Associations between active commuting and body Adiposity among Atlantic Canadians Zhijie Michael Yu and Cynthia Forbes Click here to see the full brief Though the beneficial effects of regular physical activity on both health and body weight control have been well documented, only about one in ten people in the general population are aware of the public health guidelines for physical activity. Both Canadian and American activity guidelines recommend that adults should engage in at least 150 minutes of moderate-to-vigorous intensity physical activity per week to help maintain good health and prevent disease. Several research studies using Canadian Health Measures Survey data suggest that approximately 15% of Canadian adults meet the recommended guidelines according to objectively measured physical activity. In addition, the prevalence of obesity in Canada has been constantly increasing over the past 25 years. Currently, one in six Canadian adults are obese (body mass index [BMI] ≥ 30 kg/m2). The situation is more pronounced in the Atlantic provinces in which one in four adults are classified as obese. Lifestyle changes, particularly the emergence of an obesogenic diet and a decreasing trend in total physical activity, have been ascertained as a key contributor to the obesity epidemic. An increasingly sedentary lifestyle has been found to be one of the major contributors to the decreasing levels of total physical activity. The reliance and use of motorized vehicles is one of the major sedentary lifestyle activities which has been shown to be associated with body adiposity.In contrast, recent studies have reported that active commuting is associated with lower levels of body adiposity when compared with motor vehicle use. We hypothesized that physical activities such as commuting via walking or cycling may be related to decreased body adiposity in our study population. Therefore, we carried out a cross-sectional analysis to assess whether active commuting is associated with body adiposity among participants of the Atlantic Partnership for Tomorrow’s Health (Atlantic PATH) cohort study.

Prevalence and comparison of select health behaviours among urban and rural residents: an Atlantic PATH cohort brief report Cynthia C. Forbes and Zhijie Michael Yu Click here to see the full brief Research in developed countries indicates that rural residents generally have poorer health than those living in urban areas. Rural residents have been shown to be more obese and have higher prevalence of chronic disease. These differences in obesity may be due to health-related behaviours that influence body mass. Literature also suggests that rural residents are more likely to be inactive, sedentary, have poor diets, smoking and drinking behaviour. Approximately 19% of all Canadians are classified as rural; however, in Atlantic Canada, an average 46% of the population are considered rural (43% NS, 47% NB, 41% NL, and 53% PEI). Atlantic Canada has higher prevalence rates of poor health behaviours and chronic disease when compared to Canadian averages. It is unclear what mechanisms may be responsible for these differences, but considering the suggestion that rural residents experience poorer health than urban residents, we felt this was a factor worth exploring. This research brief uses data from the Atlantic Partnership for Tomorrow Health (PATH) study to identify the characteristics and behaviours of urban/rural residents in all four provinces. We also examine any possible mediators of these behaviours between the urban/rural groups. The purpose of this brief is to 1) describe and compare the characteristics of urban/rural residents in terms of health behaviours and chronic disease status; 2) describe and compare the following behaviours of urban/rural residents: physical activity level, time spent sitting, fruit intake, vegetable intake, fruit or vegetable juice intake, smoking, and alcohol consumption; and 3) identify any characteristics from purpose #1 that mediate behaviours in purpose #2 of urban/rural residents. We hypothesized that those designated as rural would have poorer health behaviours than those in urban areas.

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.