this study are to describe the physical inactivity prevalence and recent trends in Mexican adults and to examine the association between physical inactivity with biologic and sociodemographic characteristics. Methods Representative samples of 17,183 and 10,729 adults (aged 20 to 69 years) who participated in the National Health and Nutrition Survey (ENSANUT) in 2006 and 2012, respectively. Moderate-to-vigorous physical activity (MVPA) was assessed using the short form version of the International Physical Activity Questionnaire (IPAQ), which was administered in face-to- face interviews. Self-reported IPAQ MVPA levels were adjusted using an equation derived from a previous validation study. Participants were considered inactive if they engaged in <150-minutes/week of moderate physical activity or <75 minutes/week of vigorous physical activity according to WHO classification criteria. Results The prevalence of physical inactivity was significantly higher in 2012 (19.4%, 95%CI: 18.1, 20.7) than in 2006 (13.4%, 95%CI: 12.5, 14.5). Adults in the obese category, 60-69 age group, and those in the highest socioeconomic status tertile were more likely to be physically inactive. Conclusions The proportion of the Mexican adult population who do not meet the minimum WHO physical activity criteria has increased by 6% points between 2006 and 2012. Given the increasing prevalence of obesity, the aging of the population, and the shift in socioeconomic status in Mexico, physical inactivity could continue to increase in the coming years unless effective public health interventions are implemented. [ABSTRACT FROM AUTHOR]

Objective. To provide descriptive information on the screen time levels of Mexican children. Materials and methods. 5 660 children aged 10-18 years from the 2012 National Health and Nutrition Survey (ENSANUT 2012) were studied. Screen time (watching television, movies, playing video games and using a computer) was self-reported. Results. On average, children engaged in 3 hours/day of screen time, irrespective of gender and age. Screen time was higher in obese children, children from the northern and Federal District regions of the country, children living in urban areas, and children in the highest socioeconomic status and education categories. Approximately 33% of 10-14 year olds and 36% of 15-18 year olds met the screen time guideline of ≤2 hours/day. Conclusions. 10-18 year old Mexican children accumulate an average of 3 hours/day of screen time. Two thirds of Mexican children exceed the recommended maximal level of time for this activity. [ABSTRACT FROM AUTHOR]

Previous physical activity guidelines recommended that adults be active on most or all days of the week. Current guidelines recommend accumulating ≥150 min/week of moderate-to-vigorous physical activity (MVPA), with no recommendation for frequency. This study examined the association between the frequency of physical activity throughout the week and the metabolic syndrome (MetS) in physically active adults. This cross-sectional study included 2324 adults aged 18-64 years from the 2007-2011 cycles of the nationally representative Canadian Health Measures Survey. MVPA was measured over 7 days using Actical accelerometers. Physically active participants (≥150 min/week of MVPA) were assigned to frequently active (≥5 days/week with ≥30 min of MVPA) and infrequently active (1-4 days/week with ≥30 min of MVPA) groups. Associations were examined using logistic regression controlling for age, sex, and education. The relative odds of the MetS was 4.43 (95% confidence interval: 2.26-8.69) times higher in physically inactive participants than physically active participants. Within physically active participants, the relative odds of the MetS was 1.73 (0.87-3.41) times higher in the infrequently active group than the frequently active group. However, this was not a significant difference ( p = 0.11), and after adjustment for total weekly MVPA, the relative odds of the MetS in the infrequently active group was reduced to 0.85 (0.42-1.72). The frequency of physical activity throughout the week was not independently associated with the MetS among active adults. Conversely, the weekly volume of MVPA was strongly associated with the MetS. [ABSTRACT FROM AUTHOR]

Objective: We investigated the independent association between several neighbourhood built environment features and physical inactivity within a national sample of Canadian youth, and estimated the proportion of inactivity within the population that was attributable to these built environment features. Methods: This was a cross-sectional study of 6626 youth aged 11-15 years from 272 schools across Canada. Participants resided within 1 km of their school. Walkability, outdoor play areas (parks, wooded areas, yards at home, cul-de-sacs on roads), recreation facilities, and aesthetics were measured objectively within each school neighbourhood using geographic information systems. Physical inactivity (<5 days/week of 60 minutes of moderate-to-vigorous physical activity) was assessed by questionnaire. Multilevel logistic regression analyses, which controlled for several covariates, examined relationships between built environment features and physical inactivity. Results: The final regression model indicated that, by comparison to youth living in the least walkable neighbourhoods, the risks for physical inactivity were 28-44% higher for youth living in neighbourhoods in the remaining three walkability quartiles. By comparison to youth living in neighbourhoods with the highest density of cul-de-sacs, risks for physical inactivity were 28-32% higher for youth living in neighbourhoods in the lowest two quartiles. By comparison to youth living in neighbourhoods with the least amount of park space, risks for physical inactivity were 28-37% higher for youth living in the neighbourhoods with a moderate to high (quartiles 2 and 3) park space. Population attributable risk estimates suggested that 23% of physical inactivity within the population was attributable to living in walkable neighbourhoods, 16% was attributable to living in neighbourhoods with a low density of cul-de-sacs, and 15% was attributable to living in neighbourhoods with a moderate to high amount of park space. Conclusions: Of the neighbourhood built environment exposure variables measured in this study, the three that were the most highly associated with inactivity were walkability, the density of cul-de-sacs, and park space. The association between some of these features and youths' activity levels were in the opposite direction to what has previously been reported in adults and younger children. [ABSTRACT FROM AUTHOR]

Background: The influence of the fractionalization of moderate- to vigorous- intensity physical activity (MVPA) throughout the week on the health of children is unknown. We compared cardiometabolic risk factors in physically active children who accumulated their weekly MVPA in different patterns. Methods: We studied 745 participants aged 6-19 years. MVPA was measured using accelerometers over 7 days. Three groups were created: Insufficiently Active, <60 minutes/day of MVPA on average; Infrequently Active, ≥60 minutes/day of MVPA on average but exceeding the 60 minute target <5 days; and Frequently Active, ≥60 minutes/ day MVPA on average and exceeding the 60 minute target ≥5 days. Percentile scores for 8 cardiometabolic risk factors were determined. Results: The least favorable cardiometabolic risk factor profile was observed in the Insufficiently Active group. The Frequently Active group had more favorable (5-6 percentile unit difference) diastolic blood pressure, HDL-cholesterol, insulin resistance, and metabolic syndrome scores than the Infrequently Active group, although only the difference for insulin resistance was statistically significant (P < 0.05). These differences remained after controlling for the weekly volume of MVPA. Conclusion: The fractionalization of MVPA throughout the week was associated with insulin resistance. [ABSTRACT FROM AUTHOR]

Active transportation to school provides a means for youth to incorporate physical activity into their daily routines, and this has obvious benefits for child health. Studies of active transportation have rarely focused on the negative health effects in terms of injury. This cross-sectional study is based on the 2009/10 Canadian Health Behaviour in School-Aged Children survey. A sample of children aged 11-15 years (n=20 076) was studied. Multi-level logistic regression was used to examine associations between walking or bicycling to school and related injury. Regular active transportation to school at larger distances (approximately >1.6 km; 1.0 miles) was associated with higher relative odds of active transportation injury (OR: 1.52; 95% CI 1.08 to 2.15), with a suggestion of a dose-response relationship between longer travel distances and injury (p=0.02). Physical activity interventions for youth should encourage participation in active transportation to school, while also recognising the potential for unintentional injury. [ABSTRACT FROM AUTHOR]

Background: Physical inactivity is an important modifiable risk factor for noncommunicable disease. The degree to which physical activity affects the life expectancy of Americans is unknown. Purpose: This study estimated the potential years of life gained due to leisure-time physical activity in the U.S. Methods: Data from the National Health and Nutrition Examination Survey (2007–2010); National Health Interview Study mortality linkage (1990–2006); and U.S. Life Tables (2006) were used to estimate and compare life expectancy at each age of adult life for inactive (no moderate to vigorous physical activity); somewhat-active (some moderate to vigorous activity but <500 MET minutes/week); and active (≥500 MET minutes/week of moderate to vigorous activity) adults. Analyses were conducted in 2012. Results: Somewhat-active and active non-Hispanic white men had a life expectancy at age 20 years that was ∼2.4 years longer than that for the inactive men; this life expectancy advantage was 1.2 years at age 80 years. Similar observations were made in non-Hispanic white women, with a higher life expectancy within the active category of 3.0 years at age 20 years and 1.6 years at age 80 years. In non-Hispanic black women, as many as 5.5 potential years of life were gained due to physical activity. Significant increases in longevity were also observed within somewhat-active and active non-Hispanic black men; however, among Hispanics the years-of-life-gained estimates were not significantly different from 0 years gained. Conclusions: Leisure-time physical activity is associated with increases in longevity. [ABSTRACT FROM AUTHOR]

Objective There is evidence to suggest that excessive television viewing is an independent determinant of obesity in young people. However, the pathways between television viewing and obesity are not fully understood. Therefore, the purpose of this study was to examine whether the relationship between television and body mass index ( BMI) is mediated by television snacking and junk food consumption. Methods Results are based on 15 973 youth in grades 6-10 who participated in the Canadian 2009/2010 Health Behaviour in School- Aged Children Survey ( HBSC). Participants self-reported their weight and height and BMI z-scores were calculated based on World Health Organization growth standards. Participants reported the frequency of snacking while watching television and the frequency of eating junk food (sweets, soft drinks, baked goods, French fries, potato chips). Total hours per week of television were calculated. A contemporary multiple mediation analysis was used to examine associations. Results A modest positive relationship was observed between television viewing and BMI. The mean BMI z-score was 0.15 units higher in youth in the highest television viewing quartile by comparison with the youth in the lowest quartile. However, contrary to our hypothesis, television snacking and junk food consumption were not significant positive mediators of the television and BMI relationship. Conclusion The pathways between television viewing and obesity are complicated and remain poorly understood. Future research using longitudinal or experimental designs, more precise measurement tools and formal mediation analyses is needed. This research should consider mediators related to both energy intake and expenditure. [ABSTRACT FROM AUTHOR]

The purpose of this study was to provide a contemporary estimate of the health care cost of physical inactivity in Canadian adults. The health care cost was estimated using a prevalence-based approach. The estimated direct, indirect, and total health care costs of physical inactivity in Canada in 2009 were $2.4 billion, $4.3 billion, and $6.8 billion, respectively. These values represented 3.8%, 3.6%, and 3.7% of the overall health care costs. [ABSTRACT FROM AUTHOR]

Background Current physical activity guidelines imply that, by comparison with moderate physical activity (MPA), the benefits of engaging in vigorous physical activity (VPA) are attributed to the greater energy expenditure dose per unit of time and do not relate to intensity per se. The purpose of this study was to determine whether VPA influences the metabolic syndrome (MetS) independent of its influence on the energy expenditure dose of moderate-to-vigorous physical activity (MVPA).Methods Participants consisted of 1841 adults from the 2003–06 National Health and Nutrition Examination Survey, a representative cross-sectional study. MPA and VPA were measured objectively over 7 days using Actigraph accelerometers. MetS was determined using an established clinical definition. Associations between physical activity and the MetS were determined using logistic regression and controlled for relevant covariates.Results Analyses revealed that VPA remained a meaningful predictor of the MetS after controlling for the total energy expenditure dose of MVPA such that the relative odds of the MetS was 0.28 (95% confidence interval 0.17–0.46) in the group with the highest VPA compared with the group with no VPA. VPA had a greater influence on the MetS than an equivalent energy expenditure dose of MPA. For instance, between 0 and 500 MET min/week of MPA the adjusted prevalence of the MetS decreased by 15.5%, whereas between 0 and 500 MET min/week of VPA the prevalence decreased by 37.1%.Conclusion These cross-sectional findings suggest that VPA per se has an important role in cardiometabolic disease prevention. [ABSTRACT FROM AUTHOR]

Background: Clustering of unhealthy behaviors has been reported in previous studies; however the link with all-cause mortality and differences between those with and without chronic disease requires further investigation. Objectives: To observe the clustering effects of unhealthy diet, fitness, smoking, and excessive alcohol consumption in adults with and without chronic disease and to assess all-cause mortality risk according to the clustering of unhealthy behaviors. Methods: Participants were 13,621 adults (aged 20-84) from the Aerobics Center Longitudinal Study. Four health behaviors were observed (diet, fitness, smoking, and drinking). Baseline characteristics of the study population and bivariate relations between pairs of the health behaviors were evaluated separately for those with and without chronic disease using cross-tabulation and a chi-square test. The odds of partaking in unhealthy behaviors were also calculated. Latent class analysis (LCA) was used to assess clustering. Cox regression was used to assess the relationship between the behaviors and mortality. Results: The four health behaviors were related to each other. LCA results suggested that two classes existed. Participants in class 1 had a higher probability of partaking in each of the four unhealthy behaviors than participants in class 2. No differences in health behavior clustering were found between participants with and without chronic disease. Mortality risk increased relative to the number of unhealthy behaviors participants engaged in. Conclusion: Unhealthy behaviors cluster together irrespective of chronic disease status. Such findings suggest that multi-behavioral intervention strategies can be similar in those with and without chronic disease. [ABSTRACT FROM AUTHOR]

The article reports on research which was conducted in an effort to develop a daily step count target that equates to physical activity guidelines which have been developed for children and youth and could be used to monitor physical activity in children and youth. Researchers collected accelerometer and pedometer data collected on 1,613 children and youth between the ages of 6-19 who were included in the Canadian Health Measures Survey. Researchers concluded that 12,000 steps per day could be used as a target to determine whether children and youth are meeting the current daily physical activity guidelines.

Background The influence of the built environment on health is of contemporary societal interest. The design of streets in neighbourhood settings may contribute positively to the health of populations through increased physical activity, but it may also have injury consequences. Methods We conducted a national cross-sectional study to describe the injury experiences of 9021 students from 180 Canadian schools that participated in the 2006 Health Behaviour in School-Aged Children survey. Street designs surrounding each school (5 km circular buffer) were estimated via geographic information systems for three established measures of connectivity (intersection density, average block length and connected node ratio). A composite scale of connectivity was derived using factor analysis. Multilevel logistic regression analyses were used to examine the associations between the composite connectivity measure and students' reports of physical activity injuries occurring in the street (street injuries). Results Students living in neighbourhoods with low versus high street connectivity reported possible increases in the occurrence of street injuries (OR, 1.38; 95% CI, 0.84 to 2.26). This relationship was mainly attributable to the occurrence of bicycle injuries (52% of all street injuries; OR, 2.33; 95% CI, 1.28 to 4.25). The population attributable risk was 20% for street injuries potentially caused by living in an area with low connectivity. Conclusion The design of streets, as a measure of the built environment, is related to the occurrence of youth injury. Positive effects of poorly connected street designs that are likely in terms of physical activity were offset by negative injury outcomes, although the injuries observed were mostly minor in nature. INSET: Surprise! Phone distractions cause serious injuries. [ABSTRACT FROM AUTHOR]

Background: Screen time activities (e.g., television, computers, video games) have been linked to several negative health outcomes among young people. In order to develop evidence-based interventions to reduce screen time, the factors that influence the behavior need to be better understood. High neighborhood disorder, which may encourage young people to stay indoors where screen time activities are readily available, is one potential factor to consider. Methods: Results are based on 15,917 youth in grades 6-10 (aged 10-16 years old) who participated in the Canadian 2009/10 Health Behaviour in School-aged Children Survey (HBSC). Total hours per week of television, video games, and computer use were reported by the participating students in the HBSC student questionnaire. Ten items of neighborhood disorder including safety, neighbors taking advantage, drugs/drinking in public, ethnic tensions, gangs, crime, conditions of buildings/grounds, abandoned buildings, litter, and graffiti were measured using the HBSC student questionnaire, the HBSC administrator questionnaire, and Geographic Information Systems. Based upon these 10 items, social and physical neighborhood disorder variables were derived using principal component analysis. Multivariate multilevel logistic regression analyses were used to examine the relationship between social and physical neighborhood disorder and individual screen time variables. Results: High (top quartile) social neighborhood disorder was associated with approximately 35-45% increased risk of high (top quartile) television, computer, and video game use. Physical neighborhood disorder was not associated with screen time activities after adjusting for social neighborhood disorder. However, high social and physical neighborhood disorder combined was associated with approximately 40-60% increased likelihood of high television, computer, and video game use. Conclusion: High neighborhood disorder is one environmental factor that may be important to consider for future public health interventions and strategies aiming to reduce screen time among youth. [ABSTRACT FROM AUTHOR]

Background: Excessive engagement in screen time has several immediate and long-term health implications among pre-school children. However, little is known about the factors that influence screen time in this age group. Therefore, the purpose of this study was to use the Ecologic Model of Sedentary Behavior as a guide to examine associations between intrapersonal, interpersonal, and physical environment factors within the home setting and screen time among pre-school children. Methods: Participants were 746 pre-school children (≤ 5 years old) from the Kingston, Ontario, Canada area. From May to September, 2011, parents completed a questionnaire regarding several intrapersonal (child demographics), interpersonal (family demographics, parental cognitions, parental behavior), and physical environment (television, computer, or video games in the bedroom) factors within the home setting. Parents also reported the average amount of time per day their child spent watching television and playing video/computer games. Associations were examined using linear and logistic regression models. Results: Most participants (93.7%) watched television and 37.9% played video/computer games. Several intrapersonal, interpersonal, and physical environment factors within the home setting were associated with screen time. More specifically, age, parental attitudes, parental barriers, parental descriptive norms, parental screen time, and having a television in the bedroom were positive predictors of screen time; whereas, parental education, parental income, and parental self-efficacy were negative predictors of screen time in the linear regression analysis. Collectively these variables explained 64.2% of the variance in screen time. Parental cognitive factors (self-efficacy, attitudes, barriers, descriptive norms) at the interpersonal level explained a large portion (37.9%) of this variance. Conclusions: A large proportion of screen time in pre-school children was explained by factors within the home setting. Parental cognitive factors at the interpersonal level were of particular relevance. These findings suggest that interventions aiming to foster appropriate screen time habits in pre-school children may be most effective if they target parents for behavioral change. [ABSTRACT FROM AUTHOR]

The objective of the study was to examine the effects of overweight and obesity on times to recovery among Canadian youth who have suffered one or more types of injury. The data source was the 2002 Canadian Health Behaviour in School-Aged Children (HBSC) survey. The study population included 7266 youth in grades 6 through 10 sampled from all Canadian provinces and territories. Of these, 2831 students reported an injury event and were included in the analysis. Kaplan-Meier curves and hazard ratios (HR) were used to profile survival functions and estimate relative hazards for non-recovery from injury events among normal weight, overweight and obese youth. Youth who were obese and suffered a combined injury (broken bone and strain/sprain) took longer to recover (HR: 1.81, 95% CI 0.99-3.32) compared to normal weight youth. HR for injury recovery in obese youth were not significantly elevated for broken bones (1.15, 95% CI 0.61-2.19) and sprain/strains (1.17, 95% CI 0.73-1.85) in isolation. Obesity was associated with times for injury recovery among injured youth. If these findings are confirmed in other settings, clinicians providing an injury recovery prognosis may need to take into account BMI status and allow for extra recovery time for patients in this age range. [ABSTRACT FROM AUTHOR]

Background: Cardio-metabolic risk factors are becoming more prevalent in children and adolescents. A lack of moderate-to-vigorous intensity physical activity (MVPA) is an established determinant of cardio-metabolic risk factors in children and adolescents. Less is known about the relationship between sedentary behavior and cardiometabolic health. Therefore, the objective was to examine the independent associations between volume, patterns, and types of sedentary behavior with cardio-metabolic risk factors among children and adolescents. Methods: The results are based on 2527 children and adolescents (6-19 years old) from the 2003/04 and 2005/06 National Health and Nutrition Examination Surveys (NHANES). A cardio-metabolic risk score (CRS) was calculated based on age- and sex-adjusted waist circumference, systolic blood pressure, non-high-density lipoprotein cholesterol, and C-reactive protein values. Volume and patterns of sedentary behavior and moderate-to-vigorous physical activity (MVPA) were measured objectively using accelerometers. Types of sedentary behavior were measured by questionnaire. A series of logistic regression models were used to examine associations. Results: Volume and patterns of sedentary behavior were not predictors of high CRS after adjusting for MVPA and other confounders (P > 0.1). For types of sedentary behavior, high TV use, but not high computer use, was a predictor of high CRS after adjustment for MVPA and other confounders. Children and adolescents who watched ≥4 hours per day of TV were 2.53 (95% confidence interval: 1.45-4.42) times more likely to have high CRS than those who watched <1 hour per day. MVPA predicted high CRS after adjusting for all sedentary behavior measures and other confounders. After adjustment for waist circumference, MVPA also predicted high non-obesity CRS; however, the same relationship was not seen with TV use. Conclusion: No association was observed between overall volume and patterns of sedentary behavior with cardiometabolic risk factors in this large sample of children and adolescents. Conversely, high TV use and low MVPA were independently associated with cardio-metabolic risk factors. However, the association between high TV use and clustered cardio-metabolic risk factors appears to be mediated or confounded by obesity. Thus, TV and MVPA appear to be two separate behaviors that need to be targeted with different interventions and policies. [ABSTRACT FROM AUTHOR]

Background: Cardio-metabolic risk factors are becoming more prevalent in children and adolescents. A lack of moderate-to-vigorous intensity physical activity (MVPA) is an established determinant of cardio-metabolic risk factors in children and adolescents. Less is known about the relationship between sedentary behavior and cardiometabolic health. Therefore, the objective was to examine the independent associations between volume, patterns, and types of sedentary behavior with cardio-metabolic risk factors among children and adolescents. Methods: The results are based on 2527 children and adolescents (6-19 years old) from the 2003/04 and 2005/06 National Health and Nutrition Examination Surveys (NHANES). A cardio-metabolic risk score (CRS) was calculated based on age- and sex-adjusted waist circumference, systolic blood pressure, non-high-density lipoprotein cholesterol, and C-reactive protein values. Volume and patterns of sedentary behavior and moderate-to-vigorous physical activity (MVPA) were measured objectively using accelerometers. Types of sedentary behavior were measured by questionnaire. A series of logistic regression models were used to examine associations. Results: Volume and patterns of sedentary behavior were not predictors of high CRS after adjusting for MVPA and other confounders (P > 0.1). For types of sedentary behavior, high TV use, but not high computer use, was a predictor of high CRS after adjustment for MVPA and other confounders. Children and adolescents who watched =4 hours per day of TV were 2.53 (95% confidence interval: 1.45-4.42) times more likely to have high CRS than those who watched <1 hour per day. MVPA predicted high CRS after adjusting for all sedentary behavior measures and other confounders. After adjustment for waist circumference, MVPA also predicted high non-obesity CRS; however, the same relationship was not seen with TV use. Conclusion: No association was observed between overall volume and patterns of sedentary behavior with cardiometabolic risk factors in this large sample of children and adolescents. Conversely, high TV use and low MVPA were independently associated with cardio-metabolic risk factors. However, the association between high TV use and clustered cardio-metabolic risk factors appears to be mediated or confounded by obesity. Thus, TV and MVPA appear to be two separate behaviors that need to be targeted with different interventions and policies. [ABSTRACT FROM AUTHOR]

Objectives. To examine associations between obesity and occupational injury. Methods. Participants consisted of a representative sample of 7,678 adult Canadian workers. Participants were placed into normal weight, overweight, and obese categories based on their bodymass index. Different injury types, location, and external causes were measured. Logistic regression was used to estimate relationships. Results. By comparison to normal weight workers, obese workers were more likely to report any occupational injuries (odds ratio (OR) 1.40, 95% confidence interval (CI): 0.98-1.99) and serious occupational injuries (1.49, 0.99-2.26). These relationships were more pronounced for sprains and strains (1.80, 1.04-3.11), injuries to the lower limbs (2.14, 1.12-4.11) or torso (2.36, 1.13-4.93), and injuries due to falls (2.10, 0.86-5.10) or overexertion (2.08, 0.96-4.50). Female workers, workers ≥40 years, and workers employed in sedentary occupations were particularly vulnerable. Increased risks were not identified for overweight workers. Conclusions. Obese workers experienced 40-49% higher risks for occupational injury. [ABSTRACT FROM AUTHOR]

The term 'saropenia' was coined by Irwin Rosenberg in 1989 to refer to age-related loss of skeletal muscle mass. The purpose of this current opinion is to provide an evolutionary overview of sarcopenia research since 1989. This includes the creation of an operational definition of sarcopenia; consideration of the impacts of sarcopenia on physical function, chronic disease, and mortality risk; the distinction between the process of sarcopenia and the process of age-related loss of muscle strength, a phenomenon that has recently been termed dynapenia; a comparison of the independent effects of sarcopenia and dynapenia on physical function, chronic disease, and mortality risk; and consideration of the combined influence of sarcopenia and dynapenia with obesity (i.e., sarcopenic-obesity and dynapenic-obesity) on physical function, chronic disease, and mortality risk. Irwin Rosenberg fut le premier à introduire en 1989 le terme « sarcopénie » comme étant la perte de la masse musculaire squelettique liée au vieillissement. Ce texte se propose de présenter un aperçu de l'évolution de la recherche sur la sarcopénie depuis 1989. On y lit la présentation d'une définition opérationnelle de la sarcopénie; l'impact de la sarcopénie sur les fonctions physiques, les maladies chroniques et le risque de mortalité; la distinction entre le processus de sarcopénie et la dynapénie, un phénomène défini récemment comme un processus de perte de force musculaire lié au vieillissement; la comparaison des effets indépendants de la sarcopénie et de la dynapénie sur les fonctions physiques, les maladies chroniques et le risque de mortalité; et la présentation des effets combinés de la sarcopénie et de la dynapénie en présence d'obésité (l'obésité sarcopénique et l'obésité dynapénique) sur les fonctions physiques, les maladies chroniques et le risque de mortalité. [ABSTRACT FROM AUTHOR]