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.

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