June 29, 2007

By Rosanne Prinsen, MSc, Alberta Centre for Active Living


Active healthy kids Canada's 2007 report card on physical activity
ActiveHealthyKids_v2/ programs_2007/reportcard.cfm

The Report Card closely examines physical activity opportunities for children and youth where they live, learn and play. In addition to highlighting decreased rates of physical activity and increases in screen time, the 2007 Report Card notes a troubling association between sedentary behaviours and increased reports of anxiety, depression and low self-esteem among adolescents.

Grant to develop intergenerational physical activity guidelines

Drs. Philip M. Wilson and Diane E. Mack are requesting your assistance in regards to their federally funded research study entitled "Osteoporosis and Physical Activity." The purpose of this study is to examine the measurement of lifestyle physical activity in those diagnosed with osteoporosis ...


Childhood obesity: Should primary school children be routinely screened? A systematic review and discussion of the evidence.
Westwood, M., Fayter, D., Hartley, S., Rithalia, A., Butler, G., Glasziou, P., Bland, M., Nixon, J., Stirk, L., & Rudolf, M. (2007). Childhood obesity: Should primary school children be routinely screened? A systematic review and discussion of the evidence. Arch Dis Child, 92(5), 416-422.

Background: Population monitoring has been introduced in UK primary schools in an effort to track the growing obesity epidemic. It has been argued that parents should be informed of their child's results, but is there evidence that moving from monitoring to screening would be effective?

We describe what is known about the effectiveness of monitoring and screening for overweight and obesity in primary school children and highlight areas where evidence is lacking and research should be prioritised.

Design: Systematic review with discussion of evidence gaps and future research.

Data Sources: Published and unpublished studies (any language) from electronic databases (inception to July 2005), clinical experts, Primary Care Trusts and Strategic Health Authorities, and reference lists of retrieved studies.

Review Methods: We included any study that evaluated measures of overweight and obesity as part of a population-level assessment and excluded studies whose primary outcome measure was prevalence.

Results: There were no trials assessing the effectiveness of monitoring or screening for overweight and obesity. Studies focused on the diagnostic accuracy of measurements. Information on the attitudes of children, parents and health professionals to monitoring was extremely sparse.

Conclusions: Our review found a lack of data on the potential impact of population monitoring or screening for obesity and more research is indicated. Identification of effective weight reduction strategies for children and clarification of the role of preventative measures are priorities. It is difficult to see how screening to identify individual children can be justified without effective interventions.

Children's healthy living (Heart and Stroke Foundation)

The Heart and Stroke Foundation wants children and families to live healthy and active lives. This resource will help you find information to inspire heart-healthy habits in your children. All the information on this page is Canadian, current and has been approved by Foundation experts.

Effectiveness of physical activity enhancement and obesity prevention programs in children and youth

Are Smart Growth concepts having an effect on planning and development in America? Is low-density sprawl continuing unabated, or has a new approach taken hold? This issue of On Common Ground gives you a progress report on Smart Growth.

Smartgrowth resources

Green Building, transportation, community design and density, brownfields and redevelopment, land use zoning and growth management, government fiscal issues, affordable housing, schools.

Theme PARC


June 25, 2007

By Rosanne Prinsen, MSc, Alberta Centre for Active Living

PARC/BSRC physical activity & postpartum e-workshops
Online/Teleconference, July 11 and 31 and September 6, 2007

Accuracy of pedometer steps and time for youth with disabilities

Beets, M.W., Combs, C., Pitetti, K.H., Morgan, M., Bryan, R.R., & Foley, J.T. Accuracy of pedometer steps and time for youth with disabilities APAQ, 24(3).

This study examined the accuracy of pedometer steps and activity time (Walk4Life, WL) for youth with developmental disabilities. Eighteen youth (11 girls, seven boys) four to14 years, completed six 80-metre self-paced walking trials while wearing a pedometer at five waist locations (front right, front left, back right, back left, middle back).

Trials were videotaped to determine actual steps and activity time. Time exhibited a smaller per cent error in comparison to steps across locations. Apart from the front left, location had minimal influence on accuracy. The WL demonstrates acceptable accuracy for steps and activity time.

Accuracy of voice-announcement pedometers for youth with visual impairment
Beets, M.W., Foley, J.T., Tindall,D., & Lieberman, L.J. (2007). Accuracy of voice-announcement pedometers for youth with visual impairment. APAQ, 24(3).

Thirty-five youth with visual impairments (13.5 ± 2.1yrs, 13 girls and 22 boys) walked four 100-meter distances while wearing two units (right and left placement) of three brands of voice-announcement (VA) pedometers (Centrios? Talking Pedometer, TALKiNG Pedometer, and Sportline Talking Calorie Pedometer 343) and a reference pedometer (NL2000).

Registered pedometer steps for each trial were recorded, compared to actual steps assessed via digital video. Inter-unit agreement between right and left VA pedometer placement was low (ICC range .37 to .76).

A systematic error was observed for the VA pedometers on the left placement (error range 5.6% to 12.2%), while right placement VA pedometers were at or below ± 3% from actual steps (range 2.1% to 3.3%).

The reference pedometer was unaffected by placement (ICC .98, error ~1.4%). Overall, VA pedometers demonstrated acceptable accuracy for the right placement, suggesting this position is necessary for youth with visual impairments.

Active for life: A work-based physical activity program
Green, B.B., Cheadle, A., Pellegrini, A.S., & Harris, J.R. (2007). Active for life: A work-based physical activity program. Prev Chronic Dis [serial online].

An intervention to promote healthy weight: Nutrition and physical activity self-assessment for child care (NAP SACC) theory and design
Ammerman, A.S., Ward, D.S., Benjamin, S.E., Ball SC, Sommers, J.K., Molloy, M., et al. (2007). An intervention to promote healthy weight: Nutrition and physical activity self-assessment for child care (NAP SACC) theory and design. Prev Chronic Dis [serial online].

How active are older Americans?
Kruger J., Carlson, S.A., & Buchner, D. (2007). How active are older Americans?
Prev Chronic Dis [serial online].

Modifications to the active living every day (ALED) course for adults with arthritis
Callahan, L.F., Schoster, B., Hootman, J., Brady, T., Sally, L., Donahue, K., et al. (2007). Modifications to the active living every day (ALED) course for adults with arthritis. Prev Chronic Dis [serial online].

Move More Scholars Institute: A state model of the physical activity and public health practitioners course
Schneider, L., Ward, D., Dunn, C., Vaughn, A., Newkirk, J., & Thomas, C. The Move More Scholars Institute: A state model of the physical activity and public health practitioners course. Prev Chronic Dis [serial online].

Outcome data from the LEAP (Live, Eat and Play) trial: A randomized controlled trial of a primary care intervention for childhood overweight/mild obesity
McCallum, Z., Wake, M., Gerner, B., Baur, L.A., Gibbons, K., Gold, L., Gunn, J., Harris, C., Naughton, G., Riess, C., Sanci, L., Sheehan, J., Ukoumunne, O.C., & Waters, E. (2006). Outcome data from the LEAP (Live, Eat and Play) trial: A randomized controlled trial of a primary care intervention for childhood overweight/mild obesity. Int J Obes (Lond) (4), 630-636.

A study from the Centre for Community Child Health, The University of Melbourne, Murdoch Childrens Research Institute, Parkville, Australia (

Objectives: To reduce gain in body mass index (BMI) in overweight/mildly obese children in the primary care setting.

Design: Randomized controlled trial (RCT) nested within a baseline cross-sectional BMI survey.

Setting: Twenty nine general practices, Melbourne, Australia.
Participants: (1) BMI survey: 2112 children visiting their general practitioner (GP) April-December 2002; (2) RCT: individually randomized overweight/mildly obese (BMI z-score <3.0)>
Intervention: Four standard GP consultations over 12 weeks, targeting change in nutrition, physical activity and sedentary behaviour, supported by purpose-designed family materials.

Main outcome measures: Primary: BMI at nine and 15 months post-randomization. Secondary: Parent-reported child nutrition, physical activity and health status; child-reported health status, body satisfaction and appearance/self-worth.

Results: Attrition was 10%. The adjusted mean difference (intervention-control) in BMI was -0.2 kg/m(2) (95% CI: -0.6 to 0.1; P=0.25) at 9 months and -0.0 kg/m(2) (95% CI: -0.5 to 0.5; P=1.00) at 15 months.

There was a relative improvement in nutrition scores in the intervention arm at both 9 and 15 months. There was weak evidence of an increase in daily physical activity in the intervention arm. Health status and body image were similar in the trial arms.

Conclusions: This intervention did not result in a sustained BMI reduction, despite the improvement in parent-reported nutrition. Brief individualized solution-focused approaches may not be an effective approach to childhood overweight. Alternatively, this intervention may not have been intensive enough or the GP training may have been insufficient. However, increasing either would have significant cost and resource implications at a population level.

Reliability of scores from physical activity monitors in adults with multiple sclerosis
Motl, R.W., Zhu, W., Park. Y., McAuley, E., Scott, J.A., & Snook, E. (2007). Reliability of scores from physical activity monitors in adults with multiple sclerosis. APAQ, 24(3).

We examined the reliability of scores from physical activity monitors in a sample of 193 individuals with multiple sclerosis (MS) who wore a pedometer and an accelerometer for a seven-day period.

There were no significant differences among days for the pedometer (p = .12) or the accelerometer (p = .15) indicating that week and weekend days can be analysed in a single intra-class correlation (ICC) analytic model.

The seven days of monitoring yielded ICC estimates of 0.93 for both the pedometer and accelerometer, and a minimum of three days yielded a reliability of 0.80 for both the pedometer and accelerometer. Results indicated that physical activity monitor scores are reliable measures of physical activity for individuals with MS.


Aboriginal resource from Best Start
If you are going to be working with Aboriginal people, this is a resource you will want to browse through. It’s about healthy childhood development but has some overall information about understanding Aboriginal people.

Mothers in motion
A website for women who want to lead healthy lifestyles and help their children to do the same.

Physical activity guides for mothers in motion


June 15, 2007


Campaign promotes aquatic activities as fun way to increase fitness
Ottawa, Ontario--(CCNMatthews - June 2, 2007) - According to Canada's Physical Activity Guides for Children and Youth, over half of Canadians aged five to 17 are not active enough for optimal growth and development....... To help combat this growing trend, a new partnership is being launched with Red Cross Swim, Swimming Canada, Synchro Canada, Diving Canada and Water Polo Canada. "Healthy habits and behaviours for children and youth need to be fostered from an early age," said Michele Mercier, Red Cross National Manager, Swimming & Water Safety Programs. "Swimming and the variety of aquatic activities available in Canada are great ways for children and youth to learn new skills while having fun, increase their fitness levels and ensure healthy growth and development." ....... snip

Government Community spirit program
The Committee is looking to hear from Albertans about what they think an effective and sustainable program could look like.
Take the survey at:

Study shows golf is a step toward better health
The Times Colonist (Victoria) (Fri 08 Jun 2007 Byline: Pamela Fayerman) reports on the first study to count the number of steps accumulated in 18-hole rounds. It found that regardless of the course, study participants walked more than seven kilometres and accumulated a mean number of nearly 12,000 steps, bettering the oft-recommended 10,000 steps daily. The study by Smith, Samantha Kobriger and co-authors -- conducted on three public courses in Minnesota -- was presented to 4,000 delegates at the World Physical Therapy Congress in Vancouver this week. Brian Butters, executive director of the Professional Golfers' Association of B.C., said golf is the most popular sport across Canada, so the study should be welcome news for many. Mike Longridge, assistant pro at the Marine Drive Golf Club, agreed with Butters that golfers such as himself, with a zero handicap, might get less exercise because of their shot accuracy, while golfers who slice and hook might take more steps.

Where the kids aren't
Physical activity in children is on the decline, and this is particularly apparent in public parks. Now, NC State researchers are studying urban parks and how they are being used – or not used – by local residents, particularly in disadvantaged communities which are at higher risk for obesity.


Active Transportation Quotient
This Active Transportation Quotient (ATQ) Guide and Calculator are intended to help users assess the quality of the local environment for active modes of transportation such as walking and cycling. As currently designed, the ATQ is not intended for making comparisons between communities. Instead, it helps communities assess the actual conditions against their own ideal for active transportation in that community. The ATQ is intended to be used as part of a 3 step process: Vision – Assessment – Plan. As part of the visioning process, weights are assigned to each criteria; therefore, the quotient will reflect the priorities of the community.

Explore how the SDOH impact chronic disease
Primer to Action: Social Determinants of Health A resource for health professionals ... to explore how the SDOH impact chronic disease

Neighborhoods and disability in later life - 2007
This paper uses the Health and Retirement Study to explore linkages between neighborhood features and stages of the disablement process among adults ages 55 and older in the United States. We consider multiple dimensions of the neighborhood environment including environmental stressors; safety, mobility and access to services; and social and economic conditions. In doing so, we use factor analysis to reduce indicators into 8 neighborhood scales, which we incorporate into two-level logistic regression models. Findings suggest that economic advantage matters earlier in the disablement process and economic disadvantage is linked to later stages. There also appear to be important differences by gender, with street connectivity and economic disadvantage associated with outcomes only for men. Although most neighborhood effects are relatively small in absolute terms, neighborhood economic advantage effects appear sizeable.


June 11, 2007


Seniors playground
The Globe and Mail (Sat 19 May 2007, Byline: Naomi Buck) reports that Germany is the fastest aging country in Europe. By 2050 one third of the population will be over 60. A new experiment in recreation opportunities is being tried in Berlin's Preussen Park where an outdoor fitness park is being called the country's first Playground for Seniors. Officially it is restricted to those 16 and over. It includes oscillating leg trainers, flexibility machines and a back massage pole that looks like a cat-scratching post do offer gentle opportunities to improve strength and balance and stimulate circulation.


Interventions to promote walking: systematic review.
Ogilvie, D.; Foster, C. E.; Rothnie, H.; Cavill, N.; Hamilton, V.; Fitzsimons, C. F., and Mutrie, N. BMJ. 2007 May 31.
Objective: To assess the effects of interventions to promote walking in individuals and populations.
Design: Systematic review.
Data Sources: Published and unpublished reports in any language identified by searching 25 electronic databases, by searching websites, reference lists, and existing systematic reviews, and by contacting experts. Review methods Systematic search for and appraisal of controlled before and after studies of the effects of any type of intervention on how much people walk, the distribution of effects on walking between social groups, and any associated effects on overall physical activity, fitness, risk factors for disease, health, and wellbeing.
Results: We included 19 randomised controlled trials and 29 non-randomised controlled studies. Interventions tailored to people's needs, targeted at the most sedentary or at those most motivated to change, and delivered either at the level of the individual (brief advice, supported use of pedometers, telecommunications) or household (individualised marketing) or through groups, can encourage people to walk more, although the sustainability, generalisability, and clinical benefits of many of these approaches are uncertain. Evidence for the effectiveness of interventions applied to workplaces, schools, communities, or areas typically depends on isolated studies or subgroup analysis.
Conclusions: The most successful interventions could increase walking among targeted participants by up to 30-60 minutes a week on average, at least in the short term. From a perspective of improving population health, much of the research currently provides evidence of efficacy rather than effectiveness. Nevertheless, interventions to promote walking could contribute substantially towards increasing the activity levels of the most sedentary.

Active cities: An opportunity for leadership by the big city mayors caucus
This brief makes the case that an integrated and strategic approach to civic policy making on sport, recreation, physical activity, and active transportation is the response that is required to the current obesity crisis in Canada. City-based, pan-Canadian leadership is necessary to redress the active city infrastructure deficit and imbalance, and to meet the youth crisis point head-on with tangible solutions

Activity adaptations
This is a handout from the presentation entitled "Discover, Participate, Include - Everyone!". The handout suggests keeping activity modifications to a minimum. The less change in an activity, the more the participant feels like they are like all the other participants and a part of the group. Keep in mind, the participant's physical ability rather than disability and don't be afraid to experiment with new ideas. Also covered are activity adaptations in time, in equipment, in area, in number of participants, in programming, in instructions and finally, for arts and crafts. From the 2007 PRO WinterActive Educational Forum and Trade Show.

Building media buzz
This presentation from the 2007 PRO WinterActive Educational Forum and Trade Show, will highlight the hot, new trends in media relations, including Internet Media Rooms, Media Previews, Story Ideas, and Media Toolkits. It will review the do’s and don’ts of working with print and broadcast media, in order to create a positive buzz and build long-term relationships with your key media.

Marketing and promotions for special events
This practical, information-packed session provides you with the tools you need to successfully market special events of all sizes and types. Develop dynamic brochures, postcards, flyers, and posters for your next event. Learn how to increase attendance, attract sponsors and volunteers, generate funds, and raise awareness of your organization. Find out how to generate media interest, coverage and sponsorship for your special events. This presentation is from the 2007 Parks and Recreation Ontario Educational Forum and Trade Show.

Recreation as an economic development tool

Recreation, in and of itself, can be a revenue generator. It can also be an area of cost reduction for other departments, such as social services, or a future investment area for agencies, such as police enforcement or health. How we position recreation to be supported by allied decision-makers and funders of services relates to strategically tying our goals with theirs, and in using language that speaks to their desired outcomes. In this session, real-life examples will be used to show how viewing recreation as an economic development tool helped garner support which created a greater investment in parks and recreation programs.

Serving hard-to-reach youth
A thoughtful programmer looks at even the most well-attended activity and asks ‘who’s not here that should/could be?’ Often times it’s the child or youth who can’t afford the program who doesn’t attend. Since we know many of the barriers that low-income clients and members face, this session will provide examples of programs that break down these barriers. Learn how each step in program planning, development, marketing and implementation can use a ‘low income awareness approach’ to effectively engage this hard to reach group.

Sports and fitness participation report – 2007
Provides overall participation figures for 114 sports in nine different categories (aerobic activities, conditioning activities, strength activities, individual sports, racquet sports, team sports, outdoor sports, snow sports, and water sports.)

Using the benefits of recreation to create effective community programs
Many people are familiar with the Benefits of Recreation, the catalogue developed by the Parks and Recreation Federation of Ontario (predecessor of PRO), which received international acclaim as one of the first forays into identifying the ‘hard’ benefits of this ‘soft’ service. Today’s challenge is being able to use the Benefits to drive program development in a way that makes economic and strategic sense. This session will introduce you to concepts that will help you deal with the hard decisions of what programs and services to provide - which ones to keep and which ones to lose - within a meaningful framework designed to meet both the benefits of recreation and departmental objectives.


June 1, 2007


Capital health releases annual report (2006)

The latest assessment of the region's overall health demonstrates how many factors influence people's health and how important it is for everyone to work together to improve the health of the population. That's the message in this year's annual Medical Officer of Health report, How healthy are we?

Children's Fitness Tax Credit: Less than meets the eye
an interesting take on the program...
If stairs are in the right place, people will use them. The Brockville Recorder and Times writes that if buildings don't have stairs in a visible and easy-to-find location, and in areas where people actually pass by, they won't get used a lot.

It's a concern in a sedentary society that's making an effort to promote fitness and prevent obesity, says Gayle Nicoll, a professor of architectural science at Toronto's Ryerson University. Nicoll's research was published in the March-April issue of the American Journal of Health Promotion.

Her study included three- and four-storey academic buildings. She ran a statistical analysis involving 22 variables, which included appearance; whether the stairs were comfortable, for instance with landings where people could rest; width of the stairs such that a group of people could travel together; and how far the stairs were from where people were actually working and studying.

In all, she said 53 per cent of stair use came down to just a few factors: location in the building relative to where people sat; how visible the stairs were - the amount of area that existed in the building where you could actually see the stairs; and how far away the stairs were, and the number of turns they were away from the main path of travel.

Ontario Walks is a new province-wide health initiative that encourages Ontarians to be proactive by taking responsibility for their personal and environmental wellness.

ONTARIO WALKS is the creation of Toronto resident, Tom Fiore, who originally founded the Toronto Trails Festival as a result of the health benefits he noticed from his daily walking routine.

As part of the baby boomer population, Fiore wanted to ensure that he stayed fit and healthy. He realized an urgent need for a province-wide event that would encourage reliance on personal health and environmental wellness.

"Something special happens when people take responsibility for their wellness through walking," said Tom Fiore. "They care more about their environment, adopt better health habits, and become more active, fit, aware, productive, healthy & involved citizens."

Rural Canadians at greater risk of obesity

The Winnipeg Free Press reports that Canadians living in rural areas are at greater risk of developing obesity than their city neighbours, says a doctor leading an obesity summit next week in the Calgary area.

Dr. Arya Sharma, scientific director of the Canadian Obesity Network, said city-dwellers typically burn more calories in a day than rural residents, who are more dependent on their vehicles.

Vancouver, Toronto and Montreal are Canada's slimmest cities, according to a recent survey, said Sharma. Calgary falls in behind those major centres, he said, pointing out that residents of sprawling cities are prone to being less active.

Sharma is bringing together more than 200 medical professionals in the mountains May 6-8 to discuss ways to tackle the country's staggering obesity rate.

SPARC launches New Zealand sport and physical activity survey

SPARC (Sport & Recreation New Zealand) today announced the official launch of the New Zealand Sport and Physical Activity Survey. This is a nationwide survey designed to determine physical activity levels of New Zealand adults (aged 16 and over) and their participation in sport, recreation and physical activities...

The survey is being undertaken through face-to-face nationwide interviews over a 12-month period to take account of seasonal patterns of activity. Initial survey findings will be released in mid-2008


Age and gender differences in youth physical activity: Does physical maturity matter?

Sherar, L.B., Esliger, D.W., Baxter-Jones, A.D.G., & Tremblay, M.S. (2007). Medicine & Science in Sports & Exercise. 39(5), 830-835.

Purpose: To investigate whether observed gender differences in objectively measured physical activity (PA) in children (8-13 yr) are confounded by physical maturity differences.

Methods: Four hundred and one children (194 boys and 207 girls) volunteered for this study. An Actigraph accelerometer was used to obtain seven consecutive days of minute-by-minute PA data for each participant.

Minutes of moderate to vigorous PA per day (MVPA), continuous minutes of MVPA per day (CMVPA), and minutes of vigorous PA per day (VPA) were derived from the accelerometer data.

Age at peak height velocity (APHV), an indicator of somatic maturity, was predicted in all individuals. Gender differences in the PA variables were analyzed using a two-way (gender x age)

ANOVA.Results: Levels of PA decreased with increasing chronological age in both genders. When aligned on biological age, PA declined with increasing maturity.

Conclusion: The observed age-related decline in adolescent boys and girls PA is antithetical to public health goals; as such, it is an important area of research. To fully understand gender disparities in PA, consideration must be given to the confounding effects of physical maturity.
Associations between body composition, anthropometry, and mortality in women aged 65 years and older.

Dolan, C.M., Kraemer, H., Browner, W., Ensrud K., & Kelsey, J.L. (2007).
Am J Public Health, 97(5), 913-918.
Objectives: We examined the relation between measures of body size and mortality in a predominantly white cohort of 8029 women aged 65 years and older who were participating in the Study of Osteoporotic Fractures.

Methods: Body composition measures (fat and lean mass and percentage body fat) were calculated by bioelectrical impedance analysis. Anthropometric measures were body mass index (BMI; kg/m2) and waist circumference.

Results: During eight years of follow-up, there were 945 deaths. Mortality was lowest among women in the middle of the distribution of each body size measure.

For BMI, the lowest mortality rates were in the range 24.6 to 29.8 kg/m2. The U-shaped relations were seen throughout the age ranges included in this study and were not attributable to smoking or measures of preexisting illness. Body composition measures were not better predictors of mortality than BMI or waist girth.
Conclusions: Our results do not support applying the National Institutes of Health categorization of BMI from 25 to 29.9 kg/m2 as overweight in older women, because women with BMIs in this range had the lowest mortality.

The association between low physical fitness and high body mass index or waist circumference is increasing with age in children: The "Quebec en Forme" Project

Brunet, M., Chaput, J. P., & Tremblay, A. (2007). Int J Obes (Lond), 31(4), 637-643.

Objective: To evaluate physical fitness and body composition of children involved in the Quebec en Forme (QEF) Project and to compare data obtained to the reference values of the 1981 Canada Fitness Survey (CFS).

Subjects: A total of 1,140 children (591 boys and 549 girls) of first (7 years), second (8 years) and fourth (10 years) grade from primary schools in the City of Trois-Rivieres (Quebec) were selected to participate in this study.

Measurements: Body mass index (BMI) and waist circumference (WC) were measured. The physical fitness tests included standing long jump, 1-minute in speed sit-ups and speed shuttle run.

Results: The prevalence of overweight in children ranged between 20 and 30%, which represents a substantial increase compared to the 1981 CFS.

The relationship between BMI and WC was highly significant in boys and girls (r=0.90 and 0.86, respectively, P<0.0001).>

The negative correlations between BMI or WC and the performance in all physical fitness tests were mostly significant in children of both genders (-0.16 < or =" r" or =" -0.45,">

Based on the 1981 CFS, only 4.7-14.1% of QEF boys still performed in the upper quartile of the distribution (fit boys), whereas 32.1-69% performed not much higher than the lower quartile (unfit boys) for each fitness test.

In girls, the relative fitness decrease observed in 2003 was more pronounced, as only 1-9.9% of subjects performed in the upper quartile of the distribution compared to 42.8-81.4% who did not perform higher than the lower quartile of the 1981 reference scores of the CFS.

Conclusion: This study shows that BMI and WC are negatively correlated with physical fitness and that these associations are more pronounced in older children.

Furthermore, physical fitness of our cohort, especially in girls, was much lower than what was documented in the 1981 CFS in subjects of the same age. This study thus emphasizes the necessity to develop early interventions to improve physical fitness in children and to prevent the increase of childhood obesity.

Contracts between patients and healthcare practitioners for improving patients' adherence to treatment, prevention and health promotion activities.

Bosch-Capblanch, X., Abba, K., Prictor, M., & Garner, P. (2007). Cochrane Database Syst Rev. (2), CD004808.

Background: Contracts are a verbal or written agreement that a patient makes with themselves, with health-care practitioners, or with carers, where participants commit to a set of behaviours related to the care of a patient. Contracts aim to improve the patients' adherence to treatment or health promotion programmes.

Results: We included 30 trials, all conducted in high income countries, involving 4,691 participants. Median sample size per group was 21.

We examined the quality of each trial against eight standard criteria, and all trials were inadequate in relation to three or more of these standards.

Trials evaluated contracts in addiction (10 trials), hypertension (four trials), weight control (three trials) and a variety of other areas (13 trials).

Sixteen trials reported at least one outcome that showed statistically significant differences favouring the contracts group, five trials reported at least one outcome that showed differences favouring the control group and 26 trials reported at least one outcome without differences between groups. Effects on adherence were not detected when measured over longer periods.

Conclusions: There is limited evidence that contracts can potentially contribute to improving adherence, but there is insufficient evidence from large, good quality studies to routinely recommend contracts for improving adherence to treatment or preventive health regimens.

Effects of different doses of physical activity on cardiorespiratory fitness among sedentary, overweight or obese postmenopausal women with elevated blood pressure

Church, T.S., Earnest, C.P., Skinner, J.S., & Blair, S.N. (2007). JAMA, 297, 2081-2091.

Context: Low levels of cardiorespiratory fitness are associated with high risk of mortality, and improvements in fitness are associated with reduced mortality risk. However, a poor understanding of the physical activity–fitness dose response relation remains.

Objective: To examine the effect of 50%, 100% and 150% of the NIH Consensus Development Panel recommended physical activity dose on fitness in women.

Design, Setting, and Participants: Randomized controlled trial of 464 sedentary, post-menopausal overweight or obese women whose body mass index ranged from 25.0 to 43.0 and whose systolic blood pressure ranged from 120.0 to 159.9 mm Hg. Enrollment took place between April 2001 and June 2005 in the Dallas, Tex, area.

Intervention: Participants were randomly assigned to one of four groups: 102 to the nonexercise control group and 155 to the 4-kcal/kg, 104 to the eight-kcal/kg, and 103 to the 12-kcal/kg per week energy-expenditure groups for the six-month intervention period. Target training intensity was the heart rate associated with 50% of each woman's peak O2.

Main Outcome Measure: The primary outcome was aerobic fitness assessed on a cycle ergometer and quantified as peak absolute oxygen consumption ( O2abs, L/min).

Results: The mean (SD) baseline O2abs values were 1.30 (0.25) L/min. The mean (SD) minutes of exercising per week were 72.2 (12.3) for the four-kcal/kg, 135.8 (19.5) for the eight-kcal/kg, and 191.7 (33.7) for the 12-kcal/kg per week exercise groups.

After adjustment for age, race/ethnicity, weight, and peak heart rate, the exercise groups increased their O2abs compared with the control group by 4.2% in the four-kcal/kg, 6.0% in the 8-kcal/kg, and 8.2% in the 12-kcal/kg per week groups (P<.001 for each vs control; P for trend <.001).

There was no treatment x subgroup interaction for age, body mass index, weight, baseline O2abs, race/ethnicity, or baseline hormone therapy use. There were no significant changes in systolic or diastolic blood pressure values from baseline to six months in any of the exercise groups vs the control group.

Conclusion: In this study, previously sedentary, overweight or obese post-menopausal women experienced a graded dose-response change in fitness across levels of exercise training.

The effect of walking on fitness, fatness and resting blood pressure: A meta-analysis of randomised, controlled trials.

Murphy, M.H., Nevill, A.M., Murtagh, E.M., & Holder, R.L. (2007).
Prev Med., 44(5), 377-385.

Objective: The purpose of this review was to perform a meta-analysis on walking intervention studies in order to quantify the magnitude and direction of walking-induced changes that may alter selected cardiovascular risk factors.

Method Twenty-four randomised controlled trials of walking were assessed for quality on a three-point scale. Data from these studies were pooled and treatment effects (TEs) were calculated for six traditional cardiovascular risk variables: body weight, body mass index (BMI), percentage body fat, aerobic fitness (V(O(2) )max in ml kg(-1) min(-1)) and resting systolic and diastolic blood pressure.

Weighted TEs were analyzed using a random effects model with weights obtained using the inverse of the individual TE variances. Random effects models were used to investigate the influence of both study quality and exercise volume (<150>/=150 min week(-1)).

Results: Random effects modelling showed that walking interventions increased V(O(2) ) max and decreased body weight, BMI, percent body fat and resting diastolic blood pressure in previously sedentary adults (p<0.05>

Conclusion: The results of this study provide evidence that healthy but sedentary individuals who take up a program of regular brisk walking improves several known risk factors for cardiovascular disease.

Leisure-time physical activity patterns by weight control status: 1999-2002 NHANES

Kruger, J., Yore, M.M., Kohl, H.W. III. (2007). Medicine & Science in Sports & Exercise. 39(5), 788-795.

Introduction: Regular physical activity reduces the risk of hypertension, Type 2 diabetes, coronary heart disease, stroke, and some cancers. Physical activity is associated inversely with overweight and obesity prevalence, thus potentially assisting in weight control efforts.

Purpose: The purpose of this paper is to examine the variability of physical activity levels and their patterns by self-reported weight control status in a nationally representative sample.

Methods: Four years of data from the 1999-2002 National Health and Nutrition Examination Survey (NHANES) were used to examine leisure-time physical activity patterns (regular, irregular, inactive) and the prevalence of weight control practices (trying to lose, trying to maintain, not trying to lose or maintain) among U.S. adults (N = 9496).

Results: The prevalence of regular physical activity was 32.6% among people trying to lose weight, 37.9% among people trying to maintain weight, and 21.8% among those not trying to lose or maintain weight.

Those trying to lose weight were almost three times as likely to be regularly active (vs inactive), and those trying to maintain weight were over three times more likely to be regularly active (vs inactive) than those not trying to lose or maintain weight.

The most commonly reported activities among those trying to lose weight were walking (38.3%), yard work (14.5%), biking (12.5%), and running (11.6%).

Conclusions: Despite the importance of physical activity, fewer than half the people trying to lose or maintain weight were regularly active during leisure-time. People trying to lose or maintain weight had a higher likelihood of being regularly active than those not trying to lose or maintain weight.

Walking was the most common type of physical activity among all weight control groups. Health promotion efforts should promote increased levels of physical activity among all adults.

Physical activity, obesity status, and glycemic control: The ATTICA study

Kavouras, S.A., Panagiotakos, D. B., Pitsavos, C., Chrysohoou, C., Anastasiou, C. A., Lentzas, Y., & Stefanadis, C. (2007). Medicine & Science in Sports & Exercise. 39(4), 606-611.

Purpose: We aimed to evaluate the relationship of physical activity and obesity with glycemic control and insulin resistance.

Methods: A randomized, population-based, cross-sectional health and nutrition survey was conducted in the province of Athens, Greece. Subjects included 1,514 men and 1,528 women without evidence of cardiovascular or other chronic disease.

Participants were classified as inactive, minimally active, or health-enhancing physical activity (HEPA) active based on the International Physical Activity Questionnaire.

Insulin sensitivity was assessed by the homeostatic model (HOMA), and overweight or obesity was assessed according to BMI (BMI >= 25). Related social, biological, and lifestyle factors were also recorded and used as potential confounders.

Results: Five hundred sixty-five (37.3%) men and 493 (32.3%) women were classified as physically active.

From the 1,058 (34.8%) subjects who were classified as active, 306 (10.1%) met the criteria for HEPA active, and the rest were minimally active. HEPA active and minimally active subjects smoked less and had lower BMI, waist, and waist-to-hip ratio.

Lean and overweight or obese subjects with sedentary lifestyle had greater levels of glucose, insulin, and insulin sensitivity. However, overweight or obese volunteers with physical activity levels classified as HEPA had similar levels of glucose and insulin sensitivity, with lower insulin than lean inactive individuals.

Linear regression analysis between HOMA and physical activity, taking into consideration several social and biological factors, showed that physical activity (MET[middle dot]min[middle dot]wk-1), age, BMI, and total energy intake are important predictors of HOMA, whereas other factors such as waist circumference did not reach statistical significance.

Conclusion: Our data show that physical activity is a significant factor on insulin sensitivity, whereas increased physical activity may ameliorate the well-known effects of obesity on insulin sensitivity.

Think tank on school-aged children: nutrition and physical activity to prevent the rise in obesity
Mendelson, R. (2007). Appl. Physiol. Nutr. Metab. 32(3), 495–499.

Abstract: The rise in childhood obesity has generated concern across a range of sectors. Stakeholders and experts in the area of children’s health met at a Think Tank in Toronto organized by the Canadian Council for Food and Nutrition and the Program in Food Safety, Nutrition, and Regulatory Affairs at the University of Toronto to discuss the current evidence in place to inform the development of school policies to reduce childhood obesity.

Although there is some evidence to suggest that school interventions may reduce obesity in children, there are other examples of programs that have had very little impact. The role of parents in the development of healthy eating and physical activity patterns is critical from the earliest stages of life and warrants further attention.

Delegates agreed that we need ongoing input of experts and leaders from all sectors and fields to help us to effectively promote healthy lifestyles at schools and within the home, while respecting each child's need for safety, security, and respect.


CSA standard for outdoor children's playspaces

A new edition of the CSA Z614-2007 Standard for Outdoor Children's Playspaces has been released by CSA International. A comparison table of the significant changes from previous editions is available on the CPRA web site. A PDF version or hard copy of this document can be ordered for $65 at

Interesting workplace program to encourage weight loss

Boyd's plan is simple: Employees enroll in 10-week sessions and go for weekly weigh-ins. They have motivational and informational meetings with a wellness coach, and participants get together to swap recipes and share tips.

Boyd collects a $120 cheque from each worker who signs up. At the end of 10 weeks, employees who have cut at least five pounds and attended eight out of 10 meetings get their cheques back. The cheques of workers who don't make it through the program go into Boyd's wellness fund to help pay for the initiative.

The city has three wellness coaches on-site daily, circulating through offices to offer encouragement, hand out fruit, perform blood pressure checks and talk about exercise. City employees lost more than 2,000 pounds in the fall as part of a 12-week weight-loss contest, and an additional 2,300 pounds in a similar challenge this spring.

The cost for the wellness program, coaches and all, is $225,000 a year, said Victoria Robinson, manager of insurance services for the city of Las Vegas.

If that sounds like a major investment, consider that the expense is less than 1 per cent of the city's annual health care spending, Robinson said. It's also roughly the same cost as bypass surgery for one worker.

The neighbourhood pace car program is coordinated by Active & Safe Routes to School in partnership with Canada’s Home, Car and Business Insurers. This new and innovative program can slow the traffic on residential streets and around schools dramatically without the need for physical barriers. For more info go to this link and click on the pace car logo on the homepage.

Pedometer impact on sustained physical activity behaviour – New Zealand

Trails paths and routes advisory committee - Edmonton
The TPRAC provides advice and input to the City administration on planning, maintenance, management, emerging issues and special projects pertaining to multi-use facilities.

The TPRAC works towards the enhancement of Edmonton's environment for walking, running, cycling and travel by other active modes.

Toronto coalition for active transportation

Walking, cycling win-win emission reduction strategies
From the Victoria Transport Policy Institute Victoria, BC.

What are your children learning? The impact of high school sports on the values and ethics of high school athletes

According to a report released by Josephson Institute, the values of young athletes are dramatically impacted by their sports experience. The report, What Are Your Children Learning? The Impact of High School Sports on the Values and Ethics of High School Athletes, summarizes the responses of 5,275 high school athletes to a written survey administered in 2005 and 2006.

Where technology is taking fitness management
In this article, the author describes how fitness club owners and managers are using computer technology to provide better member services and boost their revenue.