Public Health Guidelines for Sedentary Behaviour

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Public Health Guidelines for Sedentary Behaviour Mark Tremblay, Ph.D., D.Litt. (hons), FACSM, CSEP-CEP Director, Healthy Active Living and Obesity Research Group Children s Hospital of Eastern Ontario Research Institute Professor, Department of Pediatrics, University of Ottawa Chair, Active Healthy Kids Global Alliance

I have received consulting, speaking, travel and/or research support from: Canadian Institutes of Health Research Canadian Population Health Initiative Public Health Agency of Canada Statistics Canada Dairy Farmers of Canada Laval University University of British Columbia University of Victoria University of Alberta University of Calgary University of Saskatchewan University of Manitoba Lakehead University Laurentian University Nipissing University University of Toronto University of Western Ontario University of Moncton University of Guelph York University Queen s University University of Ottawa McGill University UPEI University of New Brunswick University of Guadalajara University of South Australia Conference Board of Canada University of Maringa Shanghai Sports University West Texas A&M University Dalhousie University University of Jyvaskyla The Lawson Foundation Alberta Centre for Active Living Active Healthy Kids Canada ParticipACTION Fundacion Mexicana para la Salud Canadian Obesity Network New Brunswick School District #2 City of London Manitoba Institute of Child Health Chronic Disease Prevention Alliance of Canada Canadian Federation of Biological Societies Heart and Stroke Foundation of Canada Heart and Stroke Foundation of Ontario StepsCount Chatham-Kent Public Health Unit Huron-Perth Public Health Unit Ontario School Boards Association Bruce-Grey Public Health Unit Kellogg Canada World Health Organization Ontario Ministry of Health Promotion Ontario Ministry of Health and Long-Term Care Strathclyde University American Society of Bariatric Physicians Fuzhou Normal University American College of Advanced Medicine The Moblees Ophea Respironics, Inc. Physical and Health Education Canada Upper Canada District School Board Ottawa Catholic School Board Canadian Society for Exercise Physiology Australian Council for Health, PE and Rec Halton Health Region Peel Health Region Canadian Home Economics Foundation Recreation and Parks Association of Yukon Capital Health Authority Newfoundland and Labrador Parks & Rec Refreshments Canada NB Power New Brunswick Health and Wellness Alberta Health and Wellness Nova Scotia Recreation Commission PEI Health Canadian Fitness and Lifestyle Res Institute CAHPERD Health Canada Statistics Canada Macro International CHEO Research Institute Jalisco Ministry of Health World Obesity Federation Thunder Bay Public Health South West University (China) Glasgow Caledonian University Champlain LHIN Champlain Cardiovascular Disease Network Medical Research Fund of New Brunswick North American Soc for Ped Exercise Med Interprovincial Sport and Recreation Council Pennington Biomedical Research Center Diabeaters Inc. CAMBIO Nanjing University Shangdong University Beijing Sport University Ontario Society for Health and Fitness England Department of Health Wellcome Trust McMaster University Cancer Prevention Alliance of Canada C-CHANGE TROPIC Alberta School Boards Association Canadian School Boards Association Cardel Place Coca-Cola Company International Life Sciences Institute Discovery Vitality (South Africa) ActionSante (Switzerland) Ontario College of Family Physicians Canada Foundation for Innovation South Africa Nutrition Society Da Lian Department of Education Public Heath Ontario

Presentation Overview Canadian Sedentary Behaviour Guidelines Development process Final guidelines Experiences and assessments Implications for future guidelines Take away messages

An Active Day? 6 hours 30 min 30 min 30 min YES! 45 min 4 hours 15 min 3 hours

RESEARCH INSTITUTE Physical Activity: 65 mins/day Sedentary time: 8 hours/day Sedentary Breaks: Frequent Physical Activity: 65 mins/day Sedentary time: 8 hours/day Sedentary Breaks: Infrequent Saunders et al. PLOS ONE, 2013

Physical Activity: 65 mins/day Sedentary time: 8 hours/day Screen Time: 1 hour/day Physical Activity: 65 mins/day Sedentary time: 8 hours/day Screen Time: 5 hours/day Saunders et al. PLOS ONE, 2013

CANADIAN SEDENTARY BEHAVIOUR GUIDELINES FOR the early years (0-4 years) children (5-11 years) youth (12-17 years)

Appl. Physiol. Nutr. Metab. 2012;37:753 772

6,365 21 22,417 participants

Sedentary Behaviour Guidelines Guideline: Clarity 601 responses 95% agree Guideline: Agreement 601 responses 92% agree 71.5% 76.38% 24.87% 23.3% 2.49% 2.3% 2.66% 2.5% 0.36% 0.3% 68.7% 73.23% 23.6% 25.18% 3.0% 3.19% 4.26% 4.0% 0.7% 0.71% 430 140 14 15 2 413 142 18 24 4 Completely agree Somewhat agree Neither agree nor disagree Somewhat disagree Completely disagree Completely agree Somewhat agree Neither agree nor disagree Somewhat disagree Completely disagree

Appl. Physiol. Nutr. Metab. 2012;37:370 380

Knowledge Translation: Tools and Resources published online: csep.ca/guidelines RESEARCH INSTITUTE Clinical Practice Guideline Development Report (AGREE Report)* Scientific Statements for professionals Information Sheets for professionals and the public Backgrounder Q & A Glossary of Terms Media Release *available in English only

Sedentary Behaviour Research Network (SBRN) >900 members since Summer 2011 Members from around the world Members include researchers, students, clinicians, public health professionals and private sector personnel >35,000 visitors/month to the website www.sedentarybehaviour.org

Should we consider strategies for Reducing auto-dependency car time Reducing nature-deficit disorder Reducing indoor time Reducing screen time Reducing chair time Other indices for reducing sedentary behaviours

FITT vs SITT Frequency Intensity Time Type Sedentary Interruptions Time Type

Carson et al. Paediatrics and Child Health, 2013

Knowledge and awareness of Canadian Physical Activity and Sedentary Behaviour Guidelines: a synthesis of existing evidence LeBlanc et al. Appl. Physiol. Nutr. Metab. (in press) Less than 10% of survey respondents from the Canadian population were aware of PA guidelines, and less than 5% were aware of SB guidelines. Information on the guidelines was available on 51% of public health unit and CSEP partner websites. Online metrics (e.g., downloads, site accessions) from CSEP, the Public Health Agency of Canada, and journal websites showed that online accession of the guidelines was high (e.g., all highly accessed on journal websites). This review showed that awareness of Canadian PA and SB guidelines is low amongst the general population, but higher amongst the scientific and stakeholder community.

The Movement Continuum Sedentary Physiology Exercise Physiology sleep sedentary behaviour LPA moderate physical activity intense exercise - METS +

Canadian Integrated 24-hour Movement Behaviour Guidelines: Guideline Development Meeting #1 Montebello, QC December 8 10, 2014

Guideline Evolution Energy out side of energy balance equation can learn from energy in Emerging research shows clearly that sedentary behaviour is a separate and distinct risk factor from physical activity; so is sleep; and emerging evidence that light (incidental) physical activity is also independent and/or mediates or moderates relationships with health Canada is developing the world s first integrated movement behaviour guidelines Concept has wide support and appeal from health care, public health, physical activity sector, etc.

Chaput et al. IJERPH, 2014

Take away messages Development and release of separate sedentary behaviour guidelines in Canada has been a public health success We need to evolve even further into whole day thinking This will require a reanalysis of our data (compositional analyses) Patterns likely matter movement variability This approach allows for multiple intervention entry points can be personalized