The Prevalence of Obesity in Atlantic Canadians with Arthritis Vanessa DeClercq Click here to see the full brief Arthritis is a condition that affects joints and the surrounding tissues, causing chronic pain, limiting mobility and contributing to disability. There are both non-modifiable risk factors such as age, sex, and genetics as well as modifiable risk factors including physical activity, diet, and obesity that impact the risk of developing arthritis. In addition to reducing risk, maintaining a healthy body weight or body mass index (BMI) may also prevent disease progression, reduce pain, and improve movement. Not only do the Atlantic provinces have some of the highest rates of arthritis in Canada (up to 25% of the population), but the percent of individuals in Atlantic Canada that are obese (24-30%) is also well above the national average (20%). BMI is one of the most common measures of obesity, but it does not account for body composition or fat mass distribution. Waist circumference, waist-to-hip ratio and percent body fat/fat mass are also commonly associated with the metabolic complications of obesity. BMI at 18 years of age has been shown to be a strong predictor of obesity in adulthood and a gain in BMI units has been associated with increased risk of disease. Few studies have attempted to include more than one measure of adiposity, and there is a lack of research directly comparing the different measures of adiposity in individuals with arthritis. Therefore, the purpose of this study was to examine the association between prevalence of arthritis and obesity in Atlantic Canadians using both current and past (age 18) anthropometric data.

Prevalence and correlates of sedentary behaviour in an Atlantic Canadian population-based cohort Cindy Forbes Click here to see the full brief Sitting time (i.e., sedentary behaviour) has been shown to be a risk factor for a number of chronic diseases and higher mortality, independent of physical activity levels. Despite the health risk, research suggests that the majority of the Canadian population spend about 10 hours per day sedentary. The Canadian Health Measures Survey (CHMS), first launched in 2007, collects health information via household interviews and direct measures. A main goal of the CHMS is to allow researchers to determine relationships between disease risk factors and health status, and to explore emerging public health issues among Canadians. Research has shown that in order to change behaviour, targeting interventions to specific groups of the population may prove more effective. Examining the correlates of sitting time among the Atlantic PATH cohort will allow us to determine what groups are most sedentary and may benefit from targeted interventions. The aim of this report is to examine the demographic and medical correlates associated with sitting time in a cohort of Atlantic Canadians.

The Association between Physical Activity and Self-Rated Health in Atlantic Canadians Yunsong Cui, Cindy Forbes, Ellen Sweeney, Michael Yu, Vanessa DeClercq, & Melanie Keats Click here to see the full brief Biological, psychological and social factors all influence an individual’s perception of their health status. Self-rated health (SRH) is a subjective measure of this perception, which utilizes a four- or five-point scale, ranging from “poor” to “excellent.” SRH is well-established in the field of public health; it can be used as a predictive indicator of a population’s overall health and well-being, including future morbidity, mortality, functional decline, and utilization of health care services. Previous research has demonstrated the relationship between lower levels of SRH and higher rates of mortality from chronic disease, including diabetes mellitus. Engaging in regular levels of physical activity (PA) can result in improvements in overall health, and reduce the risks associated with a sedentary lifestyle. Increased PA has the potential to prevent detrimental health conditions, including diabetes, cardiovascular disease, obesity, and some forms of cancer. Regular PA is also positively associated with higher levels of SRH. Recognizing the benefits associated with PA and the link between PA and SRH, this research brief explored the association between PA levels and SRH among Atlantic Canadians. We also explored the impact of chronic disease status on this association.

Physical activity levels in Atlantic Canadian Arthritis Patients Scott Grandy, Yunsong Cui, Vanessa DeClercq, & Melanie Keats Click here to see the full brief Arthritis is one of the most common chronic health conditions in Canada and is a leading cause of disability affecting over 4 million Canadians over 15 years of age. Of note, the prevalence of arthritis in Atlantic Canadians aged 15 and older is well above the national average (i.e., ranging from 19-23% in Atlantic Provinces versus 16% nationally). Arthritis is an inflammatory disease that affects the joints, causing chronic joint pain, swelling and stiffness, ultimately impairing an individual’s ability to carry out daily activities and negatively impacting their quality of life. The treatment approach to arthritis primarily involves symptom management, including pain relief and improving joint function. The preferred strategy is a conservative, non-pharmacological approach followed by medications and subsequently surgery as required. An important element of the non-pharmacological management strategy is weight reduction and physical activity. It is well known that a sedentary lifestyle and/or a lack of physical activity has multiple negative effects of health indices. Regrettably, while the health benefits of physical activity are well acknowledged, many Canadians are failing to reach the recommended 150 minutes per week of moderate-to-vigorous physical activity, particularly those with arthritis. A variety of factors, including environmental, demographic, psychosocial, and physical conditions can influence the physical activity levels of people living with arthritis. For example, physical factors such as join pain, stiffness, and reduced muscle strength experienced by people living with arthritis may impair an individuals’ ability to fully participant in physical activity. Notwithstanding, physical activity has been shown to improve joint function and act as an effective pain management strategy in those suffering from arthritis. Accordingly, using a population-based sample from the Atlantic Provinces, the purpose of this report is to describe and compare the physical activity levels of individuals with a self-reported history of arthritis to those who have do not have a history of the disease.

Physical Activity Levels in Atlantic Canadian Diabetes Patients Yunsong Cui, Cindy Forbes, Scott Grandy, Ellen Sweeney, Michael Yu, & Melanie Keats Click here to see the full brief Over the past 36 years the number of adults living with diabetes worldwide has nearly quadrupled, rising from 4.7% (108 million) to 8.5% (422 million). In Canada, diabetes is one of the most common chronic diseases afflicting 9.3% of the population in 2015. Similar to rising global rates, the proportion of Canadians living with diabetes is projected to reach 12.1% in 2025. The potential complications associated with diabetes are extensive and include heart attack, stroke, kidney failure, leg amputation, nerve damage, and vision loss. In Canada, people with diabetes are more likely to be hospitalized than those without diabetes. For instance, people with diabetes are three times more likely to be hospitalized as a result of cardiovascular disease, 12 times more likely as a result of end-stage renal disease, and 20 times more likely as a result of non-traumatic lower limb amputation. Diabetes-related complications can also lead to premature death, with one in ten Canadian deaths attributed to diabetes. The growing burden of diabetes reflects an increase in risk factors, such as being overweight or obese combined with a lack of physical activity. Engaging in regular physical activity has the potential to both prevent and manage diabetes. Physical activity improves the body’s sensitivity to insulin, can assist in managing blood glucose levels, increase cardiorespiratory fitness, reduce blood pressure, and assist with maintaining weight loss. Physical activity is also one of the strongest predictors of all-cause mortality in people with diabetes. The clinical practice guidelines of the Canadian Diabetes Association Expert Committee recommend at least 150 minutes per week of moderate-to-vigorous intensity physical activity, over a period of at least three days per week, with no more than two days without exercise. Recognizing the benefits associated with physical activity, using a population based sample from Atlantic Canada this report describes and compares the physical activity levels of individuals with a self-reported history of diabetes to those without a history of the disease.

Population Profile:Health Seeking Behaviours of Participants with and without a History of Cancer Ellen Sweeney Click here to see the full brief Two of every five Canadians are expected to develop cancer during their lifetime, and one in four is expected to die as a result. In 2015, this translated to approximately 196,900 new cancer diagnoses in Canada and 78,000 cancer-related deaths (41,000 men and 37,000 women). Atlantic Canada has among the highest rates of cancer in the country (Society’s Steering Committee on Cancer Statistics, 2012; Marrett et al. 2008; Xie et al., 2015). The data collected as part of the Atlantic Partnership for Tomorrow’s Health (Atlantic PATH) cohort study supports this finding by demonstrating high rates of cancer and other chronic disease. Atlantic PATH includes self-reported survey data for over 30,000 participants aged 35-69 from Nova Scotia, New Brunswick, Prince Edward Island, and Newfoundland and Labrador (Borugian et al., 2010; Yu et al., 2014). The results of the Atlantic PATH study indicate that 7.6% of participants (n=2371) have been diagnosed with at least one form of cancer.

Prevalence and correlates of physical activity behaviour in an Atlantic Canadian population-based cohort Cindy Forbes Click here to see the full brief Physical activity (PA) has been linked to improved physical and mental health, while higher levels of inactivity has been identified as an important risk factor for a number of chronic diseases. However, research suggests that the majority of the Canadian population are inactive. The Canadian Health Measures Survey (CHMS), first launched in 2007, collects health information via household interviews and direct measures. A main goal of the CHMS is to allow researchers to determine any relationships between disease risk factors and health status, and to explore emerging public health issues among Canadians. In order to change behaviour, studies show targeting specific groups of the population may be more effective. An examination of the correlates of PA among the Atlantic PATH cohort will allow us to determine what groups are inactive and may benefit from targeted interventions. Accordingly, the goal of this report is to explore any demographic or medical correlates associated with PA in a cohort of Atlantic Canadians.

Physical activity levels in Atlantic Canadian CVD Patients Melanie Keats, Cindy Forbes, Scott Grandy, & Yunsong Cui Click here to see the full brief Sixty years ago as many as 35% of Canadians who suffered a heart attack did not survive. Today, through early diagnosis and improved treatment options, as many as 95% of those who reach a hospital will survive. As a result, an estimated 1.3 million Canadians are living with heart disease and an additional 317,500 are living with the effects of stroke. Despite improved survival rates, many of those with a history of a heart attack or stroke struggle to recover and are often unable to maintain potentially lifesaving behavioral modifications. For example, despite the well documented health and cardio-protective benefits associated with physical activity, many individuals struggle to maintain optimal levels of physical activity following cardiac rehabilitation. Using a population based sample from Atlantic Canada, this report describes and compares the physical activity levels of individuals with a self-reported history of a major cardiovascular event (i.e., myocardial infarction and/or stroke) with those who have never experienced either event.

Associations between physical activity, sedentary behaviour and sleep duration and quality Cindy Forbes and Vanessa DeClercq Click here to see the full brief Lack of sleep and poor sleep quality has been linked to many poor physical and mental health outcomes including cardiovascular disease (CVD), depression, anxiety, diabetes, hypertension, obesity, and all-cause mortality. Of note, sleep quality has not only been associated with poorer health outcomes, but has been shown to exacerbate associations between other unhealthy lifestyle behaviours and health outcomes. Additionally, existing treatments for sleep disorders, while effective, may have side-effects. Physical activity (PA) has been suggested as a possible alternative treatment among general and chronic disease populations. Engaging in regular PA has been linked to changes in sleep circadian rhythms, thermogenic regulation, body weight, physical fitness, anxiety, depression, and pain; any of which could be a possible mechanism by which PA impacts sleep. While emerging evidence suggests that sedentary behaviour (SB) may also be associated with poor self-reported sleep outcomes, very little research on SB and sleep associations was found. The goal of this report is to examine any associations between PA or SB and sleep duration or quality among a cohort of Atlantic Canadians.

The relationship between sleep and obesity Vanessa DeClercq and Cindy Forbes Click here to see the full brief Strategies for preventing and treating obesity are complex and far greater than simply eating less and moving more. While multiple factors contribute to the growing obesity epidemic, studies have shown an important association between habitual sleep duration and obesity. Possible mechanisms linking sleep and obesity include changes at the physiological level (hormonal metabolic changes) that may alter hunger and appetite as well as factors that reduce energy expenditure such as reduced thermogenesis, fatigue and decreased physical activity. Reports suggest that the relationship between body mass index (BMI) and sleep is U-shaped rather than linear. Although BMI is the most reported measure of obesity, there are other indicators of adiposity such as fat mass, waist circumference or waist-to-hip ratio. Recent studies have examined sleep patterns and other adiposity measures such as body composition. For example, Poggiogalle et al. reported a negative association between fat mass and sleep duration and Ford et al. have documented an inverse association with waist circumference. However, the results for BMI are inconsistent, some showing no association and some reporting negative or U-shaped associations. These mixed findings highlight the need for additional study of body composition as it relates to sleep duration. Accordingly, the aim of this study was to examine the association between sleep duration and obesity using multiple measures/indicators of obesity in the Atlantic PATH cohort.