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Introduction. Les activités de renforcement des muscles et d’amélioration de l’équilibre sont associées à la prévention des maladies et des blessures. Les Directives canadiennes en matière de mouvement sur 24 heures offrent des recommandations concernant les activités de renforcement de l’appareil locomoteur et d’amélioration de l’équilibre. Entre 2000 et 2014, l’Enquête sur la santé dans les collectivités canadiennes (ESCC) a intégré un module évaluant la fréquence de 22 activités physiques. En 2020, un module de réponse rapide sur le mode de vie sain (HLV‑RR) posant de nouvelles questions sur la fréquence des activités de renforcement de l’appareil locomoteur et d’amélioration de l’équilibre a été intégré dans l’ESCC. Notre étude visait trois objectifs : 1) estimer et caractériser le respect des recommandations concernant les activités de renforcement de l’appareil locomoteur et d’amélioration de l’équilibre; 2) étudier les associations entre, d’une part, les activités de renforcement de l’appareil locomoteur et d’amélioration de l’équilibre et, d’autre part, l’état de santé physique et mentale et 3) analyser les tendances au fil du temps en matière de respect des recommandations (2000 à 2014).Méthodologie. Nous avons estimé, à l’aide des données du module HLV‑RR de l’ESCC 2020, la prévalence du respect des recommandations en fonction de l’âge. Des analyses de régression logistique multivariée ont porté sur les associations avec l’état de santé physique et mentale. Les données de l’ESCC de 2000 à 2014 ont fait l’objet de régressions logistiques visant à faire ressortir les tendances au fil du temps par sexe en matière de respect des recommandations.Résultats. Les adolescents de 12 à 17 ans (56,6 %; IC à 95 % : 52,4 à 60,8) et les adultes de 18 à 64 ans (54,9 %; IC à 95 % : 53,1 à 56,8) étaient nettement plus nombreux à suivre la recommandation concernant le renforcement de l’appareil locomoteur que les adultes de 65 ans et plus (41,7 %; IC à 95 % : 38,9 à 44,5). Seulement 16 % des aînés respectaient la recommandation concernant l’amélioration de l’équilibre. Le respect des recommandations est associé à un meilleur état de santé physique et mentale. La proportion de Canadiens respectant les recommandations a augmenté entre 2000 et 2014.Conclusion.Environ la moitié des Canadiens ont respecté les recommandations concernant le renforcement de l’appareil locomoteur pour leur âge. Rendre compte du respect des recommandations en matière de renforcement de l’appareil locomoteur et d’amélioration de l’équilibre assure de l’importance de ces recommandations au même niveau que celles en matière d’activité aérobique.

Background New Canadian 24-Hour Movement Guidelines for the Early Years have been released in 2017. According to the guidelines, within a 24-h period, preschoolers should accumulate at least 180 min of physical activity (of which at least 60 min is moderate-to-vigorous physical activity), engage in no more than 1 h of screen time, and obtain between 10 and 13 h of sleep. This study examined the proportions of preschool-aged (3 to 4 years) Canadian children who met these new guidelines and different recommendations within the guidelines, and the associations with adiposity indicators. Methods Participants were 803 children (mean age: 3.5 years) from cycles 2–4 of the Canadian Health Measures Survey (CHMS), a nationally representative cross-sectional sample of Canadians. Physical activity was accelerometer-derived, and screen time and sleep duration were parent-reported. Participants were classified as meeting the overall 24-Hour Movement Guidelines if they met all three specific time recommendations for physical activity, screen time, and sleep. The adiposity indicators in this study were body mass index (BMI) z-scores and BMI status (World Health Organization Growth Standards). Results A total of 12.7% of preschool-aged children met the overall 24-Hour Movement Guidelines , and 3.3% met none of the three recommendations. A high proportion of children met the sleep duration (83.9%) and physical activity (61.8%) recommendations, while 24.4% met the screen time recommendation. No associations were found between meeting individual or combined recommendations and adiposity. Conclusions Very few preschool-aged children in Canada (~13%) met all three recommendations contained within the 24-Hour Movement Guidelines . None of the combinations of recommendations were associated with adiposity in this sample. Future work should focus on identifying innovative ways to reduce screen time in this population, and should examine the associations of guideline adherence with health indicators other than adiposity.

Active video games (AVGs) have gained interest as a way to increase physical activity in children and youth. The effect of AVGs on acute energy expenditure (EE) has previously been reported; however, the influence of AVGs on other health-related lifestyle indicators remains unclear. This systematic review aimed to explain the relationship between AVGs and nine health and behavioural indicators in the pediatric population (aged 0-17 years). Online databases (MEDLINE, EMBASE, psycINFO, SPORTDiscus and Cochrane Central Database) and personal libraries were searched and content experts were consulted for additional material. Included articles were required to have a measure of AVG and at least one relevant health or behaviour indicator: EE (both habitual and acute), adherence and appeal (i.e., participation and enjoyment), opportunity cost (both time and financial considerations, and adverse events), adiposity, cardiometabolic health, energy intake, adaptation (effects of continued play), learning and rehabilitation, and video game evolution (i.e., sustainability of AVG technology). 51 unique studies, represented in 52 articles were included in the review. Data were available from 1992 participants, aged 3-17 years, from 8 countries, and published from 2006-2012. Overall, AVGs are associated with acute increases in EE, but effects on habitual physical activity are not clear. Further, AVGs show promise when used for learning and rehabilitation within special populations. Evidence related to other indicators was limited and inconclusive. Controlled studies show that AVGs acutely increase light- to moderate-intensity physical activity; however, the findings about if or how AVG lead to increases in habitual physical activity or decreases in sedentary behaviour are less clear. Although AVGs may elicit some health benefits in special populations, there is not sufficient evidence to recommend AVGs as a means of increasing daily physical activity.

Accumulating evidence suggests that, independent of physical activity levels, sedentary behaviours are associated with increased risk of cardio-metabolic disease, all-cause mortality, and a variety of physiological and psychological problems. Therefore, the purpose of this systematic review is to determine the relationship between sedentary behaviour and health indicators in school-aged children and youth aged 5-17 years. Online databases (MEDLINE, EMBASE and PsycINFO), personal libraries and government documents were searched for relevant studies examining time spent engaging in sedentary behaviours and six specific health indicators (body composition, fitness, metabolic syndrome and cardiovascular disease, self-esteem, pro-social behaviour and academic achievement). 232 studies including 983,840 participants met inclusion criteria and were included in the review. Television (TV) watching was the most common measure of sedentary behaviour and body composition was the most common outcome measure. Qualitative analysis of all studies revealed a dose-response relation between increased sedentary behaviour and unfavourable health outcomes. Watching TV for more than 2 hours per day was associated with unfavourable body composition, decreased fitness, lowered scores for self-esteem and pro-social behaviour and decreased academic achievement. Meta-analysis was completed for randomized controlled studies that aimed to reduce sedentary time and reported change in body mass index (BMI) as their primary outcome. In this regard, a meta-analysis revealed an overall significant effect of -0.81 (95% CI of -1.44 to -0.17, p = 0.01) indicating an overall decrease in mean BMI associated with the interventions. There is a large body of evidence from all study designs which suggests that decreasing any type of sedentary time is associated with lower health risk in youth aged 5-17 years. In particular, the evidence suggests that daily TV viewing in excess of 2 hours is associated with reduced physical and psychosocial health, and that lowering sedentary time leads to reductions in BMI.

During the COVID-19 pandemic, public health approaches and disease-transmission varied widely across Canadian regions. This may have led to different trajectories for moderate-to-vigorous intensity physical activity (MVPA) and screen time during this period. The purpose of this investigation was to describe age- and gender-specific regional trends in MVPA and screen time for Canadian youth (ages 12-17 years) and adults (ages 18+) from 2018 to 2021. Data was collected using the Canadian Community Health Survey, which includes representative data for 5 distinct regions: Atlantic Canada, Québec, Ontario, the Prairie Provinces, and British Columbia (BC). Participants aged 12+ in each region self-reported their total daily screen time, as well as MVPA in 5 domains: overall, recreational, school, occupational/household and active transportation. Results were compared for 2018 (pre-pandemic), January-March of 2020, September-December of 2020, and 2021 using repeated measures -tests. Among youth, all regions except for Atlantic Canada and BC experienced significant reductions in the proportion of youth meeting MVPA recommendations in the fall of 2020 (all < 0.001), although these had returned to baseline for all regions except Ontario by 2021. Trends varied across regions among adults aged 18-64 years. In Québec, there was 7-percentage point reduction in the proportion of males meeting the MVPA recommendations in the fall of 2020 compared to 2018, while there was a 4-percentage point increase among females in 2021 (all  < 0.05). In Ontario and the Prairie provinces, males saw a 4-percentage point decrease in activity recommendation adherence in 2021, when compared to 2018 (  < 005). There were no other significant differences for any region when comparing the fall of 2020 or 2021 with 2018 (all  > 0.05). Among adults aged 65+ years, significant increases in MVPA were observed in Atlantic Canada and the Prairies in the fall of 2020, and in Atlantic Canada, Québec and the Prairies in 2021 (all  < 0.05). With limited exceptions, self-reported screen time increased significantly across regions and age groups for both males and females (all < 0.05). MVPA levels of Canadians during the COVID-19 pandemic varied both by region and age group. Self-reported MVPA of Canadian youth dropped in most regions in the fall of 2020, before returning to pre-pandemic levels in 2021. Activity levels of Canadians aged 18-64 years were relatively stable during the pandemic and increased for Canadians aged 65+ in most regions. Differences in trajectories across genders observed at the national level were often less apparent in individual regions. Recreational screen use increased across all regions, ages and genders with very few exceptions. These results highlight the differences and similarities in activity and screen time trajectories across the Canadian population and suggest the need for additional research to identify best practices for promoting healthy movement behaviours during future pandemics.

The purpose of this review was to determine the most valid and reliable questions for targeting key modes of sedentary behaviour (SB) in a broad range of national and international health surveillance surveys. This was done by reviewing the SB modules currently used in population health surveys, as well as examining SB questionnaires that have performed well in psychometric testing. Health surveillance surveys were identified via scoping review and contact with experts in the field. Previous systematic reviews provided psychometric information on pediatric questionnaires. A comprehensive search of four bibliographic databases was used to identify studies reporting psychometric information for adult questionnaires. Only surveys/studies published/used in English or French were included. The review identified a total of 16 pediatric and 18 adult national/international surveys assessing SB, few of which have undergone psychometric testing. Fourteen pediatric and 35 adult questionnaires with psychometric information were included. While reliability was generally good to excellent for questions targeting key modes of SB, validity was poor to moderate, and reported much less frequently. The most valid and reliable questions targeting specific modes of SB were combined to create a single questionnaire targeting key modes of SB. Our results highlight the importance of including SB questions in survey modules that are adaptable, able to assess various modes of SB, and that exhibit adequate reliability and validity. Future research could investigate the psychometric properties of the module we have proposed in this paper, as well as other questionnaires currently used in national and international population health surveys.

The objective of this paper is to describe the exercise and changes in screen time habits, and their relationship with health, among participants of the Canadian Perspectives Survey Series (CPSS). Between March 29th and April 3rd 2020, CPSS participants (n = 4,524) reported whether they were exercising outdoors or indoors and whether they increased, decreased or maintained their TV, Internet and video game use. Participants also reported their self-perceived general and mental health. More women reported very good or excellent mental health if they were exercising outdoors (54%) compared with those who were not (41%). More women reported very good or excellent general health if they were exercising outdoors (75%) compared with those who were not (49%), with the same trend evident for those exercising indoors (69%) compared to those who were not (62%). More men (65%) and women (62%) rated their mental and general health as very good or excellent if they maintained or decreased TV time compared with those who increased TV time (57% and 43%, respectively), with the same evident for Internet use in women only (maintained/decreased: 61% versus increased: 44%). More men (63%) and women (52%) rated their mental health as very good or excellent if they maintained or decreased video game time compared with those who increased video game time (48% and 29%, respectively). More men and women reported very good or excellent mental and general health if they increased none or one type of screen and/or were exercising outdoors compared with those who increased 2 or 3 types of screens and who were not exercising outdoors, with the exception of general health among men. Maintaining opportunities for outdoor exercise and limiting screen time may promote better mental and general health during periods of confinement.

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

Muscle-strengthening and balance activities are associated with the prevention of illness and injury. Age-specific Canadian 24-Hour Movement Guidelines include recommendations for muscle/bone-strengthening and balance activities. From 2000-2014, the Canadian Community Health Survey (CCHS) included a module that assessed frequency in 22 physical activities. In 2020, a healthy living rapid response module (HLV-RR) on the CCHS asked new questions on the frequency of muscle/bonestrengthening and balance activities. The objectives of the study were to (1) estimate and characterize adherence to meeting the muscle/bone-strengthening and balance recommendations; (2) examine associations between muscle/bone-strengthening and balance activities with physical and mental health; and (3) examine trends (2000-2014) in adherence to recommendations. Using data from the 2020 CCHS HLV-RR, we estimated age-specific prevalence of meeting recommendations. Multivariate logistic regressions examined associations with physical and mental health. Using data from the 2000-2014 CCHS, sex-specific temporal trends in recommendation adherence were explored using logistic regression. Youth aged 12 to 17 years (56.6%, 95% CI: 52.4-60.8) and adults aged 18 to 64 years (54.9%, 95% CI: 53.1-56.8) had significantly greater adherence to the muscle/ bone-strengthening recommendation than adults aged 65 years and older (41.7%, 95% CI: 38.9-44.5). Only 16% of older adults met the balance recommendation. Meeting the recommendations was associated with better physical and mental health. The proportion of Canadians who met the recommendations increased between 2000 and 2014. Approximately half of Canadians met their age-specific muscle/bonestrengthening recommendations. Reporting on the muscle/bone-strengthening and balance recommendations elevates their importance alongside the already recognized aerobic recommendation.

On average, 45% of Canadian adults meet the recommended 150 minutes per week of moderate-to-vigorous physical activity. This singular statistic masks a wide range of adherence levels among different groups within the population. The purpose of this paper is to determine how sex, age, and family arrangement intersect with known risk factors for physical inactivity to identify groups within the Canadian population most at risk of not meeting the physical activity recommendation. Using six combined cycles of the Canadian Health Measures Survey (from 2007 to 2019), this study examines how the percentage of Canadian males and females aged 18 to 79 years meeting the physical activity recommendation differs across sociodemographic, family arrangement, and health factors. Logistic regression was used to examine whether the association between specific factors and adherence to the physical activity recommendation differed by sex. Latent class analysis was used to identify sex-specific combinations of sociodemographic, family arrangement and health-related factors within the Canadian population that are associated with varying levels of adherence to the physical activity recommendation. More males met the physical activity recommendation compared with females (49% versus 38%). Latent classes with the lowest adherence to the physical activity recommendation (19% among females and 29% among males) primarily included those who were single or married with no children and who had a high probability of having many risk factors for physical inactivity, including being older, having a lower education, having lower income, smoking, having central adiposity, and having poor or fair self-rated general health. Latent classes with the highest adherence to the physical activity recommendation (61% among females and 67% among males) primarily included individuals with no spouse and no children and who had a low probability of having any risk factors for physical inactivity. For females, an additional class (32% of which met the physical activity recommendation) comprised young single mothers who had several risk factors for physical inactivity, including having low income, smoking and having central adiposity. Understanding how risk factors for physical inactivity intersect with sex, age, and family arrangement may inform strategies aimed at increasing physical activity among those who are most vulnerable.