Make Life Harder

I’ve just returned from the final day of the Global Summit on the Physical Activity of Children.  The highlight today was a keynote by Mike Evans, a physician who has created a number of extremely successful viral videos on health-related topics.

His talk was of interest to me as both as a health researcher, and as someone who is actively involved in knowledge translation (KT).  I think the most important thing that he discussed was the idea that failure is ok, and even crucial to success in both research and in KT.  He talked about making a Minimum Viable Product, which is basically the best thing you can duct tape together, warts and all.  You then constantly evaluate and tweak the product, with each iteration sucking slightly less than the one before.  It’s the model that Peter and I have used here at Obesity Panacea (www.obesitypanacea.blogspot.com was very different from the blog you see today!), and continue to use as we play around with Youtube and Twitter and podcasts.

But Dr Evans talked about using the Minimum Viable Product idea to go from an idea to having a working healthcare intervention in a span of just 90 days. In other words, do a bit of homework, talk to your target audience, then try out a basic intervention. Then evaluate, build on what worked, and drop the rest. I can see some hurdles with that approach (just getting ethics approval in <90 days can be a real challenge sometimes) but I think it makes sense, especially when compared with the alternative of spending years developing an intervention that may be tossed aside or irrelevant by the time it is ready to roll out.

During his talk Dr Evans also showed one of his videos, this one focusing on making life harder as a means of embedding physical activity into your day. I personally use almost all of the strategies in the video, and I think it does a great job of getting the message across.

As a last thought on the conference, I just wanted to say congrats to Mark Tremblay and all the organizers, as well as the folks at Active Healthy Kids Canada (especially Lindsay Whiting) for putting on a great conference. Hope to see you all again soon.

Travis

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Physical activity vs sedentary behaviour; what is more important for kids?

My personal highlight from day 2 of the Global Summit on the Physical Activity of Children was a debate on the relative importance of sedentary behaviour and physical activity for child health.  Arguing for physical activity was Dr Ulf Ekelund, while sedentary behaviour was argued by David Dunstan.  Rather than go point by point, I thought I’d touch on some of the main themes that were discussed. And just to be clear, this was my perception of the debate, so if anyone had a different perception I’d love to hear it in the comments (similarly, if anyone feels I misunderstood the points of the speakers please let me know).

Objective and Subjective Sedentary Behaviour Are Not the Same

One of the first points raised by Ulf Ekelund is that objectively measured sedentary behaviour is not consistently associated with health outcomes in children.  In contrast, screen-based measures of sedentary behaviour are much more consistently linked with negative health outcomes.  Take, for example, this paper from my PhD that found that screen time was strongly associated with health risk in kids aged 8-11 years, whereas objectively measured sedentary time showed no association with health outcomes.  In other words it may be the screens that matter, rather than the sitting.

Physical Activity Gives the Biggest Bang For Your Buck

In contrast to the wishy washy evidence linking objectively measured sedentary behaviour and health in kids, there is pretty consistent linking physical activity with health in this same group.  Dr Ekelund has done some interesting work in this area.  For example, the below figure shows data from one of Dr Ekelund’s studies which found that moderate intensity physical activity was associated with health outcomes in kids irrespective of how much time they spent being sedentary.  In contrast, sedentary behaviour was not associated with any health outcome after adjusting for moderate physical activity.  In other words, physical activity was the more important to health than sedentary behaviour for these kids (JP Chaput found similar results using a cohort of Canadian children).

Kids and Adults Are Not the Same
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New Zealand & Mozambique Get Top Grades on Physical Activity Report Cards

Image via Active Health Kids Canada (Source)

Image via Active Health Kids Canada (Click to view full size)

Today is the first full day at the Global Summit on the Physical Activity of Children, and it began with the unveiling of Physical Activity Report Cards from 15 different countries.  Canada has been releasing an annual Report Card on childhood physical activity for 10 years, but this year they were joined by countries ranging from England and the USA to Ghana and Kenya. Canada and the USA received overall grades of D- (not a big surprise who for those of us that have followed these things over the years), while New Zealand and Mozambique had the top grades (B for both countries).  In addition to overall physical activity, the report cards also looked at different key indicators for each country.

Interestingly, Canada scored relatively well on indicators related to school physical activity, family and peer support, and government policy and the built environment (I say relatively well because the grades were still typically low, but they were nonetheless in the top third of countries).  In other words, in Canada we seem to be doing a good job of putting the supports in place for kids to be active (or at least paying it lip service), but it’s not making much of a difference in terms of actual physical activity levels.  Below is a video of Joel Barnes, lead author of the Canadian Report Card, explaining their key findings for this year.


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Come find me at the Global Summit on the Physical Activity of Children

This week I head to the Global Summit on the Physical Activity of Children in Toronto, Canada. I’ll be an official blogger at the conference and I’m looking forward to a bunch of great sessions (Full disclosure: several colleagues, including my former supervisor, were heavily involved in organizing the conference, and as a blogger my registration fees have been waived. That being said, I had already committed to attend the Summit anyway because it looks like a great conference).

Since beginning my Post Doc in December my research has been focusing on adult populations (specifically people with heart disease and other chronic conditions), so it will be nice to be back to pediatric research for a few days! I’ll be blogging more throughout the week, but I wanted to list my general itinerary here in case anyone wants to pop over and say hello. Also, if you’re planning to attend/blog about other sessions let me know and I’m happy to link to it here. For anyone tweeting about the conference, the official hashtag is #AHKCSummit.


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Active Transportation and Health: Cycling > Walking > Driving

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Photo by Tejvan Pettinger (Source)

Today’s guest post comes from my friend, colleague, and former labmate Richard Larouche.  You can find out more about Richard at the bottom of this post.

Regular readers of Obesity Panacea will know that today’s children are not active enough. For example, according to the 2007-2009 Canadian Health Measures Survey, only 9% of boys and 4% of girls meet the Canadian physical activity guidelines (Colley et al., 2011, available here). These guidelines recommend that children and youth accumulate at least 60 minutes of daily moderate-to-vigorous physical activity – that is activities that are intense enough to increase one’s heart rate and accelerate breathing.

There are many sources of daily physical activity including organized sports, physical education, active transportation, household tasks, etc. Today, I will focus on active transportation, which is the use of non-motorized means such as walking and cycling to travel to and from places.

Travis and I have recently published a comprehensive review of 68 studies that looked at active transportation to and from school among children and youth (Larouche et al., 2014a, available here). To be eligible for the review, studies needed to examine the relationship between active transportation and one of the 3 following outcomes: 1) physical activity; 2) body composition (i.e., body weight and waist circumference); and 3) cardiovascular fitness.

We found consistent evidence that active transportation was associated with higher physical activity levels, not only during the journey to and from school, but during the whole day as well. Furthermore, the difference in physical activity between children using active vs. motorized travel modes was even greater among those who traveled longer distances.

35% of the studies showed that active travelers had a more favourable body composition. However, over half of the studies found no such differences. In our article, we proposed several potential explanations for these findings. I will briefly mention 3 of these hypotheses:

  1. Active travelers may compensate for the increased energy expenditure during active transportation by eating more during the rest of the day.
  2. The energy expenditure of active transportation may simply be insufficient to have a substantial impact on body composition for the typical child who walks or bikes to and from school over a short distance.
  3. Active transportation tends to be more common among children from low socio-economic status families (e.g., families with lower income and/or parental education level). Previous studies indicate that these children are more likely to be overweight or obese.

Finally, for cardiovascular fitness, our findings differed by travel mode. Indeed, the association between walking to and from school and fitness was inconsistent: some studies showed no differences and others found that walkers were slightly fitter. However, all 5 studies that specifically examined cycling found that cyclists were substantially fitter. This included a 6 year longitudinal study which showed that children who switched from motorized travel to cycling increased their fitness over time.

The Canadian Health Measures Survey

More recently, I performed a series of analyses using data from the 2007-2009 Canadian Health Measures Survey (Larouche et al., 2014b, available here). This survey conducted by Statistics Canada is representative of the overall Canadian population.

In the survey, 1,016 youth aged 12-19 years were questioned on the amount of time that they usually spend walking and cycling while traveling to and from school or work or while doing errands. This provided an opportunity to examine active transportation beyond the school trip and how it relates to physical activity, body composition and cardiovascular disease risk factors.

Both walking and cycling were associated with higher physical activity levels, even after controlling for gender, age, parental education and the complex survey design.
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What are your views on moral aspects of sport?

A PhD student at Dalhousie University is studying moral aspects of sport, and he needs your help completing a short questionnaire.  The questionnaire is completed online, and available here.  You do not need to have experience playing sport to participate in this study. Anyone can participate, as long as you can read English and are 18 years of age or older.

A short description of the survey:

Should religious clothing be banned from sports, even if it doesn’t enhance performance? Are initiation rituals inherently wrong? Should coaches value equal playing time above winning? Is fighting in hockey a good thing?  Click here to take a quick survey about moral issues in sport. Your opinions are very important and will help researchers better understand how to promote more civil and productive debates in sport! Email Shea (Sb@dal.ca) for more info! 

Full details can be found here.

Travis

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