major initiatives related to childhood obesity and physical … · 2019-04-11 · •...
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Major Initiatives Related to Childhood Obesity and Physical
Inactivity in Canada: The Year in Review
Mark Tremblay, Ph.D., D.Litt. (hon), FACSM Director, Healthy Active Living and Obesity Research Group
Children’s Hospital of Eastern Ontario Research Institute Chief Scientific Officer, Active Healthy Kids Canada
Professor, Department of Pediatrics, University of Ottawa
The function of protecting and developing health must rank
even above that of restoring it when impaired.
Hippocrates
2010-2011 INITIATIVES 1. FPT Framework for Action to Promote Healthy Weights
2. Health Canada and FCPC Nutrition Labeling Initiative
3. Launch of CBC “Live Right Now”
4. Public Health Agency of Canada’s Innovation Strategy Funding
5. Publication of CHMS physical activity findings
6. Release of new Physical Activity Guidelines
7. Launch of ParticipACTION “Think Again” campaign
8. Building Trust to Address the Epidemic of Obesity
9. Release of new Sedentary Behaviour Guidelines
10. SPAR Minister’s Collaborative Action for Afterschool Period
11. Canadian Pediatric Weight Management Registry begins
12. Our Health Our Future: A National Dialogue on Healthy Weights
13. Release of Active Healthy Kids Canada Report Card
14. Canadian Obesity Network “National Obesity Summit”
15. TROPIC initiates process to update Pediatric Obesity Guidelines
16. Nature Play Day Canada
17. Canadian Beverage Association – Canadian Calorie Label Initiative
18. Sports Day in Canada
19. Canadian Assessment of Physical Literacy Developed
20. Creation of Active Canada 20/20
1. F-P-T Framework for Action to Promote Healthy Weights
September, 2010
• Framework for action with three integrated strategies 1. Making childhood overweight and obesity a collective priority for
action among multiple government departments and sectors of Canadian society
2. Coordinating efforts on three key policy priorities 1. Supportive environments
2. Early action
3. Nutritious foods
3. Measuring and reporting on collective progress
Vision: Canada is a country that creates
and maintains the conditions for
healthy weights so that children
can have the healthiest possible lives.
• Guiding Principles – Prevention is a priority – Prevention is the hallmark of a quality health
system – Prevention is the first step in management – Health promotion has many approaches that
should be used – Health promotion is everyone’s business
2. Health Canada and FCPC Nutrition Labelling Initiative
October, 2010
3. Launch of CBC “Live Right Now”
• Live Right Now is a national initiative designed to inspire Canadians to join together and change the health of this country. The idea is built around the small steps everyone can take in their life to improve their health.
• Led by the CBC/Radio-Canada – Canada’s National Public Broadcaster with support and guidance from Advisory Board Partners
January, 2011
4. PHAC Innovation Strategy Funding January, 2011
• Two strategic calls made in 2010 with funding announced for Phase 1 in 2011 – Achieving Healthier Weights in Canadian Communities
• Prevention focus
• 37 projects funded
• Up to $250,000 per project, 12-15 months
– Managing Obesity Across the Lifecycle: An Interventions Approach
• Treatment and Management focus
• 5 projects funded
• Up to $250,000 per project, 12-15 months
– Phase 2 details to come in autumn 2011
5. Publication of CHMS PA Findings
Canadian Health Measures Survey Statistics Canada in partnership with
Health Canada and the
Public Health Agency of Canada
2007-2009 (cycle 1)
• Anthropometry – height, weight, waist and
hip circumference, sitting height, 5 skinfolds
• Cardiorespiratory Fitness – blood pressure, resting
heart rate, modified Canadian Aerobic Fitness Test (step test)
• Musculoskeletal Fitness – hand grip strength
– sit-and-reach flexibility
– curl-ups
• Physical Activity – accelerometry
January, 2011
Portrait of a typical Canadian 12 year old Canadian children today are taller,
heavier, fatter, rounder, weaker and less flexible than in 1981.
These results forecast accelerated non-communicable disease
development, increased health care costs, and loss of future
productivity. Tremblay et al. Health Reports, 2010
Results – Children and Youth
• 7% of Canadian children and youth accumulate 60 minutes of moderate-to-vigorous physical activity (MVPA) on at least 6 days per week
• Boys are more active than girls (9% versus 4% meet the guidelines)
• Physical activity declines with increasing age
• Physical activity declines with increasing adiposity in boys
• Canadian children and youth are sedentary for ~8.6 hours per day (62% of waking hours)
6. Release of new Canadian PA Guidelines January, 2011
Children 5-11 years Youth 12-17 years Adults 18-65 years
Older Adults ≥65 years
Relevant Papers and Reports
• http://pubs.nrc-cnrc.gc.ca/rp-ps/inDetail.jsp?jcode=apnm&lang=eng&vol=32&is=S2E (Foundation Papers)
• http://www.ijbnpa.org/series/canada_physical_activity (Systematic Reviews)
• http://www.csep.ca/english/view.asp?x=804 (PA Guidelines Report)
• http://www.csep.ca/english/ (New Guideline Resources)
7. Launch of ParticipACTION “Think Again” Campaign
January, 2011
8. Building Trust to Address the Epidemic of Obesity
February, 2011
Guiding Principles for Effective Partnerships
1. Share each other’s equity 2. Stay true to who you are 3. Acknowledge and manage risk 4. Create compelling communications 5. Inspire, motivate and activate your stakeholders 6. Be clear 7. Measure and evaluate
An Approach to Effective Partnerships
• Three-Phase Approach – Phase I: Assessing Potential Partners
– Phase II: Building Partnerships • The Relationship
• The Agreement
– Phase III: Managing Partnerships • Project Management
• Evaluation
• Communication
• http://www.participaction.com/en-us/For-Partners-And-Stakeholders/Research-Library.aspx
9. Release of new Sedentary Behaviour Guidelines
February, 2011
SCREEN INVASION
An Active Day?
8 hours 30 min
30 min
30 min 4 hours
YES Courtesy of Dr. David Dunstan
Canadian Sedentary Behaviour Guidelines for Children and Youth
GUIDELINES
For health benefits, children (aged 5-11 years) and youth (aged 12-17 years) should minimize the time they spend being sedentary each day. This may be achieved by
• Limiting recreational screen time to no more than 2 hours per day; lower levels are associated with additional health benefits.
• Limiting sedentary (motorized) transport, extended sitting and time spent indoors throughout the day.
Relevant Papers and Reports
• http://pubs.nrc-cnrc.gc.ca/rp-ps/inDetail.jsp?jcode=apnm&lang=eng&vol=32&is=S2E (Foundation Papers)
• http://www.csep.ca/english/view.asp?x=881 (Sedentary Guidelines Report)
• http://www.csep.ca/english/ (New Guideline Resources)
10. SPAR Minister’s Collaborative Action for Afterschool Period
February, 2011
Federal, Provincial and Territorial Ministers Take Action to
Support Sport, Physical Activity and Healthy Weights
• In an effort to achieve the 2015 physical activity targets for children and youth
established in 2008, Ministers recognized that the after-school time period provides a
prime opportunity to encourage increased physical activity among children and youth.
Ministers agreed to explore opportunities to work with other departments and
stakeholders, to identify shared approaches aimed at increasing physical activity in the
after-school period.
• Ministers endorsed the Declaration on Prevention and Promotion and the document
Curbing Childhood Obesity: A FPT Framework for Action to Promote Healthy Weights.
They also agreed to work with Ministers of health and health promotion / healthy living
who released these initiatives in September 2010.
11. Canadian Pediatric Weight Management Registry (CANPWR) Begins
March, 2011
• Purpose: To develop a pan- Canadian pediatric weight management registry to examine the health of obese youth and the effectiveness of pediatric weight management in Canada.
• Study Design and Methods: Prospective cohort study that will enroll patients who are newly referred to pediatric weight management programs across Canada.
• Subject Selection: Children and adolescents presenting to Canadian Pediatric Weight management programs will be approached for interest by the clinical team and after discussion with the research team will be consented for participation.
• Multi-site registry (Vancouver, Edmonton, Hamilton, Ottawa, Montreal)
• Harmonized core measures (physical measures and questionnaires)
Study Objectives: 1: Assemble a common database of health outcomes
and their determinants in obese youth. 2: Characterize health status, changes in health over
time and key determinants of metabolic and psychosocial health status before and after intervention of obese children receiving weight management care.
3: Establish and pilot a multi-centre, web-based data platform of standardized measures and data management processes to support the national pediatric weight management registry.
12. Our Health Our Future: A National Dialogue on Healthy Weights
March, 2011
• Our Health Our Future is a national dialogue to inform Canadians about the
issue of childhood overweight and obesity, and to engage various sectors of
Canadian society to help address this important public health issue.
• Our Health Our Future recognizes that a complex system of factors contribute
to overweight and obesity. To address the causes of obesity we need to change
the social and physical environments that influence children’s and families’
eating habits and physical activity levels.
• This initiative recognizes that all Canadians can play a role in identifying ways
to create the conditions that support healthy eating, physical activity and healthy
weights.
• Our goal with Our Health Our Future is to kick-start a longer-term societal shift
to support healthy weights by making the environments where children live,
learn and play more supportive of physical activity and healthy eating.
How it works • Through an online idea forum and submissions centre at
www.ourhealthourfuture.gc.ca, youth, parents, caregivers and all Canadians can share their perspectives on the factors that contribute to childhood obesity and options that can influence and support healthy choices.
• Key stakeholders, including youth, non-governmental
organizations, national Aboriginal organizations, media and industry will be invited to face-to-face dialogues across the country to explore areas for joint and/or complementary action.
• The outcomes will be shared at a national summit in fall 2011
and will contribute to the development of a report and recommendations for action that will be presented to federal, provincial and territorial Health Ministers.
13. Release of Active Healthy Kids Canada Report Card
April, 2011
Failing grade!
0
100
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300
400
500
600
700
800
900
1000
Print Radio Television Online Total
Nu
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f H
its
Media Type
Total Number of Hits by Media Type
2005
2006
2007
2008
2009
2010
Active Healthy Kids Canada Report Card
www.activehealthykids.ca
14. Canadian Obesity Network National Obesity Summit
April, 2011
2nd National Obesity Summit
This year's Summit was a great
success, with almost 800 delegates
on hand from across the country and
as far away as China, South Africa
and Australia. National, provincial
and local media interest was strong,
and the Twittersphere was abuzz with
almost 500 Tweets from the event
reaching upwards of 80,000 people.
15. TROPIC Initiates Process to Update Pediatric Obesity Guidelines
April, 2011
Our Mission
The goal of TROPIC is to develop
collaborations between clinicians and
researchers working in the area of child
and adolescent obesity management. Our
focus is on initiating and contributing to
knowledge transfer and exchange activities
in partnership with the
Canadian Obesity Network.
Treatment and Research of Obesity in Pediatrics in Canada
http://www.obesitynetwork.ca/tropic
Paper Grade of Recommendation
Level of Evidence
Classification of overweight and obesity in children and adolescents (p. 27-32)
A C C C C
3 4 4 4 4
Clinical evaluation of obese children and adolescents (p.45-49) A B C C C C
3 3 4 4 4 4
Dietary intervention for the treatment of pediatric obesity (p. 79-82) B C C
2 4 4
Physical activity and exercise therapy in children and adolescents (p. 83-86)
A A C
2 2 4
Combined diet and exercise in the treatment of pediatric overweight and obesity (p. 87-88)
A A
2 2
Pharmacotherapy and bariatric surgery for the treatment of obesity in children and adolescents (p. 89-91)
B C C
1 4 4
Individual approaches to the prevention of pediatric obesity using physical activity (p. 95-101)
B C C
3 4 4
Prevention of childhood obesity through nutrition: review of effectiveness (p. 102-104)
C C C
4 4 4
Update and Expansion of the Canadian Clinical Practice
Guidelines for Pediatric Obesity
Steering Committee Meeting
Friday April 29, 2011
Salon Jarry, Le Centre Sheraton, Montreal
Attending: K Morrison, JP Chanoine, S Kirk, J McGavock, P Boisvert, M Tremblay, K Ambler,
L Pinsonneault, G Tomkinson, S Connor Gorber
Meeting Objectives
1. Determine objectives for update and expansion of pediatric CPG project
2. Establish tasks, teams and timeline for project
16. Nature Play Day Canada June, 2011
“I like to play indoors better ’cause that’s where all the
electrical outlets are.”
A Fourth-Grader in San Diego
From R. Louv. Last Child in the Woods. 2005
NATURE-DEFICIT DISORDER
Nature Play Day Canada
• The Child and Nature Alliance of Canada invites you and your community to celebrate outdoor play and join us for Nature Play Day! This Canada-wide day of playing in nature is all about finding a simple way to connect with nearby nature in your backyard, local park, schoolyard, rooftop garden . . . wherever really!
• WHERE: In communities, schools, businesses and households across CANADA!
• WHO: Parents, grandparents, teachers, schools, families, youths, communities . . . EVERYONE!
• HOW: Register your Nature Play Day Canada event on our map and pledge to participate in an outdoor activity on June 15th.
June 15, 2011
http://www.childnature.ca/nature-play-day-canada
17. Canadian Beverage Association Canadian Calorie Label Initiative
June, 2011
18. Sports Day in Canada September, 2011
19. Canadian Assessment of Physical Literacy (CAPL) Developed
2011
What is Physical Literacy? • A construct which captures the essence of what a quality physical
education or a quality community sport activity program aims to achieve. – It is the foundation of characteristics, attributes, behaviours, awareness,
knowledge and understanding related to healthy active living, the promotion of physical recreation opportunities and positive health choices across the lifespan.
• Its measurement includes elements of fitness, motor skill development, awareness / knowledge / understanding, physical activity and sedentary behaviours, and awareness of safety issues.
Motor Skills
Awareness, Knowledge
& Understanding
Physical Fitness
Physical Activity
Behaviours
Physical Literacy
20. Development of Active Canada 20/20 2010 - 2011
Active Canada 20/20
A Physical Activity Strategy and Change Agenda for Canada
Active Canada 20/20 – A Physical Activity Strategy for Canada, is the response
to an urgent national need to increase physical activity and reduce sedentary living.
Eighty-five percent of Canadian adults and 93% of Canadian children and youth do
not achieve the minimum level of physical activity necessary to ensure long-term
good health and well being.
Active Canada 20/20 provides a clear vision and a change agenda to describe what
Canada must do to increase physical activity, reduce sedentary behaviour, thereby
reducing risk and achieving the many benefits of a society that is active and healthy.
Active Canada 20/20 can impact every community in Canada. It is designed to
engage decision makers and rally the collaborative, coordinated and consistent
efforts of all stakeholders at every level to make a difference for the well being and
sustainability of our communities, our country, our social programs and, most
importantly, our people.
2010-2011 INITIATIVES 1. FPT Framework for Action to Promote Healthy Weights
2. Health Canada and FCPC Nutrition Labeling Initiative
3. Launch of CBC “Live Right Now”
4. Public Health Agency of Canada’s Innovation Strategy Funding
5. Publication of CHMS physical activity findings
6. Release of new Physical Activity Guidelines
7. Launch of ParticipACTION “Think Again” campaign
8. Building Trust to Address the Epidemic of Obesity
9. Release of new Sedentary Behaviour Guidelines
10. SPAR Minister’s Collaborative Action for Afterschool Period
11. Canadian Pediatric Weight Management Registry begins
12. Our Health Our Future: A National Dialogue on Healthy Weights
13. Release of Active Healthy Kids Canada Report Card
14. Canadian Obesity Network “National Obesity Summit”
15. TROPIC initiates process to update Pediatric Obesity Guidelines
16. Nature Play Day Canada
17. Canadian Beverage Association – Canadian Calorie Label Initiative
18. Sports Day in Canada
19. Canadian Assessment of Physical Literacy Developed
20. Creation of Active Canada 20/20
Conclusion
Unprecedented activity across all sectors is occurring in Canada in an effort to decrease obesity and increase the physical activity of
children –
But it is still not enough!
Acknowledgements
• Friends and colleagues from the Healthy Active Living community in Canada
• Healthy Active Living and Obesity Research Group (HALO) at the Children’s Hospital of Eastern Ontario Research Institute