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Harandian K, Necsa B, Barnett TA, Pagani LS. Family Meal Environment Differentially Conditions the Prospective Association between Early Childhood Screen Time and Key Social Relationships in Adolescent Girls. Children (Basel) 2024; 11:145. [PMID: 38397257 PMCID: PMC10886694 DOI: 10.3390/children11020145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 01/19/2024] [Accepted: 01/22/2024] [Indexed: 02/25/2024]
Abstract
Background: Despite screen time recommendations, children are increasingly spending time on electronic devices, rendering it an important risk factor for subsequent social and developmental outcomes. Sharing meals could offer a way to promote psychosocial development. This study examines the interaction between family meal environment and early childhood screen time on key adolescent social relationships. Methods: Participants are 1455 millennial children (49% boys) from the Quebec Longitudinal Study of Child Development birth cohort. Parents reported on child screen use at ages 2 and 6 years and family meal environment quality at age 6 years. Parents and children reported on parent-child relationships and peer victimization experiences, respectively, at age 13 years. Sex-stratified multiple regression estimated the direct association between screen time trends, family meal environment quality, and their interaction on later social relationship outcomes. Results: For girls, when preschool screen time increased, sharing family meals in high-quality environments was associated with more positive and less conflictual relationships with their mothers, whereas meals shared in low- and moderate-quality environments were associated with fewer instances of victimization by their peers. Non-linear associations were not significant for boys. Conclusion: Capitalizing on family meal environment represents a simple/cost-efficient activity that can compensate for some long-term risks associated with increased screen use, above and beyond pre-existing and concurrent individual and family characteristics. Public health initiatives may benefit from considering family meals as a complementary intervention strategy to screen use guidelines.
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Affiliation(s)
- Kianoush Harandian
- School of Psycho-Education, University of Montreal, Montreal, QC H3C 3J7, Canada; (K.H.); (B.N.)
- School Environment Research Group, University of Montreal, Montreal, QC H3C 3J7, Canada
| | - Beatrice Necsa
- School of Psycho-Education, University of Montreal, Montreal, QC H3C 3J7, Canada; (K.H.); (B.N.)
| | - Tracie A. Barnett
- Sainte-Justine’s Hospital Research Center, Montreal, QC H3T 1C5, Canada
- Department of Family Medicine, McGill University, Montreal, QC H3S 1Z1, Canada
| | - Linda S. Pagani
- School of Psycho-Education, University of Montreal, Montreal, QC H3C 3J7, Canada; (K.H.); (B.N.)
- School Environment Research Group, University of Montreal, Montreal, QC H3C 3J7, Canada
- Sainte-Justine’s Hospital Research Center, Montreal, QC H3T 1C5, Canada
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Reid RER, Henderson M, Barnett TA, Kakinami L, Tremblay A, Mathieu ME. Children and chrono-exercise: Timing of physical activity on school and weekend days depends on sex and obesity status. Chronobiol Int 2024; 41:72-80. [PMID: 38083868 DOI: 10.1080/07420528.2023.2292097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 12/02/2023] [Indexed: 01/16/2024]
Abstract
Recommendations for physical activity (PA) typically focus on frequency, intensity, duration, and type, but timing (chrono-exercise) is also important. The objective of this study is to describe when children are active on school and weekend days and explore PA timing across sex and body mass index (BMI) categories. 359 children (53% male), aged 9.6 (0.9) y, were categorized as normal weight (≥-1 standard deviations (SD) and <1SD; n = 193), overweight (≥1SD and <2SD; n = 80), or obese (≥2SD; n = 86) using WHO BMIz. Moderate-to-vigorous PA (MVPA) was assessed using ActiGraph LS-7164. The results are described as Mean(SD). ANOVA evaluated MVPA across sexes and BMI categories. Normal weight boys were more active than boys with obesity on school (Δ20.33 min; p < 0.001) and weekend days (Δ15.04 min; p < 0.05). On school days, significant differences existed between 9:00 h-11:00 h and 12:00 h-14:00 h (p < 0.017), while on weekends, smaller differences existed throughout the day. Girls' MVPA was similar across BMI categories, on all days (p > 0.05). On school days, 12:00 h-13:00 h represented the most active hour for all participants (~14% total daily MVPA). Peak weekend MVPA was distributed across multiple hours. Differences in MVPA timing emerged on school-days and weekends. Timing may be important when examining the nuances of MVPA in relation to sex and bodyweight in children.
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Affiliation(s)
- Ryan E R Reid
- Department of Human Kinetics, Saint Francis Xavier University, Antigonish, Canada
| | - Mélanie Henderson
- Department of Pediatrics, Research Center, Sainte-Justine University Hospital Research Center and Université de Montréal, Montréal, Canada
| | - Tracie A Barnett
- Department of Family Medicine, McGill University, Montréal, Canada
| | - Lisa Kakinami
- Department of Mathematics and Statistics, Concordia University, Montréal, Canada
| | | | - Marie-Eve Mathieu
- School of Kinesiology and Physical Activity Sciences, Université de Montréal, Montréal, Canada
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Hunter S, Veerasingam E, Barnett TA, Patte KA, Leatherdale ST, Pabayo R. Correction: The association between income inequality and adolescent body mass index: findings from the COMPASS study (2016-2019). Can J Public Health 2023; 114:1016. [PMID: 37858002 PMCID: PMC10726681 DOI: 10.17269/s41997-023-00819-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
Affiliation(s)
- Stephen Hunter
- School of Public Health, University of Alberta, Edmonton, AB, Canada.
| | | | - Tracie A Barnett
- Department of Family Medicine, McGill University, Montreal, QC, Canada
| | - Karen A Patte
- Department of Health Sciences, Brock University, St. Catharines, ON, Canada
| | - Scott T Leatherdale
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Roman Pabayo
- School of Public Health, University of Alberta, Edmonton, AB, Canada
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Hunter S, Veerasingam E, Barnett TA, Patte KA, Leatherdale ST, Pabayo R. The association between income inequality and adolescent body mass index: findings from the COMPASS study (2016-2019). Can J Public Health 2023; 114:1006-1015. [PMID: 37526917 PMCID: PMC10726682 DOI: 10.17269/s41997-023-00798-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 06/06/2023] [Indexed: 08/02/2023]
Abstract
OBJECTIVES Income inequality has been linked to high and unhealthy body mass index (BMI), though there is a dearth of evidence in adolescents. Therefore, this study examines the association between income inequality and BMI in a large sample of Canadian adolescents. METHODS A pooled cross-sectional design was used. Participants were adolescents (n = 101,901) from 157 Canadian secondary schools participating in the 2016-2017, 2017-2018, or 2018-2019 waves of the Cannabis, Obesity, Mental health, Physical activity, Alcohol, Smoking, and Sedentary behaviour (COMPASS) study. BMI was calculated from self-reported height and weight and converted to World Health Organization (WHO) z-BMI scores. Gini coefficients were calculated at the census division level (n = 49) using data from the 2016 Canadian Census. Multilevel modelling was performed to account for the clustering of students nested within schools, which were nested within census divisions. Interactions were included to determine whether associations were heterogeneous for males and females. RESULTS Income inequality demonstrated a non-linear association with WHO z-BMI score (z-Gini: β = 0.05, 95%CI: 0.02, 0.08; z-Gini2: β = -0.02, 95% CI: -0.04, -0.01) among adolescents after adjusting for student-, school-, and census division-level covariates. This association was more pronounced among females. CONCLUSION The association between income inequality and BMI, being overweight, or having obesity appears to be non-linear. Public health units and schools may benefit from incorporating upstream factors such as income inequality into their interventions attempting to promote healthy weights.
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Affiliation(s)
- Stephen Hunter
- School of Public Health, University of Alberta, Edmonton, AB, Canada.
| | | | - Tracie A Barnett
- Department of Family Medicine, McGill University, Montreal, QC, Canada
| | - Karen A Patte
- Department of Health Sciences, Brock University, St. Catharines, ON, Canada
| | - Scott T Leatherdale
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Roman Pabayo
- School of Public Health, University of Alberta, Edmonton, AB, Canada
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Bird M, Barnett TA, Fuller D, Chinerman D, Mathieu MÈ, Datta GD. Multidimensional school features associated with physical activity among youth at risk of obesity: an exploratory principal component and generalized estimating equation analysis. BMC Public Health 2023; 23:2010. [PMID: 37845705 PMCID: PMC10577956 DOI: 10.1186/s12889-023-16889-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 03/24/2022] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Schools may be high-leverage points for the promotion of physical activity (PA), yet little is known about school built and social environments among youth at high risk of obesity. PURPOSE To characterise school built and social environments that may be salient for PA and to examine associations between school PA environments and PA in youth at risk of obesity. METHODS Data from youth attending 206 schools (314 youth in 2005-2008, and 129 youth in 2008-2010) within the QUALITY cohort study, a longitudinal investigation of youth at high risk of obesity were used. Features of schools, based on built, policy/programming and social environments were identified using principal components (PC) analysis. Gender-stratified generalized estimating equation (GEE) models were used to explore associations between school features and accelerometer measured mean counts per minute (MCPM), mean daily moderate-to-vigorous physical activity (MVPA) and the odds of meeting MVPA guidelines cross-sectionally and prospectively using 90% confidence intervals. RESULTS Nine PCs were identified. Associations were observed between PA and 7 of the 9 PCs. The social environment seemed to be particularly important. Social Norms to Promote PA was associated with an increase in girls' baseline MCPM and MVPA. High Willingness to Promote PA was associated with boys' MCPM, MVPA, and odds of meeting MVPA guidelines, at both baseline and follow-up. CONCLUSION School built and social contexts may be associated with PA cross-sectionally and over time. Further studies are necessary to confirm the direction and magnitude of effects and to establish their relevance to school-based health promotion efforts.
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Affiliation(s)
- Madeleine Bird
- Public Health Agency of Canada, Office of International Affairs for the Health Portfolio, Ottawa, ON, Canada
| | - Tracie A Barnett
- Department of Family Medicine, McGill University, 5858 Côte-Des-Neiges Rd, Montreal, QC, H3S 1Z1, Canada
| | - Daniel Fuller
- Department of Community Health & Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Deanna Chinerman
- Department of Family Medicine, McGill University, 5858 Côte-Des-Neiges Rd, Montreal, QC, H3S 1Z1, Canada
- Department of Kinesiology, CHU Sainte-Justine, University of Montreal, 3175 Chemin de La Côte-Sainte-Catherine, Montréal, QC, H3T 1C5, Canada
| | - Marie-Ève Mathieu
- Department of Kinesiology, CHU Sainte-Justine, University of Montreal, 3175 Chemin de La Côte-Sainte-Catherine, Montréal, QC, H3T 1C5, Canada
- School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Geetanjali D Datta
- Department of Social and Preventive Medicine, School of Public Health, University of Montreal, 7101 Avenue du Parc, 3E Étage, Montréal, QC, H3N 1X9, Canada.
- Department of Medicine, Cedars-Sinai Medical Center, PDC Green, 700 N San Vicente Blvd5Th Fl, West Hollywood, CA, 90069, USA.
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Salmon C, Quesnel-Vallée A, Barnett TA, Benedetti A, Cloutier MS, Datta GD, Kestens Y, Nicolau B, Parent MÉ. Neighbourhood social deprivation and risk of prostate cancer. Br J Cancer 2023; 129:335-345. [PMID: 37188877 PMCID: PMC10338528 DOI: 10.1038/s41416-023-02299-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 04/24/2023] [Accepted: 04/28/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Striking geographic variations in prostate cancer incidence suggest an aetiological role for spatially-distributed factors. We assessed whether neighbourhood social deprivation, which can reflect limited social contacts, unfavourable lifestyle and environmental exposures, is associated with prostate cancer risk. METHODS In 2005-2012, we recruited 1931 incident prostate cancer cases and 1994 controls in a case-control study in Montreal, Canada. Lifetime residential addresses were linked to an area-based social deprivation index around recruitment (2006) and about 10 years earlier (1996). Logistic regression estimated adjusted odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS Men residing in areas characterised by greater social deprivation had elevated prostate cancer risks (ORs of 1.54 and 1.60 for recent and past exposures, respectively; highest vs lowest quintiles), independently from area- and individual-level confounders and screening patterns. The increase in risk with recent high social deprivation was particularly elevated for high-grade prostate cancer at diagnosis (OR 1.87, 95% CI 1.32-2.64). Associations were more pronounced for neighbourhoods with higher proportions of separated/divorced or widowed individuals in the past, and with higher percentages of residents living alone recently. CONCLUSIONS These novel findings, suggesting that neighbourhood-level social deprivation increases the risk of prostate cancer, point out to potential targeted public health interventions.
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Affiliation(s)
- Charlotte Salmon
- Unité d'épidémiologie et de biostatistique, Centre Armand-Frappier Santé Biotechnologie, Institut national de la recherche scientifique, Université du Québec, 531 Boulevard des Prairies, Laval, QC, H7V 1B7, Canada
| | - Amélie Quesnel-Vallée
- Department of Sociology, McGill University, 3460 McTavish Street, Montreal, QC, H3A 0E6, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, 2001 McGill College Avenue, Montreal, QC, H3A 1G1, Canada
| | - Tracie A Barnett
- Department of Family Medicine, McGill University, 5858 Chemin de la Côte-des-Neiges, Montreal, QC, H3S 1Z1, Canada
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, 2001 McGill College Avenue, Montreal, QC, H3A 1G1, Canada
- Respiratory Epidemiology and Clinical Research Unit, Research Institute of the McGill University Health Centre, 5252 Maisonneuve Boulevard, Montreal, QC, H4A 3S5, Canada
| | - Marie-Soleil Cloutier
- Centre Urbanisation Culture Société, Institut national de la recherche scientifique, Université du Québec, 385 Sherbrooke Street East, Montreal, QC, H2X 1E3, Canada
| | - Geetanjali D Datta
- Department of Medicine and Cancer Research Center for Health Equity, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Département de médecine sociale et préventive, École de santé publique, Université de Montréal, 7101 Avenue du Parc, Montreal, QC, H3N 1X9, Canada
- Centre de recherche en santé publique, 7101 Avenue du Parc, Montreal, QC, H3N 1X9, Canada
| | - Yan Kestens
- Département de médecine sociale et préventive, École de santé publique, Université de Montréal, 7101 Avenue du Parc, Montreal, QC, H3N 1X9, Canada
- Centre de recherche en santé publique, 7101 Avenue du Parc, Montreal, QC, H3N 1X9, Canada
| | - Belinda Nicolau
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, 2001 McGill College Avenue, Montreal, QC, H3A 1G1, Canada
| | - Marie-Élise Parent
- Unité d'épidémiologie et de biostatistique, Centre Armand-Frappier Santé Biotechnologie, Institut national de la recherche scientifique, Université du Québec, 531 Boulevard des Prairies, Laval, QC, H7V 1B7, Canada.
- Département de médecine sociale et préventive, École de santé publique, Université de Montréal, 7101 Avenue du Parc, Montreal, QC, H3N 1X9, Canada.
- Research Centre of the Centre Hospitalier de l'Université de Montréal, 850 rue Saint-Denis, Montreal, QC, H2X 0A9, Canada.
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Kakinami L, Danieles PK, Hosseininasabnajar F, Barnett TA, Henderson M, Van Hulst A, Serbin LA, Stack DM, Paradis G. The longitudinal effects of maternal parenting practices on children's body mass index z-scores are lagged and differential. BMC Pediatr 2023; 23:270. [PMID: 37248489 DOI: 10.1186/s12887-023-03902-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 02/10/2023] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND The longitudinal relation between parenting practices and styles with children's body mass index z-scores (zBMI) is poorly understood. Previous studies suggest the relationship may be complex, but small samples and short follow-ups diminish the strength of the evidence. The objectives of this study were to investigate whether the relationship is bidirectional, time-varying, and lagged using data from a large, representative birth cohort of Quebec children. METHODS Data were from the Québec Longitudinal Study of Child Development (QLSCD), a prospective birth cohort (n = 1,602). The mothers' interactions with their children (at ages 6, 8, 10, and 12 years) were utilized in factor analysis to identify three latent parenting practices (disciplinarian, lenient, and responsive). The parenting practices were analyzed with K-means clustering to identify the parenting styles. The temporal and bidirectional relationships were assessed in a cross-lagged path analysis using a structural equation modelling framework. Mixed models controlling for age, sex, income, mother's education, and whether the participant was first-born were estimated. Missing data were handled with full information maximum likelihood. RESULTS From the linear mixed models, greater lenient and responsive parenting practices were associated with higher zBMI (B = 0.03, p < 0.05) two years later. However, there was no evidence that the relationship was bidirectional nor that parenting style was predictive of children's zBMI. CONCLUSION While mothers' parenting practices were unaffected by their children's zBMI, parental practices were predictive of future zBMI among their prepubertal children. More in-depth exploration of parenting practices and their potential impact on pediatric weight is needed.
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Affiliation(s)
- Lisa Kakinami
- Department of Mathematics and Statistics, Concordia University, 1455 de Maisonneuve Blvd West, Montréal, QC, H3G 1M8, Canada.
- PERFORM Centre, Concordia University, Montréal, QC, Canada.
| | - Prince Kevin Danieles
- Department of Mathematics and Statistics, Concordia University, 1455 de Maisonneuve Blvd West, Montréal, QC, H3G 1M8, Canada
| | - Fatemeh Hosseininasabnajar
- Department of Mathematics and Statistics, Concordia University, 1455 de Maisonneuve Blvd West, Montréal, QC, H3G 1M8, Canada
| | - Tracie A Barnett
- Department of Family Medicine, McGill University, Montréal, QC, Canada
- Centre de Recherche du CHU Sainte-Justine, Montréal, QC, Canada
| | - Mélanie Henderson
- Centre de Recherche du CHU Sainte-Justine, Montréal, QC, Canada
- Department of Pediatrics, Université de Montréal, Montréal, QC, Canada
- School of Public Health, Department of Social and Preventive Medicine, Université de Montréal, Montréal, QC, Canada
| | | | - Lisa A Serbin
- Department of Psychology, Concordia University, Montréal, QC, Canada
- Centre for Research in Human Development, Montréal, Canada
| | - Dale M Stack
- Department of Psychology, Concordia University, Montréal, QC, Canada
- Centre for Research in Human Development, Montréal, Canada
| | - Gilles Paradis
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, QC, Canada
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Marrone E, Longo C, O'Loughlin J, Villeneuve PJ, Zappitelli M, Bartlett-Esquilant G, Barnett TA. Association between annual exposure to air pollution and systolic blood pressure among adolescents in Montréal, Canada. Health Promot Chronic Dis Prev Can 2023; 43:191-198. [PMID: 37043547 PMCID: PMC10111566 DOI: 10.24095/hpcdp.43.4.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2023]
Abstract
INTRODUCTION In adults, chronic exposure to air pollution is associated with elevated blood pressure, but few studies have examined this relationship in youth. We investigated the association between annual ambient concentrations of air pollutants (fine particulate matter [PM2.5] and nitrogen dioxide [NO2]) and systolic blood pressure (SBP) among adolescents in Montréal, Canada. METHODS Participants were students aged 15 to 17 years who provided SBP and residential postal code data in 2004/05 through their enrolment in the Nicotine Dependence in Teens study. Annual estimates for 2004 of residential exposure to NO2 and PM2.5 were provided by the Canadian Urban Environmental Health Research Consortium and linked to participants' residential postal code. Elevated SBP was defined as SBP ≥ 90th percentile adjusted for age, sex and height. Logistic regression was used to estimate odds ratios and 95% confidence intervals (CIs) for each pollutant with respect to elevated SBP, adjusted for relevant confounders. RESULTS The sample consisted of 508 adolescents (mean age: 16.9, 46% male); 4% had elevated SBP. Although estimates were not statistically significant, there were generally modest positive associations between pollutant levels and SBP. The adjusted prevalence odds ratio of elevated SBP was 1.33 (95% CI: 0.64, 3.05) for every interquartile range (IQR) increase in residential PM2.5 levels (2.1μg/m3). Similarly, the adjusted prevalence odds ratio of elevated SBP was 1.17 (95% CI: 0.47, 2.70) for every IQR increase in residential NO2 levels (10.2 ppb). CONCLUSION Findings support a possible relationship between exposure to air pollutants and increased SBP in adolescents, warranting further investigation for this important public health concern.
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Affiliation(s)
- Erica Marrone
- Department of Family Medicine, McGill University, Montréal, Quebec, Canada
| | - Cristina Longo
- Department of Respiratory Medicine and Department of Pediatric Respiratory Medicine, University of Amsterdam, Amsterdam, North Holland, The Netherlands
| | | | - Paul J Villeneuve
- Department of Health Sciences, Carleton University, Ottawa, Ontario, Canada
| | - Michael Zappitelli
- Division of Nephrology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | | | - Tracie A Barnett
- Department of Family Medicine, McGill University, Montréal, Quebec, Canada
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Drouin O, Perez T, Barnett TA, Ducharme FM, Fleegler E, Garg A, Lavoie K, Li P, Métras MÉ, Sultan S, Tse SM, Zhao J. Impact of Unmet Social Needs, Scarcity, and Future Discounting on Adherence to Treatment in Children With Asthma: Protocol for a Prospective Cohort Study. JMIR Res Protoc 2023; 12:e37318. [PMID: 36881458 PMCID: PMC10131837 DOI: 10.2196/37318] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/08/2022] [Accepted: 11/18/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Asthma is one of the most prevalent chronic diseases of childhood and disproportionately affects children with lower socioeconomic status. Controller medications such as inhaled corticosteroids significantly reduce asthma exacerbations and improve symptoms. However, a large proportion of children still have poor asthma control, in part owing to suboptimal adherence. Financial barriers contribute to hindering adherence, as do behavioral factors related to low income. For example, unmet social needs for food, lodging, and childcare may create stress and worry in parents, negatively influencing medication adherence. These needs are also cognitively taxing and force families to focus on immediate needs, leading to scarcity and heightening future discounting; thus, there is the tendency to attribute greater value to the present than to the future in making decisions. OBJECTIVE In this project, we will investigate the relationship between unmet social needs, scarcity, and future discounting as well as their predictive power over time on medication adherence in children with asthma. METHODS This 12-month prospective observational cohort study will recruit 200 families of children aged 2 to 17 years at the Asthma Clinic of the Centre Hospitalier Universitaire Sainte-Justine, a tertiary care pediatric hospital in Montreal, Canada. The primary outcome will be adherence to controller medication, measured using the proportion of prescribed days covered during follow-up. Exploratory outcomes will include health care use. The main independent variables will be unmet social needs, scarcity, and future discounting, measured using validated instruments. These variables will be measured at recruitment as well as at 6- and 12-month follow-ups. Covariates will include sociodemographics, disease and treatment characteristics, and parental stress. Primary analysis will compare adherence to controller medication, measured using the proportion of prescribed days covered, between families with versus those without unmet social needs during the study period using multivariate linear regression. RESULTS The research activities of this study began in December 2021. Participant enrollment and data collection began in August 2022 and are expected to continue until September 2024. CONCLUSIONS This project will allow the documentation of the impact of unmet social needs, scarcity, and future discounting on adherence in children with asthma using robust metrics of adherence and validated measures of scarcity and future discounting. If the relationship between unmet social needs, behavioral factors, and adherence is supported by our findings, this will suggest the potential for novel targets for integrated social care interventions to improve adherence to controller medication and reduce risk across the life course for vulnerable children with asthma. TRIAL REGISTRATION ClinicalTrials.gov NCT05278000; https://clinicaltrials.gov/ct2/show/NCT05278000. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/37318.
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Affiliation(s)
- Olivier Drouin
- CHU Sainte-Justine Research Centre, Montreal, QC, Canada
- Division of General Pediatrics, Department of Pediatrics, CHU Sainte-Justine, Montréal, QC, Canada
- Department of Pediatrics, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
- Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montreal, QC, Canada
| | - Tamara Perez
- CHU Sainte-Justine Research Centre, Montreal, QC, Canada
| | - Tracie A Barnett
- CHU Sainte-Justine Research Centre, Montreal, QC, Canada
- Department of Family Medicine, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Francine M Ducharme
- Department of Pediatrics, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
- Clinical Research and Knowledge Transfer Research Centre, Department of Pediatrics, CHU Sainte-Justine, Montreal, QC, Canada
| | - Eric Fleegler
- Division of Emergency Medicine, Boston Children's Hospital, Boston, MA, United States
- Department of Pediatrics, Harvard Medical School, Boston, MA, United States
| | - Arvin Garg
- Department of Pediatrics, University of Massachusetts Medical School, Boston, MA, United States
- Division of General Academic Pediatrics, Department of Pediatrics, Boston Medical Center and School of Medicine, Boston University, Boston, MA, United States
| | - Kim Lavoie
- Montreal Behavioural Medicine Centre, CIUSSS du Nord-de-l'Ile-de-Montreal, Montreal, QC, Canada
- Department of Psychology, Université de Quebec à Montreal, Montreal, QC, Canada
| | - Patricia Li
- Centre for Outcomes Research and Evaluation, McGill University Health Centre Research Institute, Montreal, QC, Canada
- Department of Pediatrics, McGill University, Montreal, QC, Canada
- Division of General Pediatrics, Montreal Children's Hospital, Montreal, QC, Canada
| | - Marie-Élaine Métras
- Pharmacy Department and Pharmacy Practice Research Unit, CHU Sainte-Justine, Montreal, QC, Canada
| | - Serge Sultan
- Department of Pediatrics, Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
- Department of Psychology, Faculty of Arts and Sciences, Université de Montréal, Montreal, QC, Canada
| | - Sze Man Tse
- Division of General Pediatrics, Department of Pediatrics, CHU Sainte-Justine, Montréal, QC, Canada
- Division of Respiratory Medicine, Department of Pediatrics, Sainte-Justine University Hospital Center, University of Montreal, Montreal, QC, Canada
| | - Jiaying Zhao
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
- Institute for Resources, Environment and Sustainability, University of British Columbia, Vancouver, BC, Canada
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10
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Harnois-Leblanc S, Drapeau V, Van Hulst A, Barnett TA, McNealis V, Friedrich M, Bigras JL, Nuyt AM, Benedetti A, Mathieu MÈ, Henderson M. Abstract P134: Dietary Intake and Vascular Function and Myocardial Structure in Canadian Youth With and Without Type 1 Diabetes: The Cardea Study. Circulation 2023. [DOI: 10.1161/circ.147.suppl_1.p134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
Introduction:
People living with T1D are disproportionally more affected by CVD than the general population. As emerging evidence points to direct effects of diet on vascular function and cardiac structure, dietary interventions may be effective strategies to mitigate CVD risk early on.
Hypothesis:
We tested the hypothesis that specific dietary components and diet quality are associated with early markers of vascular and cardiac structure and function in youth with T1D. We compared these to associations in healthy controls.
Methods:
Cross-sectional study of 100 youth with T1D aged 14-18 yrs recruited at the Diabetes Clinic at Sainte-Justine Hospital University Center (Montreal, Canada) and 97 age and sex-matched healthy controls. Pulse-wave velocity (PWV) estimated arterial stiffness; velocity time integral (VTI) and acceleration during a flow-mediated dilation test assessed endothelial function. We measured left ventricular mass/height (LVMH), papillary mass, and wall thickness with cardiac MRI. Diet was measured with 3 x 24-h dietary recalls. Nutrients and foods were analyzed with the CANDAT software based on the Canadian Nutrient File. We assessed daily consumption of fruits, vegetables, fish, red meat, sugar-sweetened beverages and juices (SBJs), and sweets and chips. Food groups were all adjusted for total energy intake. We used the Diet Quality Index-International (DQI-I) to assess overall diet quality. We estimated linear regression models for each diet variable/outcome combination separately in youth with T1D and healthy controls adjusting for age, sex, ethnicity, parental education, physical activity and sedentary time (by accelerometer), and heart rate.
Results:
Girls comprised 48% of the sample; the mean age was 16.3 yrs (SD=1.3). The T1D group included more youth having overweight or obesity (43% vs. 20%), and was more ethnically diverse (White: 60% vs. 72%), compared to controls. Average glycated hemoglobin was 8.5% (SD=1.4) and median diabetes duration 6 yrs (IQR=3-10) in youth with T1D.
In youth with T1D
: Consuming more fruits was associated with lower PWV (beta [95% CI] per serving: -0.21 [-0.40; -0.02] m/s). Greater SBJ intake was paradoxically associated with higher VTI (per % total energy intake: 0.34 [0.04; 0.65] cm). DQI-I was related to a higher LVMH (per unit: 0.5 [0.1; 0.9] g/m).
In controls
: Eating more fruit was associated with a greater LVMH (per serving: 2.5 [0.1; 4.7] g/m). Higher SBJ intake was associated with a lower wall thickness (per % total energy intake: -0.10 [-0.20; -0.01] mm).
Conclusions:
Findings suggest that consuming more fruit could prevent arterial stiffening in youth with T1D. We previously reported that youth with T1D had lower LVMH than controls, and findings herein suggest that better diet quality could help compensate for this deficit. Overall, our results provide evidence on diet as a potential strategy to lower CVD risk in youth with T1D.
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11
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Barnett TA, Koushik A, Schuster T. Cross-sectional studies and causal inference - it's complicated. Am J Epidemiol 2023; 192:517-519. [PMID: 36722176 DOI: 10.1093/aje/kwad026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 01/18/2023] [Accepted: 01/24/2023] [Indexed: 02/02/2023] Open
Abstract
In this issue of the Journal, Savitz and Wellenius (Am J Epidemiol. XXXX;XXX(XX):XXXX-XXXX) discuss the contribution of cross-sectional studies to causal inference when the data are used to address etiologic research questions. We elaborate on their thoughts with a discussion of the conditions needed for addressing etiology with the cross-sectional design, using a modern causal inference lens.
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Affiliation(s)
- Tracie A Barnett
- Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada.,Centre de recherche du CHU Sainte-Justine, Montreal, QC, Canada
| | - Anita Koushik
- Université de Montréal Hospital Research Centre (CRCHUM) and Department of Social and Preventive Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Tibor Schuster
- Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
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12
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Harnois-Leblanc S, Sylvestre MP, Van Hulst A, Barnett TA, Mathieu MÈ, Mesidor M, McGrath JJ, Tremblay A, Drapeau V, Paradis G, Henderson M. Estimating causal effects of physical activity and sedentary behaviours on the development of type 2 diabetes in at-risk children from childhood to late adolescence: an analysis of the QUALITY cohort. Lancet Child Adolesc Health 2023; 7:37-46. [PMID: 36356598 DOI: 10.1016/s2352-4642(22)00278-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 09/09/2022] [Accepted: 09/14/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Uncertainty remains regarding the causal effect of physical activity and sedentary behaviours on the development of type 2 diabetes in children. We aimed to estimate average treatment effects of physical activity and sedentary behaviours on risk of type 2 diabetes in individuals who are at risk during childhood and adolescence. METHODS We used data from the Quebec Adipose and Lifestyle Investigation in Youth (QUALITY) cohort of children of western European descent (white non-Hispanic race or ethnicity) with a parental history of obesity (defined as a BMI of 30 kg/m2 or more, or a waist circumference of more than 102 cm in men and 88 cm in women) evaluated at the ages of 8-10 years (baseline), 10-12 years (first follow-up cycle), and 15-17 years (second follow-up cycle) in Québec, Canada. We measured moderate-to-vigorous physical activity (MVPA) and sedentary time by accelerometry, and leisure screen time by questionnaire at each cycle. Outcomes included fasting and 2 h post-load glycaemia and validated indices of insulin sensitivity and insulin secretion. We estimated average treatment effects of MVPA, sedentary time, and screen time on markers of type 2 diabetes using longitudinal marginal structural models with time-varying exposures, outcomes, and confounders from the ages of 8-10 to 15-17 years and inverse probability of treatment and censoring weighting. We considered both the current and cumulative effects of exposures on outcomes. FINDINGS 630 children were evaluated at baseline (age 8-10 years) between July, 2005, and December, 2008, 564 were evaluated at the first follow-up (age 10-12 years) between July, 2007, and March, 2011, and 377 were evaluated at the second follow-up (age 15-17 years) between September, 2012, and May, 2016. Based on cumulative exposure results, estimated average treatment effects for MVPA were 5·6% (95% CI 2·8 to 8·5) on insulin sensitivity and -3·8% (-7·1 to -0·5) on second-phase insulin secretion per 10 min daily increment from the ages of 8-10 years to age 15-17 years. Average treatment effects for sedentary time and reported screen time resulted in reduced insulin sensitivity (-8·2% [-12·3 to -3·9] and -6·4% [-10·1 to -2·5], respectively), increased second-phase insulin secretion (5·9% [1·9 to 10·1] and 7·0% [-0·1 to 14·7], respectively), and higher fasting glycaemia (0·03 mmol/L [0·003 to 0·05] and 0·02 mmol/L [0·01 to 0·03], respectively) per additional daily hour from the ages of 8-10 years to 15-17 years. INTERPRETATION Using modern causal inference approaches strengthened the evidence of MVPA and sedentary behaviours as key drivers of development of type 2 diabetes in at-risk children and adolescents, and should be considered as key targets for prevention. FUNDING Canadian Institutes of Health Research, Heart and Stroke Foundation of Canada, and Fonds de Recherche du Québec-Santé. TRANSLATION For the French translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Soren Harnois-Leblanc
- School of Public Health, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada; Research Center of Centre Hospitalier Universitaire Sainte-Justine, Montréal, QC, Canada; Research Centre of Centre Hospitalier Universitaire de Montréal, Montréal, QC, Canada
| | - Marie-Pierre Sylvestre
- School of Public Health, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada; Research Centre of Centre Hospitalier Universitaire de Montréal, Montréal, QC, Canada
| | - Andraea Van Hulst
- Ingram School of Nursing, Faculty of Medicine, McGill University, Montréal, QC, Canada
| | - Tracie A Barnett
- Research Center of Centre Hospitalier Universitaire Sainte-Justine, Montréal, QC, Canada; Department of Family Medicine, Faculty of Medicine, McGill University, Montréal, QC, Canada
| | - Marie-Ève Mathieu
- School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada; Research Center of Centre Hospitalier Universitaire Sainte-Justine, Montréal, QC, Canada
| | - Miceline Mesidor
- School of Public Health, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada; Research Centre of Centre Hospitalier Universitaire de Montréal, Montréal, QC, Canada
| | - Jennifer J McGrath
- Department of Psychology and PERFORM, Faculty of Arts and Science, Concordia University, Montréal, QC, Canada
| | - Angelo Tremblay
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec City, QC, Canada
| | - Vicky Drapeau
- Department of Physical Education, Faculty of Education Sciences, Université Laval, Québec City, QC, Canada
| | - Gilles Paradis
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montréal, QC, Canada
| | - Mélanie Henderson
- School of Public Health, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada; Department of Pediatrics, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada; Research Center of Centre Hospitalier Universitaire Sainte-Justine, Montréal, QC, Canada.
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13
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Pagani LS, Harbec MJ, Fortin G, Harandian K, Barnett TA. Early school-age family meal characteristics matter for the later development of boys and girls. Dialogues Health 2022; 1:100007. [PMID: 38515878 PMCID: PMC10953959 DOI: 10.1016/j.dialog.2022.100007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 03/07/2022] [Accepted: 03/14/2022] [Indexed: 03/23/2024]
Abstract
Objective Sharing a meal together offers an innovative approach to study the family environment. How often families eat together may not capture the distinct experience for sons and daughters. Instead, studying family meal characteristics might be more enlightening. This study aims to examine the prospective associations between family meal environment quality at age 6 years and later well-being at age 12 years in 734 boys and 758 girls. Method Participants are from the Quebec Longitudinal Study of Child Development birth cohort. When children were aged 6 years, parents reported on their family meal environment experience. At age 12 years, child outcomes included parent-reported healthy lifestyle habits, teacher-reported academic achievement, and self-reported social adjustment. The relationship between early family meal environment quality and later child outcomes were analyzed using multivariate linear regressions. Results For girls, better family meal environment quality at age 6 years predicted an earlier bedtime, a lower consumption of soft drinks and sweet snacks, more classroom engagement, and fewer behavior problems at age 12 years. For boys, better family meal environment quality at age 6 years predicted an earlier bedtime and less anxiety and more prosocial behaviour at age 12 years. These significant relationships were adjusted for a multitude of child/family characteristics. Conclusion From a population-health perspective, our findings suggest that family meals represent a cost-efficient, effective protective factor that likely has long-term influences on bio-psycho-social development. Information campaigns that promote family meals as a health intervention could optimize the well-being of boys and girls.
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Affiliation(s)
- Linda S. Pagani
- School of Psycho-Education, University of Montreal, 90 Vincent d'Indy, Montreal, Quebec H2V 2S9, Canada
- School Environment Research Group, University of Montreal, 7070 Parc, Montreal, Quebec H3N 1X7, Canada
- Sainte-Justine's Pediatric Hospital Research Center, University of Montreal, 3175 Côte-Sainte-Catherine, Montreal, Quebec H3T 1C5, Canada
| | - Marie-Josée Harbec
- School of Psycho-Education, University of Montreal, 90 Vincent d'Indy, Montreal, Quebec H2V 2S9, Canada
- School Environment Research Group, University of Montreal, 7070 Parc, Montreal, Quebec H3N 1X7, Canada
- Sainte-Justine's Pediatric Hospital Research Center, University of Montreal, 3175 Côte-Sainte-Catherine, Montreal, Quebec H3T 1C5, Canada
| | - Geneviève Fortin
- School of Psycho-Education, University of Montreal, 90 Vincent d'Indy, Montreal, Quebec H2V 2S9, Canada
- School Environment Research Group, University of Montreal, 7070 Parc, Montreal, Quebec H3N 1X7, Canada
| | - Kianoush Harandian
- School of Psycho-Education, University of Montreal, 90 Vincent d'Indy, Montreal, Quebec H2V 2S9, Canada
- School Environment Research Group, University of Montreal, 7070 Parc, Montreal, Quebec H3N 1X7, Canada
| | - Tracie A. Barnett
- Sainte-Justine's Pediatric Hospital Research Center, University of Montreal, 3175 Côte-Sainte-Catherine, Montreal, Quebec H3T 1C5, Canada
- Family Medicine Department, McGill University, 5858 Côte-des-Neiges, Montreal, Quebec H3S 1Z1, Canada
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14
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Bird M, Datta GD, Chinerman D, Kakinami L, Mathieu ME, Henderson M, Barnett TA. Associations of neighborhood walkability with moderate to vigorous physical activity: an application of compositional data analysis comparing compositional and non-compositional approaches. Int J Behav Nutr Phys Act 2022; 19:55. [PMID: 35585542 PMCID: PMC9118591 DOI: 10.1186/s12966-022-01256-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 02/08/2022] [Indexed: 12/04/2022] Open
Abstract
Background We compared the relation between neighborhood features and moderate to vigorous physical activity (MVPA) using linear regression analysis and the more novel compositional data analysis (CoDA). Compositional data analysis allows us to take the time children allocate to different movement behaviours during a 24-hour time period into account. Methodology Data from youth participants (n = 409) in the QUALITY (QUebec Adipose and Lifestyle InvesTigation in Youth) cohort were included. Time spent in MVPA, light physical activity, sedentary behavior, and sleep (“24-hour movement behaviours”) was measured using accelerometers. Neighborhood data were collected using a geographic information system and through direct observation. In CoDA models, we used orthogonal logratio coordinates, which allows for the association of neighbourhood walkability with MVPA to be estimated with respect to the average composition of all other behaviours within a 24-hour time frame. In baseline linear regression models, MVPA was regressed cross-sectionally on neighborhood walkability. All models were stratified by sex, and controlled for BMI z-scores, pubertal development, seasonal variation, parental education, and neighbourhood safety. Results Based on CoDA, girls who lived in more walkable neighborhoods had 10% higher daily MVPA (95% CI: 2%, 19%), taking into account all other movement behaviours. Based on linear regression, girls who resided in more walkable neighborhoods engaged in 4.2 (95% confidence interval [CI]: 1.2, 6.6) more minutes of MVPA per day on average than girls residing in less walkable neighborhoods. Conclusions Unlike with traditional linear models, all movement behaviours were included in a single model using CoDA, allowing for a more complete picture of the strength and direction of the association between neighbourhood Walkability and MVPA. Application of CoDA to investigate determinants of physical activity provides additional insight into potential mechanisms and the ways in which people allocate their time. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-022-01256-6.
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Affiliation(s)
- Madeleine Bird
- Centre de recherche du Centre hospitalier universitaire (CHU) Sainte-Justine, Montréal, Canada.,Département de médecine sociale et préventive, École de santé publique de l'Université de Montréal, Montréal, Canada.,Office of International Affairs for the Health Portfolio, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Geetanjali D Datta
- Département de médecine sociale et préventive, École de santé publique de l'Université de Montréal, Montréal, Canada.,Le Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, Canada.,Cedars-Sinai Medical Center, Department of Medicine, Los Angeles, CA, USA
| | - Deanna Chinerman
- Department of Family Medicine, Faculty of Medicine, McGill University, 5858 Côte-des-Neiges Rd, Montreal, QC, H3S 1Z1, Canada
| | - Lisa Kakinami
- Department of Mathematics and Statistics, Concordia University, Montréal, Canada
| | - Marie-Eve Mathieu
- Centre de recherche du Centre hospitalier universitaire (CHU) Sainte-Justine, Montréal, Canada.,School of Kinesiology and Physical Activity Sciences, University of Montréal, Montréal, Canada
| | - Mélanie Henderson
- Centre de recherche du Centre hospitalier universitaire (CHU) Sainte-Justine, Montréal, Canada.,Département de médecine sociale et préventive, École de santé publique de l'Université de Montréal, Montréal, Canada.,Department of Pediatrics, University of Montréal, Montréal, Canada
| | - Tracie A Barnett
- Centre de recherche du Centre hospitalier universitaire (CHU) Sainte-Justine, Montréal, Canada. .,Department of Family Medicine, Faculty of Medicine, McGill University, 5858 Côte-des-Neiges Rd, Montreal, QC, H3S 1Z1, Canada.
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15
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Harnois-Leblanc S, Van Hulst A, Ybarra M, Barnett TA, Mathieu MÈ, McGrath JJ, Tremblay A, Paradis G, Drapeau V, Sylvestre MP, Henderson M. Natural history and determinants of dysglycemia in Canadian children with parental obesity from ages 8-10 to 15-17 years: The QUALITY cohort. Pediatr Diabetes 2022; 23:274-285. [PMID: 35023257 DOI: 10.1111/pedi.13315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 01/07/2022] [Accepted: 01/09/2022] [Indexed: 11/27/2022] Open
Abstract
In children, the mechanisms implicated in deterioration of glucose homeostasis versus reversion to normal glucose tolerance (NGT) remain uncertain. We aimed to describe the natural history of dysglycemia from childhood to late adolescence and to identify its early determinants. We used baseline (8-10 years, n = 630), 1st follow-up (10-12 years, n = 564) and 2nd follow-up (15-17 years, n = 377) data from the QUALITY cohort of White Canadian children with parental obesity. Children underwent a 2-h oral glucose tolerance test at each cycle with plasma glucose and insulin measured at 0/30/60/90/120 min. American Diabetes Association criteria defined dysglycemia (impaired fasting glucose, impaired glucose tolerance or type 2 diabetes). Longitudinal patterns of insulin sensitivity and beta-cell function were estimated using generalized additive mixed models. Model averaging identified biological, sociodemographic and lifestyle-related determinants of dysglycemia. Of the children NGT at baseline, 66 (21%) developed dysglycemia without reverting to NGT. Among children with dysglycemia at baseline, 24 (73%) reverted to NGT. In children with dysglycemia at 1st follow-up, 18 (53%) later reverted to NGT. Among biological, sociodemographic and lifestyle determinants at 8-10 years, only fasting and 2-h glucose were associated with developing dysglycemia (odds ratio [95% CI] per 1 mmol/L increase: 4.50 [1.06; 19.02] and 1.74 [1.11; 2.73], respectively). Beta-cell function decreased by 40% in children with overweight or obesity. In conclusion, up to 75% of children with dysglycemia reverted to NGT during puberty. Children with higher fasting and 2-h glucose were at higher risk for progression to dysglycemia, while no demographic/lifestyle determinants were identified.
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Affiliation(s)
- Soren Harnois-Leblanc
- School of Public Health, Université de Montréal, Montréal, Québec, Canada.,Research Center of Centre Hospitalier Universitaire Sainte-Justine, Montréal, Québec, Canada.,Research Centre of Centre Hospitalier Universitaire de Montréal, Montréal, Québec, Canada
| | - Andraea Van Hulst
- Ingram School of Nursing, McGill University, Montréal, Québec, Canada
| | - Marina Ybarra
- Research Center of Centre Hospitalier Universitaire Sainte-Justine, Montréal, Québec, Canada
| | - Tracie A Barnett
- Research Center of Centre Hospitalier Universitaire Sainte-Justine, Montréal, Québec, Canada.,Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montréal, Québec, Canada
| | - Marie-Ève Mathieu
- Research Center of Centre Hospitalier Universitaire Sainte-Justine, Montréal, Québec, Canada.,School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Jennifer J McGrath
- PERFORM Centre and Department of Psychology, Faculty of Arts and Science, Concordia University, Montréal, Québec, Canada
| | - Angelo Tremblay
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec City, Québec, Canada
| | - Gilles Paradis
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine and Health Sciences, McGill University, Montréal, Québec, Canada
| | - Vicky Drapeau
- Department of Physical Education, Faculty of Education, Université Laval, Québec City, Québec, Canada
| | - Marie-Pierre Sylvestre
- School of Public Health, Université de Montréal, Montréal, Québec, Canada.,Research Centre of Centre Hospitalier Universitaire de Montréal, Montréal, Québec, Canada
| | - Mélanie Henderson
- School of Public Health, Université de Montréal, Montréal, Québec, Canada.,Research Center of Centre Hospitalier Universitaire Sainte-Justine, Montréal, Québec, Canada.,Department of Pediatrics, Faculty of Medicine, Université de Montreal, Montréal, Québec, Canada
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16
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Harbec MJ, Goldfield G, Barnett TA, Pagani LS. Physical Activity as Both Predictor and Outcome of Emotional Distress Trajectories in Middle Childhood. J Dev Behav Pediatr 2022; 43:159-167. [PMID: 34570070 DOI: 10.1097/dbp.0000000000001005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 07/23/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This prospective longitudinal study assesses the reciprocal relationship between physical activity, including sport participation, and depressive and anxiety symptoms, conceptualized as emotional distress, over time. METHOD Boys and girls are from the Quebec Longitudinal Study of Child Development birth cohort (N = 1428). Trajectories of emotional distress symptoms from ages 6 to 10 years, assessed by teachers, were generated using latent class analysis. Multinomial logistic regression analyses examined sport participation at age 5 years, measured by parents, as a predictor of emotional distress trajectory outcomes. Analyses of covariance compared physical activity, measured by children at age 12 years, across different trajectories of emotional distress. RESULTS We identified 3 emotional distress trajectories: "low" (77%), "increasing" (12%), and "declining" (11%). Boys who never participated in sport at age 5 years were more likely to be in the "increasing" (adjusted odds ratio [OR] = 1.63, 95% confidence interval [CI] = 1.01-2.63) or "declining" (adjusted OR = 2.19, 95% CI = 1.28-3.75) emotional distress trajectories compared with boys who participated in any sporting activity. Furthermore, boys in the "low" emotional distress trajectory demonstrated better physical activity outcomes at age 12 years (F(2, 1438) = 6.04, p < 0.05). These results, exclusively for boys, are above and beyond pre-existing individual and family factors. CONCLUSION This study supports the relevance of enhancing current public health strategies to understand and promote physical activity and emotional adjustment in early childhood to achieve better a more active lifestyle and overall health across development. We underscore male needs for physical activity for health promotion.
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Affiliation(s)
- Marie-Josée Harbec
- School of Psycho-Education, University of Montreal, Montreal, Quebec
- School Environment Research Group, University of Montreal, Montreal, Quebec
| | - Gary Goldfield
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario, Ottawa, Ontario
| | - Tracie A Barnett
- Family Medicine Department, McGill University, Montreal, Quebec; and
| | - Linda S Pagani
- School of Psycho-Education, University of Montreal, Montreal, Quebec
- School Environment Research Group, University of Montreal, Montreal, Quebec
- Sainte-Justine's Pediatric Hospital Research Center, University of Montreal, Montreal, Quebec
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17
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Roberge JB, Contreras G, Kakinami L, Van Hulst A, Henderson M, Barnett TA. Validation of desk-based audits using Google Street View® to monitor the obesogenic potential of neighbourhoods in a pediatric sample: a pilot study in the QUALITY cohort. Int J Health Geogr 2022; 21:2. [PMID: 35346220 PMCID: PMC8961916 DOI: 10.1186/s12942-022-00301-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 03/15/2022] [Indexed: 01/16/2023] Open
Abstract
Background The suitability of geospatial services for auditing neighbourhood features relevant to pediatric obesity remains largely unexplored. Our objectives were to (i) establish the measurement properties of a desk-based audit instrument that uses Google Street View ® to assess street- and neighbourhood-level features relevant to pediatric obesity (QUALITY-NHOOD tool, the test method) and (ii) comment on its capacity to detect changes in the built environment over an 8-year period. In order to do so, we compared this tool with an on-site auditing instrument (the reference method). Methods On-site audits of 55 street- and neighbourhood-level features were completed in 2008 in 512 neighbourhoods from the QUALITY cohort study. In 2015, both repeat on-site and desk-based audits were completed in a random sample of 30 of these neighbourhoods. Results Agreement between both methods was excellent for almost all street segment items (range 91.9–99.7%), except for road type (81.0%), ads/commercial billboards (81.7%), road-sidewalk buffer zone (76.1%), and road-bicycle path buffer zone (53.3%). It was fair to poor for perceived quality, safety and aesthetics items (range 59.9–87.6%), as well as for general impression items (range 40.0–86.7%). The desk-based method over-detected commercial billboards and road-sidewalk buffer zone, and generally rated neighbourhoods as less safe, requiring more effort to get around, and having less aesthetic appeal. Change detected over the 8-year period was generally similar for both methods, except that the desk-based method appeared to amplify the increase in the number of segments with signs of social disorder. Conclusions The QUALITY-NHOOD tool is deemed adequate for evaluating and monitoring changes in pedestrian- and traffic-related features applicable to pediatric populations. Applications for monitoring the obesogenic nature of neighbourhoods appear warranted. Supplementary Information The online version contains supplementary material available at 10.1186/s12942-022-00301-8.
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18
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Gauvin L, Barnett TA, Dea C, Doré I, Drouin O, Frohlich KL, Henderson M, Sylvestre MP. Quarantots, quarankids, and quaranteens: how research can contribute to mitigating the deleterious impacts of the COVID-19 pandemic on health behaviours and social inequalities while achieving sustainable change. Can J Public Health 2022; 113:53-60. [PMID: 35089590 PMCID: PMC8796597 DOI: 10.17269/s41997-021-00569-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 08/11/2021] [Indexed: 12/12/2022]
Abstract
The adoption and maintenance of healthy behaviours including age-appropriate amounts of physical activity, limited sedentary and screen time, and healthy eating are the foundations for youth development and thriving. In reviewing extant evidence, we observe that the COVID-19 pandemic has been associated with marked reductions in physical activity, increased sedentary and screen time, and increased food intake and unhealthy snacking. Deleterious effects in movement behaviours appear to be more pronounced among vulnerable groups and food insecurity has become more widespread. To contribute to mitigating these impacts, we advocate for strengthened evidence-based public health. Towards this end, ongoing surveillance should be intensified and augmented with additional indicators of social inequalities. More importantly, substantial efforts must be devoted to developing, implementing, and evaluating complex interventions aimed at equitably promoting recommended 24-hour movement behaviours and healthy eating guidelines in home, childcare, school, and neighbourhood settings.
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Affiliation(s)
- Lise Gauvin
- Centre de recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), 850 Rue Saint-Denis, Montréal, Québec, H2X 0A9, Canada. .,Département de médecine sociale et préventive, École de Santé Publique de l'Université de Montréal (ESPUM), P.O. Box 6128, Centre-ville Station, Montréal, Québec, H3C 3J7, Canada.
| | - Tracie A Barnett
- Centre de recherche du Centre Hospitalier Universitaire Sainte-Justine (CRCHUSJ), Montreal, Québec, Canada.,Department of Family Medicine, Faculty of Medicine, McGill University, Montreal, Québec, Canada
| | - Catherine Dea
- Département de médecine sociale et préventive, École de Santé Publique de l'Université de Montréal (ESPUM), P.O. Box 6128, Centre-ville Station, Montréal, Québec, H3C 3J7, Canada.,Direction Régionale de Santé Publique, Centre Intégré Universitaire de Santé et Services Sociaux du Centre-Sud-de-L'Île-de-Montréal, Montréal, Québec, Canada
| | - Isabelle Doré
- Centre de recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), 850 Rue Saint-Denis, Montréal, Québec, H2X 0A9, Canada.,Département de médecine sociale et préventive, École de Santé Publique de l'Université de Montréal (ESPUM), P.O. Box 6128, Centre-ville Station, Montréal, Québec, H3C 3J7, Canada.,École de Kinésiologie et des Sciences de l'Activité Physique (EKSAP), Faculté de médecine, Université de Montréal, Montréal, Québec, Canada
| | - Olivier Drouin
- Département de médecine sociale et préventive, École de Santé Publique de l'Université de Montréal (ESPUM), P.O. Box 6128, Centre-ville Station, Montréal, Québec, H3C 3J7, Canada.,Centre de recherche du Centre Hospitalier Universitaire Sainte-Justine (CRCHUSJ), Montreal, Québec, Canada.,Département de pédiatrie, Faculté de médecine, Université de Montréal, Montréal, Québec, Canada
| | - Katherine L Frohlich
- Département de médecine sociale et préventive, École de Santé Publique de l'Université de Montréal (ESPUM), P.O. Box 6128, Centre-ville Station, Montréal, Québec, H3C 3J7, Canada.,Centre de Recherche en Santé Publique (CReSP), Montréal, Québec, Canada
| | - Mélanie Henderson
- Département de médecine sociale et préventive, École de Santé Publique de l'Université de Montréal (ESPUM), P.O. Box 6128, Centre-ville Station, Montréal, Québec, H3C 3J7, Canada.,Centre de recherche du Centre Hospitalier Universitaire Sainte-Justine (CRCHUSJ), Montreal, Québec, Canada.,Département de pédiatrie, Faculté de médecine, Université de Montréal, Montréal, Québec, Canada
| | - Marie-Pierre Sylvestre
- Centre de recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), 850 Rue Saint-Denis, Montréal, Québec, H2X 0A9, Canada.,Département de médecine sociale et préventive, École de Santé Publique de l'Université de Montréal (ESPUM), P.O. Box 6128, Centre-ville Station, Montréal, Québec, H3C 3J7, Canada
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Salmon C, Parent MÉ, Quesnel-Vallée A, Barnett TA. A scoping review of social relationships and prostate cancer screening. Prev Med 2022; 154:106892. [PMID: 34798197 DOI: 10.1016/j.ypmed.2021.106892] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 11/11/2021] [Accepted: 11/14/2021] [Indexed: 11/27/2022]
Abstract
According to current US recommendations, the choice to undergo screening for prostate cancer should be an individual one, after considering with a clinician the balance of harms and benefits, and the values and preferences in the decision. Social relationships may influence such a decision. The purpose of this scoping review was to map the evidence on the association between social relationships and prostate cancer screening in the epidemiological literature and to highlight gaps in knowledge. We performed a systematic search of all relevant articles published up to February 1st 2021. We used variations in search terms related to prostate cancer screening, as well as indicators of social relationships. From the 908 records identified, 19 studies, published in 2007-2020, were included. The most common indicator of social relationships was marital status. Overall, married men or men with a partner had a higher screening uptake. Church attendance, based on studies conducted in the United states, was also associated with screening. We found little evidence linking screening with parenthood status or perceived social support. The overall evidence points to a potentially causal association between social relationships and men's decision to undergo prostate cancer screening. More research is needed on the underlying mechanisms and on the potential barriers and facilitators for screening.
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Affiliation(s)
- Charlotte Salmon
- Epidemiology and Biostatistics Unit, Centre Armand-Frappier Santé Biotechnologie, Institut national de la recherche scientifique, University of Quebec, Laval, QC, Canada
| | - Marie-Élise Parent
- Epidemiology and Biostatistics Unit, Centre Armand-Frappier Santé Biotechnologie, Institut national de la recherche scientifique, University of Quebec, Laval, QC, Canada; Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montréal, QC, Canada
| | - Amélie Quesnel-Vallée
- Department of Sociology, Faculty of Arts, McGill University, Montréal, QC, Canada; Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
| | - Tracie A Barnett
- Epidemiology and Biostatistics Unit, Centre Armand-Frappier Santé Biotechnologie, Institut national de la recherche scientifique, University of Quebec, Laval, QC, Canada; Department of Family Medicine, McGill University, Montréal, QC, Canada; Sainte-Justine Research Centre, University of Montreal, Montréal, QC, Canada.
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20
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Ybarra M, Danieles PK, Barnett TA, Mathieu MÈ, Van Hulst A, Drouin O, Kakinami L, Bigras JL, Henderson M. Promoting healthy lifestyle behaviours in youth: Findings from a novel intervention for children at risk of cardiovascular disease. Paediatr Child Health 2021; 26:478-485. [DOI: 10.1093/pch/pxab033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 05/07/2021] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objectives
Obesity is the most prevalent risk factor for cardiovascular disease (CVD) in children. We developed a 2-year lifestyle intervention for youth at risk of CVD. We assessed changes in body mass index z-scores (zBMI) and key cardiometabolic risk factors, physical fitness, and capacity among those who completed the program.
Methods
The CIRCUIT program is a multidisciplinary lifestyle intervention for children aged 4 to 18 years at risk of CVD, based on a personalized plan to improve cardiometabolic outcomes by increasing physical activity and reducing sedentary behaviours. Both at baseline and 2-year follow-up, we measured zBMI, blood pressure z-scores (zBP), adiposity (%body and %trunk fat), fasting blood glucose and lipid profile, aerobic (VO2max) and anaerobic (5×5 m shuttle run test) fitness, and physical capacity indicators. Differences between baseline and follow-up were examined using paired t-tests (for age-sex standardized outcomes) and multivariable mixed effect models, adjusted for age and sex (for other outcomes).
Results
Among the 106 participants (53 males) who completed the 2-year program, mean age at baseline was 10.9 years (SD=3.2). After 2 years, zBMI and diastolic zBP decreased by 0.30SD (95% CI: −0.44; −0.16) and 0.43SD (95% CI: −0.65; −0.23), respectively. Participants improved %body and %trunk fat, lipid profile, aerobic and anaerobic fitness levels, and physical capacity (p<0.02). No changes in systolic zBP nor in fasting plasma glucose were observed.
Conclusion
Our findings showed improved zBMI, cardiometabolic outcomes, physical fitness, and capacity among children at risk of CVD, suggesting that CIRCUIT is a promising intervention.
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Affiliation(s)
- Marina Ybarra
- Research Center of Sainte Justine University Hospital, Université de Montréal, Montreal, Quebec, Canada
| | - Prince Kevin Danieles
- Research Center of Sainte Justine University Hospital, Université de Montréal, Montreal, Quebec, Canada
- Department of Mathematics and Statistics, Concordia University, Montreal, Quebec, Canada
| | - Tracie A Barnett
- Research Center of Sainte Justine University Hospital, Université de Montréal, Montreal, Quebec, Canada
- Department of Family Medicine, McGill University, Montreal, Quebec, Canada
| | - Marie-Ève Mathieu
- Research Center of Sainte Justine University Hospital, Université de Montréal, Montreal, Quebec, Canada
- School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Andraea Van Hulst
- Ingram School of Nursing, McGill University, Montreal, Quebec, Canada
| | - Olivier Drouin
- Research Center of Sainte Justine University Hospital, Université de Montréal, Montreal, Quebec, Canada
- Department of Pediatrics, University of Montréal, Montreal, Quebec, Canada
| | - Lisa Kakinami
- Department of Mathematics and Statistics, Concordia University, Montreal, Quebec, Canada
- PERFORM Centre, Concordia University, Montreal, Quebec, Canada
| | - Jean-Luc Bigras
- Research Center of Sainte Justine University Hospital, Université de Montréal, Montreal, Quebec, Canada
- Department of Pediatrics, University of Montréal, Montreal, Quebec, Canada
| | - Mélanie Henderson
- Research Center of Sainte Justine University Hospital, Université de Montréal, Montreal, Quebec, Canada
- Department of Pediatrics, University of Montréal, Montreal, Quebec, Canada
- School of Public Health, Department of Social and Preventive Medicine, Université de Montréal, Montreal, Quebec, Canada
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21
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Ybarra M, Barnett TA, Yu J, Van Hulst A, Drouin O, Kakinami L, Saint-Charles J, Henderson M. Personal Social Networks and Adiposity in Adolescents: A Feasibility Study. Child Obes 2021; 17:542-550. [PMID: 34264758 DOI: 10.1089/chi.2020.0343] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background and Objective: Weight-related behaviors are determined by multiple individual and contextual factors, with recent evidence implicating personal social networks (PSNs). Greater understanding of these relationships could help inform healthy weight promoting interventions. We conducted a feasibility study among youth at risk of obesity to document process outcomes, to discern relationships between PSN features and weight-related behaviors, and to generate hypotheses with respect to perceived social support (SS) and sex. Methods: Participants (egos) nominated up to 10 people (alters) with whom they discussed important matters. Egos reported their own and each alter's age, sex, body shape, lifestyle behaviors, relation, frequency of exercising with each alter, and of being encouraged by each alter to exercise. We examined relationships between PSN features and weight-related outcomes and explored the role of SS, using both correlational and linear regression analyses. Results: There were 45 participants (mean age 16.4 years) and body mass index z-score (zBMI) ranged from -1.2 to 3.9. There were few missing responses to PSN items; broad variation across most items, including SS scores, was reported. Correlations pointed to plausible relationships implicating PSN features and lifestyle behaviors. In exploratory analyses, network-based SS was positively associated with adiposity in girls and negatively associated in boys, while lifestyle role modelling was not associated with adiposity. Conclusions: Our findings support the feasibility of measuring the PSN in youth and the potential for using social network analysis to investigate social and behavioral mechanisms associated with obesity.
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Affiliation(s)
- Marina Ybarra
- Research Center of Sainte Justine University Hospital, Université de Montréal, Montréal, Québec, Canada
| | - Tracie A Barnett
- Research Center of Sainte Justine University Hospital, Université de Montréal, Montréal, Québec, Canada.,Department of Family Medicine, McGill University, Montréal, Québec, Canada
| | - Jennifer Yu
- Epidemiology and Biostatistics Unit, Center Armand-Frappier Santé Biotechnologie, Institut National de la Recherche Scientifique, Université du Québec, Laval, Québec, Canada
| | - Andraea Van Hulst
- Ingram School of Nursing, McGill University, Montreal, Québec, Canada
| | - Olivier Drouin
- Research Center of Sainte Justine University Hospital, Université de Montréal, Montréal, Québec, Canada.,Department of Pediatrics, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Lisa Kakinami
- Department of Mathematics and Statistics, Concordia University, Montreal, Québec, Canada
| | - Johanne Saint-Charles
- Institut Santé et Société, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Mélanie Henderson
- Research Center of Sainte Justine University Hospital, Université de Montréal, Montréal, Québec, Canada.,Department of Pediatrics, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada.,Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montréal, Québec, Canada
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22
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Puzhko S, Schuster T, Barnett TA, Renoux C, Munro K, Barber D, Bartlett G. Difference in patterns of prescribing antidepressants known for their weight-modulating and cardiovascular side effects for patients with obesity compared to patients with normal weight. J Affect Disord 2021; 295:1310-1318. [PMID: 34706445 DOI: 10.1016/j.jad.2021.08.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/03/2021] [Accepted: 08/06/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Patients with depression and comorbid obesity may be more prone to weight modulating and cardiovascular side effects of selected antidepressants (AD). It is important to ascertain whether these AD prescriptions differ by patient weight status. METHODS Canadian Primary Care Sentinel Surveillance Network (CPCSSN) electronic medical records were used. Participants were adults with depression prescribed an AD in 2000-2016, with weight categories established before the first prescription. Logistic regression and mixed effects models were applied to examine associations between obesity and AD prescribing, adjusted for sex, age, and comorbidities. Machine learning algorithm random forest (RF) was used to evaluate the importance of weight in predicting prescribing patterns. RESULTS Of 26,571 participants, 72.4% were women, mean age was 38.9 years (standard deviation (SD)=14.2) and mean BMI 27.0 kg/m2 (SD = 6.5); 9.5% had ≥ 1 comorbidity. Patients with obesity, compared to normal weight patients, were more likely to receive bupropion (adjusted odds ratio (aOR) 1.24, 95%CI: 1.09,1.42), fluoxetine (aOR 1.14, 95%CI: 0.97,1.34), and amitriptyline (aOR 1.13, 95%CI: 0.93,1.36), and less likely to receive mirtazapine (aOR 0.55, 95%CI: 0.44,0.68) and escitalopram (aOR 0.88, 95%CI: 0.80, 0.97). RF analysis showed that weight was among the most important predictors of prescribing patterns, equivalent to age and more important than sex. CONCLUSIONS AD prescribing patterns for patients with obesity appear to be different for selected AD types, including AD known for their weight-modulating and cardiovascular side effects. Longitudinal studies are needed to examine whether these prescribing patterns are associated with significant health outcomes.
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Affiliation(s)
- S Puzhko
- Department of Family Medicine, Faculty of Medicine, McGill University, 5858 Chemin de la Côte-des-Neiges, suite 300, H3S 1Z1, Montréal, Qc, Canada.
| | - T Schuster
- Department of Family Medicine, Faculty of Medicine, McGill University, 5858 Chemin de la Côte-des-Neiges, suite 300, H3S 1Z1, Montréal, Qc, Canada.
| | - T A Barnett
- Department of Family Medicine, Faculty of Medicine, McGill University, 5858 Chemin de la Côte-des-Neiges, suite 300, H3S 1Z1, Montréal, Qc, Canada.
| | - C Renoux
- Department of Neurology & Neurosurgery, McGill University, 3801 Rue Université, H3A 2B4, Montréal, Qc, Canada; Department of Epidemiology and Biostatistics, McGill University, Montréal, Qc, Canada; Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Qc, Canada.
| | - K Munro
- Department of Family Medicine, Faculty of Medicine, McGill University, 5858 Chemin de la Côte-des-Neiges, suite 300, H3S 1Z1, Montréal, Qc, Canada.
| | - D Barber
- Department of Family Medicine, Faculty of Medicine, Queen's University, 220 Bagot Street, K7L 3G2, Kingston, On, Canada.
| | - G Bartlett
- School of Medicine, University of Missouri, 7 Hospital Drive, Medical Sciences Building, Suite MA306N, 65211, Columbia, MO, United States.
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Barnett TA, Contreras G, Ghenadenik AE, Zawaly K, Van Hulst A, Mathieu MÈ, Henderson M. Identifying risk profiles for excess sedentary behaviour in youth using individual, family and neighbourhood characteristics. Prev Med Rep 2021; 24:101535. [PMID: 34987952 PMCID: PMC8693790 DOI: 10.1016/j.pmedr.2021.101535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 08/20/2021] [Accepted: 08/22/2021] [Indexed: 11/29/2022] Open
Abstract
There are few known determinants of sedentary behaviour (SB) in children. We generated and compared profiles associated with risk of excess SB among children (n = 294) both at 8-10 and 10-12 years of age (Visits 1 and 2, respectively), using data from the QUebec Adipose and Lifestyle InvesTigation in Youth. Excess SB was measured by accelerometry and defined as >50% of total wear time at <100 counts/minutes. Recursive partitioning analyses were performed with candidate individual-, family-, and neighbourhood-level factors assessed at Visit 1, and distinct groups at varying risk of excess SB were identified for both timepoints. From the ages of 8-10 to 10-12 years, the prevalence of excess SB more than doubled (24.5% to 57.1%). At Visit 1, excess SB was greatest (73%) among children simultaneously not meeting physical activity guidelines, reporting >2 h/day of weekday non-academic screen time, living in low-dwelling density neighbourhoods, having poor park access, and living in neighbourhoods with greater disadvantage. At Visit 2, the high-risk group (70%) was described by children simultaneously not meeting physical activity guidelines, reporting >2 h/day of non-academic screen time on weekends, and living in neighbourhoods with low disadvantage. Risk factors related to individual lifestyle behaviours are generally consistent, and neighbourhood factors generally inconsistent, as children age from late childhood to pre-adolescence. Multiple factors from developmental, behavioural and contextual domains increase risk for excess sedentary behaviour; these warrant consideration to devise effective prevention or management strategies.
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Affiliation(s)
- Tracie A Barnett
- Department of Family Medicine, McGill University, Montréal, Canada; Centre de recherche du Centre Hospitalier Universitaire Sainte-Justine, Montréal, Canada
- Centre de recherche du Centre Hospitalier Universitaire Sainte-Justine, Montréal, Canada
| | - Gisèle Contreras
- Centre for Chronic Disease Prevention and Health Equity, Public Health Agency of Canada, Montreal, Canada
| | - Adrian E Ghenadenik
- Department of Family Medicine, McGill University, Montréal, Canada; Centre de recherche du Centre Hospitalier Universitaire Sainte-Justine, Montréal, Canada
| | - Kristina Zawaly
- Department of Family Medicine, McGill University, Montréal, Canada; Centre de recherche du Centre Hospitalier Universitaire Sainte-Justine, Montréal, Canada
- Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand
| | | | | | - Mélanie Henderson
- Centre de recherche du Centre Hospitalier Universitaire Sainte-Justine, Montréal, Canada
- Department of Paediatrics, Université de Montréal, Montréal, Canada
- School of Public Health, Department of Social and Preventive Medicine, Université de Montréal, Montréal, Canada
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24
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Barnett TA, Ghenadenik AE, Van Hulst A, Contreras G, Kestens Y, Chaix B, Cloutier MS, Henderson M. Neighborhood built environment typologies and adiposity in children and adolescents. Int J Obes (Lond) 2021; 46:588-596. [PMID: 34848835 DOI: 10.1038/s41366-021-01010-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 09/30/2021] [Accepted: 10/20/2021] [Indexed: 01/21/2023]
Abstract
BACKGROUND/OBJECTIVES Neighborhoods are complex, multidimensional systems. However, the interrelation between multiple neighborhood dimensions is seldom considered in relation to youth adiposity. We created a neighborhood typology using a range of built environment features and examined its association with adiposity in youth. SUBJECTS/METHODS Analyses are based on data from the QUALITY cohort, an ongoing study on the natural history of obesity in Quebec youth with a history of parental obesity. Adiposity was measured at baseline (8-10 years) and follow up, ~8 years later. Neighborhood features were measured at baseline through in-person neighborhood assessments and geocoded administrative data and were summarized using principal components analysis. Neighborhood types were identified using cluster analysis. Associations between neighborhood types and adiposity were examined using multivariable linear regressions. RESULTS Five distinct neighborhood types characterized by levels of walkability and traffic-related safety were identified. At ages 8-10 years, children in moderate walkability/low safety neighborhoods had higher BMI Z-scores [β: 0.41 (0.12; 0.71), p = 0.007], fat mass index [β: 1.22 (0.29; 2.16), p = 0.010], waist circumference [β: 4.92 (1.63; 8.21), p = 0.003], and central fat mass percentage [β: 1.60 (0.04; 3.16), p = 0.045] than those residing in moderate walkability/high safety neighborhoods. Attenuated associations were observed between neighborhood types and adiposity 8 years later. Specifically, residents of moderate walkability/low safety neighborhoods had a higher FMI [β: 1.42 (-0.07; 2.90), p = 0.062], and waist circumference [β: 5.04 (-0.26; 10.34), p = 0.062]. CONCLUSIONS Neighborhoods characterized by lower traffic safety appear to be the most obesogenic to children, regardless of other walkability-related features. Policies targeting neighborhood walkability for children may need to prioritize vehicular traffic safety.
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Affiliation(s)
- Tracie A Barnett
- Department of Family Medicine, McGill University, Montreal, QC, Canada. .,Centre de recherche du CHU Sainte-Justine, Montreal, QC, Canada.
| | | | | | - Gisele Contreras
- Centre for Chronic Disease Prevention and Health Equity, Public Health Agency of Canada, Montreal, QC, Canada
| | - Yan Kestens
- Centre de Recherche en Santé Publique (CReSP), Montreal, QC, Canada.,École de santé publique de l'Université de Montréal, Département de médecine sociale et préventive, Montreal, QC, Canada
| | - Basile Chaix
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris, France
| | - Marie-Soleil Cloutier
- Institut National de la recherche scientifique, Centre Urbanisation Culture Société, Montréal, QC, Canada
| | - Melanie Henderson
- Centre de recherche du CHU Sainte-Justine, Montreal, QC, Canada.,École de santé publique de l'Université de Montréal, Département de médecine sociale et préventive, Montreal, QC, Canada.,Department of Pediatrics, Université de Montréal, Montreal, QC, Canada
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25
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Roberge JB, Harnois-Leblanc S, McNealis V, van Hulst A, Barnett TA, Kakinami L, Paradis G, Henderson M. Body Mass Index Z Score vs Weight-for-Length Z Score in Infancy and Cardiometabolic Outcomes at Age 8-10 Years. J Pediatr 2021; 238:208-214.e2. [PMID: 34302856 DOI: 10.1016/j.jpeds.2021.07.046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 07/13/2021] [Accepted: 07/16/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To confirm that World Health Organization weight-for-length z scores (zWFL) and World Health Organization body mass index z scores (zBMI) in infancy are associated with adiposity and cardiometabolic measures at 8-10 years old and to compare the predictive ability of the 2 methods. STUDY DESIGN zWFL and zBMI at 6, 12, and 18 months of age were computed using data extracted from health booklets, among participants in the Québec Adipose and Lifestyle InvesTigation in Youth prospective cohort (n = 464). Outcome measures at 8-10 years included adiposity, lipid profile, blood pressure, and insulin dynamics. The relationships between zWFL, zBMI, and each outcome were estimated using multivariable linear regression models. Outcome prediction at 8-10 years was compared between the 2 methods using eta-squared and the Lin concordance correlation coefficient. RESULTS zWFL and zBMI were associated with all measures of adiposity at 8-10 years. Associations with other cardiometabolic measures were less consistent. For both zWFL and zBMI across infancy, eta-squared were highly similar and the Lin coefficients were markedly high (≥0.991) for all outcomes. CONCLUSIONS There was no evidence that zBMI and zWFL in infancy differed in their ability to predict adiposity and cardiometabolic measures in childhood. This lends support to the sole use of zBMI for growth monitoring and screening of overweight and obesity from birth to 18 years. TRIAL REGISTRATION ClinicalTrials.gov: NCT03356262.
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Affiliation(s)
- Jean-Baptiste Roberge
- CHU Sainte-Justine Research Centre, University of Montréal, Montréal, Canada; Department of Pediatrics, Faculty of Medicine, University of Montréal, Montréal, Canada
| | - Soren Harnois-Leblanc
- CHU Sainte-Justine Research Centre, University of Montréal, Montréal, Canada; School of Public Health, University of Montréal, Montréal, Canada
| | - Vanessa McNealis
- CHU Sainte-Justine Research Centre, University of Montréal, Montréal, Canada
| | | | - Tracie A Barnett
- CHU Sainte-Justine Research Centre, University of Montréal, Montréal, Canada; Department of Family Medicine, McGill University, Montréal, Canada
| | - Lisa Kakinami
- Department of Mathematics and Statistics, McGill University, Montréal, Canada; PERFORM Centre, Concordia University, Montréal, Canada
| | - Gilles Paradis
- Department of Epidemiology, Biostatistics and Occupational Health, Montréal, Canada
| | - Mélanie Henderson
- CHU Sainte-Justine Research Centre, University of Montréal, Montréal, Canada; Department of Pediatrics, Faculty of Medicine, University of Montréal, Montréal, Canada; School of Public Health, University of Montréal, Montréal, Canada.
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Roberge JB, Harnois-Leblanc S, McNealis V, van Hulst A, Barnett TA, Kakinami L, Paradis G, Henderson M. 54 Body Mass Index vs Weight-for-Length in Infancy and Cardiometabolic Outcomes at Age 8-10 Years. Paediatr Child Health 2021. [DOI: 10.1093/pch/pxab061.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Primary Subject area
Public Health and Preventive Medicine
Background
The WHO provides body mass index (BMI) curves for infants 0 to < 2 years old, but how these compare to the recommended method (weight-for-length [WFL]) in predicting later adiposity and cardiometabolic measures is uncertain.
Objectives
Our project aimed to: 1) confirm that WFL and BMI in infancy are associated with adiposity and cardiometabolic measures at 8-10 years old; and 2) compare the predictive ability of the two methods. We hypothesized that both methods would perform similarly.
Design/Methods
WFL and BMI Z-scores (zWFL and zBMI) at 6, 12, and 18 months of age were computed using data extracted from health booklets, used among participants in a prospective cohort study investigating the natural history of obesity and cardiovascular risk in youth (n = 464). Outcome measures at 8-10 years included adiposity, lipid profile, blood pressure, and insulin dynamics. The relationships between zWFL, zBMI, and each outcome were estimated using multivariable linear regression models. Outcome prediction at 8-10 years was compared between the two methods, using eta-squared and Lin’s concordance correlation.
Results
zWFL and zBMI were associated with all measures of adiposity at 8-10 years. Associations with other cardiometabolic measures were less consistent. For both zWFL and zBMI across infancy, eta-squared were highly similar and the Lin’s coefficients were markedly high (> 0.991) for all outcomes.
Conclusion
zBMI measured in infants appeared to be equivalent to zWFL for predicting adiposity and cardiometabolic measures in childhood. This lends support to the sole use of zBMI for growth monitoring and screening of overweight and obesity from birth to 18 years.
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Affiliation(s)
| | | | | | | | | | | | - Gilles Paradis
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University
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Henderson M, Friedrich M, Van Hulst A, Pelletier C, Barnett TA, Benedetti A, Bigras JL, Drapeau V, Lavoie JC, Levy E, Mathieu ME, Nuyt AM. CARDEA study protocol: investigating early markers of cardiovascular disease and their association with lifestyle habits, inflammation and oxidative stress in adolescence using a cross-sectional comparison of adolescents with type 1 diabetes and healthy controls. BMJ Open 2021; 11:e046585. [PMID: 34497076 PMCID: PMC8438758 DOI: 10.1136/bmjopen-2020-046585] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Little is known regarding associations between potentially modifiable lifestyle habits and early markers of cardiovascular disease (CVD) in pediatric type 1 diabetes (T1D), hindering early prevention efforts. Specific objectives are: (1) compare established risk factors (dyslipidemia, hypertension) with novel early markers for CVD (cardiac phenotype, aortic distensibility, endothelial function) in adolescents with T1D and healthy age-matched and sex-matched controls; (2) examine associations between these novel early markers with: (i) lifestyle habits; (ii) adipokines and measures of inflammation; and (iii) markers of oxidative stress among adolescents with T1D and controls, and determine group differences in these associations; (3) explore, across both groups, associations between CVD markers and residential neighbourhood features. METHODS AND ANALYSES Using a cross-sectional design, we will compare 100 participants aged 14-18 years with T1D to 100 healthy controls. Measures include: anthropometrics; stage of sexual maturity (Tanner stages); physical activity (7-day accelerometry); sleep and sedentary behaviour (self-report and accelerometry); fitness (peak oxygen consumption); and dietary intake (three non-consecutive 24- hour dietary recalls). Repeated measures of blood pressure will be obtained. Lipid profiles will be determined after a 12- hour fast. Cardiac structure/function: non-contrast cardiac magnetic resonance imaging (CMR) images will evaluate volume, mass, systolic and diastolic function and myocardial fibrosis. Aortic distensibility will be determined by pulse wave velocity with elasticity and resistance studies at the central aorta. Endothelial function will be determined by flow-mediated dilation. Inflammatory markers include plasma leptin, adiponectin, tumour necrosis factor alpha (TNF-α), type I and type II TNF-α soluble receptors and interleukin-6 concentrations. Measures of endogenous antioxidants include manganese superoxide dismutase, glutathione peroxidase and glutathione in blood. Neighbourhood features include built and social environment indicators and air quality. ETHICS AND DISSEMINATION This study was approved by the Sainte-Justine Hospital Research Ethics Board. Written informed assent and consent will be obtained from participants and their parents. TRIAL REGISTRATION NUMBER NCT04304729.
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Affiliation(s)
- Mélanie Henderson
- Department of Pediatrics, Université de Montréal, Montréal, Québec, Canada
- Research Center, Sainte-Justine University Health Center, Montréal, Québec, Canada
- School of Public Health, Department of Social and Preventive Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Matthias Friedrich
- Department of Cardiology, McGill University Health Centre, Montréal, Québec, Canada
| | - Andraea Van Hulst
- Ingram School of Nursing, McGill University, Montréal, Québec, Canada
| | - Catherine Pelletier
- Research Center, Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - Tracie A Barnett
- Research Center, Sainte-Justine University Health Center, Montréal, Québec, Canada
- Department of Family Medicine, McGill University, Montréal, Québec, Canada
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, Québec, Canada
- Research Institute, McGill University Health Centre, Montréal, Québec, Canada
| | - Jean-Luc Bigras
- Department of Pediatrics, Université de Montréal, Montréal, Québec, Canada
- Research Center, Sainte-Justine University Health Center, Montréal, Québec, Canada
| | - Vicky Drapeau
- Department of Physical Education, Université Laval, Québec, Québec, Canada
| | - Jean-Claude Lavoie
- Department of Pediatrics, Université de Montréal, Montréal, Québec, Canada
- Research Center, Sainte-Justine University Health Center, Montréal, Québec, Canada
- Department of Nutrition, Université de Montréal, Montréal, Québec, Canada
| | - Emile Levy
- Department of Pediatrics, Université de Montréal, Montréal, Québec, Canada
- Research Center, Sainte-Justine University Health Center, Montréal, Québec, Canada
- Department of Nutrition, Université de Montréal, Montréal, Québec, Canada
| | - Marie-Eve Mathieu
- Research Center, Sainte-Justine University Health Center, Montréal, Québec, Canada
- School of Kinesiology and Physical Activity Sciences, Université de Montréal, Montréal, Québec, Canada
| | - Anne-Monique Nuyt
- Department of Pediatrics, Université de Montréal, Montréal, Québec, Canada
- Research Center, Sainte-Justine University Health Center, Montréal, Québec, Canada
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Chemtob K, Reid RER, Guimarães RDF, Henderson M, Mathieu ME, Barnett TA, Tremblay A, Van Hulst A. Adherence to the 24-hour movement guidelines and adiposity in a cohort of at risk youth: A longitudinal analysis. Pediatr Obes 2021; 16:e12730. [PMID: 32997442 DOI: 10.1111/ijpo.12730] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 07/30/2020] [Accepted: 08/24/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND The 24-hour movement guidelines provide recommendations for physical activity, screen time and sleep duration for children. OBJECTIVES Describe adherence to the guidelines and their cross-sectional and longitudinal associations with adiposity from childhood to adolescence. METHODS Data are from the QUALITY Cohort. Children were followed at 8 to 10 years (childhood; n = 630), 10 to 12 years (early adolescence; n = 564) and 15 to 17 years (adolescence; n = 377). Physical activity, screen time, and sleep duration were measured by accelerometry and questionnaires. Body mass index z-scores (zBMI), waist circumference, waist-to-height ratio and percent body fat were based on clinical measurements. Multiple linear regressions estimated associations. RESULTS In childhood, early adolescence and adolescence, 14%, 6%, and 0% of participants met the 24-hour movement guidelines, respectively. Meeting fewer guideline components was cross-sectionally associated with higher adiposity at each visit. Meeting fewer guideline components in childhood was longitudinally associated with higher adiposity at later visits. For example, those meeting none of the guideline components (vs all) in childhood had a 1.66 SD (95% CI: 0.42, 2.89) higher zBMI in early adolescence. CONCLUSION Few participants met the guidelines. Not meeting the guidelines in childhood is associated with higher adiposity 2 and 7 years later. Interventions are needed to increase adherence to the 24-hour movement guidelines across childhood and adolescence.
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Affiliation(s)
- Keryn Chemtob
- Ingram School of Nursing, McGill University, Montreal, Quebec, Canada
| | - Ryan E R Reid
- Human Kinetics Department, St Francis Xavier University, Antigonish, Nova Scotia, Canada
| | - Roseane de Fátima Guimarães
- École de kinésiologie et des sciences de l'activité physique, Université de Montréal, Montreal, Quebec, Canada.,Centre de recherche du CHU Sainte Justine, Montreal, Quebec, Canada
| | - Mélanie Henderson
- Centre de recherche du CHU Sainte Justine, Montreal, Quebec, Canada.,Department of Pediatrics, Université de Montréal, Montreal, Quebec, Canada
| | - Marie-Eve Mathieu
- École de kinésiologie et des sciences de l'activité physique, Université de Montréal, Montreal, Quebec, Canada.,Centre de recherche du CHU Sainte Justine, Montreal, Quebec, Canada
| | - Tracie A Barnett
- Centre de recherche du CHU Sainte Justine, Montreal, Quebec, Canada.,Department of Family Medicine, McGill University, Montreal, Quebec, Canada
| | - Angelo Tremblay
- Département de kinésiologie, Université Laval, Quebec City, Quebec, Canada
| | - Andraea Van Hulst
- Ingram School of Nursing, McGill University, Montreal, Quebec, Canada
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O'Loughlin E, Sabiston CM, Kakinami L, McGrath JJ, Consalvo M, O'Loughlin JL, Barnett TA. Development and Validation of the Reasons to Exergame (RTEX) Scale in Young Adults: Exploratory Factors Analysis. JMIR Serious Games 2020; 8:e16261. [PMID: 32538792 PMCID: PMC7325003 DOI: 10.2196/16261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 02/20/2020] [Accepted: 03/05/2020] [Indexed: 02/03/2023] Open
Abstract
Background Exergaming is associated with positive health benefits; however, little is known about what motivates young people to exergame. Objective This study aimed to develop a new Reasons to Exergame (RTEX) scale and describe its psychometric properties (Study 1) including test-retest reliability (Study 2). We also examined the test-retest reliability of self-report exergaming behavior measures (Study 2). Methods We identified scale items in consultation with experts. In Study 1, we conducted an Exploratory Factor Analysis of RTEX and examined how the factors identified relate to exergaming frequency and intensity in a population-based sample of 272 young adults. In Study 2, we examined the test-retest reliability of RTEX factors and self-report measures of past-week exergaming frequency and intensity among 147 college students. Results We identified four factors in RTEX: exergaming for fitness, exergaming for enjoyment, preferring exergaming over other gaming options, and choosing exergaming over competing interests (eg, sports). Test-retest reliability of RTEX factors (ICC 0.7-0.8) and self-report exergaming frequency (ICC 0.4-0.9) was adequate. Exergaming for fitness and enjoyment were positively associated with the frequency of exergaming with friends and family, and with exergaming intensity. Preferring exergaming over other gaming options and choosing exergaming over competing interests (eg, sports) were not related to exergaming behavior. Conclusions RTEX is a psychometrically sound scale with four factors that measure reasons to exergame. Replication of these findings is needed in larger, more diverse samples.
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Affiliation(s)
- Erin O'Loughlin
- Centre de Recherche du CHUM, Concordia University, Montreal, QC, Canada.,Department of Social and Preventive Medicine, Université de Montréal, Montreal, QC, Canada.,Individualized Program Department, Concordia University, Montreal, QC, Canada
| | - Catherine M Sabiston
- Division of Neurosurgery, Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Lisa Kakinami
- Department of Family Medicine, McGill University, Montreal, QC, Canada.,PERFORM Centre, Concordia University, Montreal, QC, Canada
| | - Jennifer J McGrath
- PERFORM Centre, Concordia University, Montreal, QC, Canada.,Psychology Department, Concordia University, Montreal, QC, Canada
| | - Mia Consalvo
- Department of Family Medicine, McGill University, Montreal, QC, Canada
| | - Jennifer L O'Loughlin
- Department of Social and Preventive Medicine, Université de Montréal, Montreal, QC, Canada
| | - Tracie A Barnett
- Department of Family Medicine, McGill University, Montreal, QC, Canada.,Sainte-Justine Research Centre, Université de Montréal, Montreal, QC, Canada.,Epidemiology and Biostatistics Unit, Centre Armand-Frappier Santé Biotechnologie, Institut National de la Recherche Scientifique, Laval, QC, Canada
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Manousaki D, Barnett TA, Mathieu ME, Maximova K, Simoneau G, Harnois-Leblanc S, Benedetti A, McGrath JJ, Henderson M. Tune out and turn in: the influence of television viewing and sleep on lipid profiles in children. Int J Obes (Lond) 2020; 44:1173-1184. [PMID: 32203106 DOI: 10.1038/s41366-020-0527-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 12/20/2019] [Accepted: 01/07/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Physical activity is beneficial to lipid profiles; however, the association between sedentary behavior and sleep and pediatric dyslipidemia remains unclear. We aimed to investigate whether sedentary behavior or sleep predicted lipid profiles in children over a 2-year period. SUBJECTS/METHODS Six hundered and thirty children from the QUALITY cohort, with at least one obese parent, were assessed prospectively at ages 8-10 and 10-12 years. Measures of sedentary behavior included self-reported TV viewing and computer/video game use. Seven-day accelerometry was used to derive sedentary behavior and sleep duration. Adiposity was assessed using DEXA scans. Twenty-four-hour dietary recalls yielded estimates of carbohydrate and fat intake. Outcomes included fasting total cholesterol, triglycerides, HDL and LDL-cholesterol. Multivariable models were adjusted for adiposity and diet. RESULTS At both Visit 1 (median age 9.6 year) and Visit 2 (median age 11.6 year), children were of normal weight (55%), overweight (22%), or obese (22%). Every additional hour of TV viewing at Visit 1 was associated with a 7.0% triglyceride increase (95% CI: 3.5, 10.6; P < 0.01) and 2.6% HDL decrease (95% CI: -4.2, -0.9; P < 0.01) at Visit 2; findings remained significant after adjusting for adiposity and diet. Every additional hour of sleep at Visit 1 predicted a 4.8% LDL decrease (95% CI: -9.0, -0.5; P = 0.03) at Visit 2, after adjusting for fat intake; this association became nonsignificant once controlling for adiposity. CONCLUSIONS Longer screen time during childhood appears to deteriorate lipid profiles in early adolescence, even after accounting for other major lifestyle habits. There is preliminary evidence of a deleterious effect of shorter sleep duration, which should be considered in further studies.
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Affiliation(s)
- Despoina Manousaki
- CHU Sainte-Justine Research Center, University of Montreal, Montreal, QC, Canada.,Department of Human Genetics, McGill University, Montreal, QC, Canada
| | - Tracie A Barnett
- CHU Sainte-Justine Research Center, University of Montreal, Montreal, QC, Canada.,Department of Family Medicine, McGill University, Montreal, QC, Canada.,Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Laval, QC, Canada
| | - Marie-Eve Mathieu
- CHU Sainte-Justine Research Center, University of Montreal, Montreal, QC, Canada.,Department of Kinesiology, University of Montreal, Montreal, QC, Canada
| | - Katerina Maximova
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Gabrielle Simoneau
- CHU Sainte-Justine Research Center, University of Montreal, Montreal, QC, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - Soren Harnois-Leblanc
- CHU Sainte-Justine Research Center, University of Montreal, Montreal, QC, Canada.,Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, QC, Canada
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.,Department of Medicine, Respiratory epidemiology and clinical research unit, McGill University Health Centre, McGill University, Montréal, QC, Canada
| | - Jennifer J McGrath
- PERFORM Centre & Department of Psychology, Concordia University, Montréal, QC, Canada
| | - Mélanie Henderson
- CHU Sainte-Justine Research Center, University of Montreal, Montreal, QC, Canada. .,Department of Pediatrics, University of Montreal, Montreal, QC, Canada.
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Puzhko S, Schuster T, Barnett TA, Renoux C, Rosenberg E, Barber D, Bartlett G. Evaluating Prevalence and Patterns of Prescribing Medications for Depression for Patients With Obesity Using Large Primary Care Data (Canadian Primary Care Sentinel Surveillance Network). Front Nutr 2020; 7:24. [PMID: 32258046 PMCID: PMC7090027 DOI: 10.3389/fnut.2020.00024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 02/25/2020] [Indexed: 12/28/2022] Open
Abstract
Introduction: Depression is a serious disorder that brings a tremendous health and economic burden. Many antidepressants (AD) have obesogenic effects, increasing the population of obese patients at increased risk for a more severe disease course and poor treatment response. In addition, obese patients with depression may not be receiving the recommended standard of care due to "obesity bias." It is important to evaluate prescribing pharmacological treatment of depression in patients with obesity. Objectives: To describe the prevalence and patterns of AD prescribing for patients with depression and comorbid obesity compared with normal weight patients, and to examine the association of prescribing prevalence with obesity class. Methods: Study sample of adult patients (>18 years old) with depression was extracted from the national Canadian Primary Care Sentinel Surveillance Network (CPCSSN) Electronic Medical Records database for 2011-2016. Measures were prescribing of at least one AD (outcome) and body mass index (BMI) to categorize patients into weight categories (exposure). Data were analyzed cross-sectionally using descriptive statistics and mixed effects logistic regression model with clustering on CPCSSN networks and adjusting for age, sex, and the comorbidities. Results: Of 120,381 patients with depression, 63,830 patients had complete data on studied variables (complete cases analysis). Compared with normal weight patients, obese patients were more likely to receive an AD prescription (adjusted Odds Ratio [aOR] = 1.17; 95% Confidence Interval [CI]: 1.12-1.22). Patients with obesity classes II and III were 8% (95% CI: 1.00, 1.16) and 6% (95% CI: 0.98, 1.16) more likely, respectively, to receive AD. After imputing missing data using Multiple Imputations by Chained Equations, the results remained unchanged. The prevalence of prescribing >3 AD types was higher in obese category (7.27%, [95% CI: 6.84, 7.73]) than in normal weight category (5.6%; [95% CI: 5.24, 5.99]). Conclusion: The association between obesity and high prevalence of AD prescribing and prescribing high number of different AD to obese patients, consistent across geographical regions, raises a public health concern. Study results warrant qualitative studies to explore reasons behind the difference in prescribing, and quantitative longitudinal studies evaluating the association of AD prescribing patterns for obese patients with health outcomes.
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Affiliation(s)
- Svetlana Puzhko
- Department of Family Medicine, Faculty of Medicine, McGill University, Montréal, QC, Canada
| | - Tibor Schuster
- Department of Family Medicine, Faculty of Medicine, McGill University, Montréal, QC, Canada
| | - Tracie A Barnett
- Department of Epidemiology and Biostatistics, INRS-Institut Armand-Frappier, Université du Québec à Montreal (UQAM), Laval, QC, Canada
| | - Christel Renoux
- Department of Neurology and Neurosurgery, McGill University, Montréal, QC, Canada.,Department of Epidemiology and Biostatistics, McGill University, Montréal, QC, Canada.,Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, QC, Canada
| | - Ellen Rosenberg
- Department of Family Medicine, Faculty of Medicine, McGill University, Montréal, QC, Canada
| | - David Barber
- Department of Family Medicine, Faculty of Medicine, Queen's University, Kingston, ON, Canada
| | - Gillian Bartlett
- Department of Family Medicine, Faculty of Medicine, McGill University, Montréal, QC, Canada
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O'Loughlin EK, Dutczak H, Kakinami L, Consalvo M, McGrath JJ, Barnett TA. Exergaming in Youth and Young Adults: A Narrative Overview. Games Health J 2020; 9:314-338. [PMID: 32017864 DOI: 10.1089/g4h.2019.0008] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Because of rapid evolution in exergaming technology and content, the literature on the benefits of exergaming needs ongoing review. Updated syntheses incorporating high-quality critical assessments of included articles can provide cutting-edge evidence to drive research and practice. The objectives were to summarize evidence from systematic reviews and meta-analyses on the association between exergaming and (1) physical activity (PA), sedentary behavior and energy expenditure (EE); and (2) body composition, body mass index (BMI), and other weight-related outcomes among persons younger than 30 years; and to summarize recommendations in the articles retained. The Elton B. Stephens Co. (ESBSCO) database for reviews was searched from January 1995 to July 2019. Data on study characteristics, findings, and recommendations for future research, game design, and intervention development were extracted from articles that met the inclusion criteria, quality scores were attributed to each article, and a narrative overview of the evidence was undertaken. Twenty-eight reviews, with 5-100 articles per review, were identified. Seventeen assessed the evidence on the association between exergaming and PA, EE, and/or sedentary behavior, and 11 examined the association with body composition, BMI, or other weight-related outcomes. There was substantial heterogeneity across reviews in objectives, definitions, and methods. A positive relationship between exergaming and EE is well documented, but whether exergaming increases PA or changes body composition is not established. The reviews retained also provide evidence that exergaming is a healthier alternative to sedentary behavior and that it can be an exciting enjoyable pastime for youth, which adds variety in PA options for health and dietary interventions. Exergaming is likely more physically health promoting than traditional videogames because of higher EE and possibly improved physical fitness and body composition. Longitudinal studies are needed to assess if exergaming reduces sedentary time, has other health benefits, or is a sustainable behavior. We recommend that exergaming interventions be designed using behavior change theory, and that future reviews use standard review criteria and include recommendations for research, game design, and intervention development.
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Affiliation(s)
- Erin K O'Loughlin
- INDI department, Concordia University, Montreal, Canada.,Department of Social and Preventive Medicine, Centre de Recherche du Centre Hospitalier de l'Université de Montreal (CRCHUM), Montreal, Canada
| | - Hartley Dutczak
- Department of Public Health, Environments and Society. Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH, UK
| | - Lisa Kakinami
- Department of Mathematics and Statistics, Concordia University, Montreal, Canada.,PERFORM Centre, Concordia University, Montreal, Canada
| | - Mia Consalvo
- Communications Department, Concordia University, Montreal, Canada
| | - Jennifer J McGrath
- PERFORM Centre, Concordia University, Montreal, Canada.,Psychology Department, Concordia University, Montreal, Canada
| | - Tracie A Barnett
- Department of Family Medicine, McGill University, Montreal, Canada.,CR du CHU Sainte-Justine, Montreal, Canada.,Centre Armand Frappier Santé Biotechnologie, Laval, Canada
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Côté-Lussier C, Knudby A, Barnett TA. A novel low-cost method for assessing intra-urban variation in night time light and applications to public health. Soc Sci Med 2020; 248:112820. [PMID: 32036268 DOI: 10.1016/j.socscimed.2020.112820] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 12/16/2019] [Accepted: 01/27/2020] [Indexed: 12/12/2022]
Abstract
Night time lighting (NTL) pollution is a public health concern given its known impact on a range of health outcomes. The daily cycle of the hue of natural ambient light shifting from relatively blue-white light at noon to relatively yellow-red light at sunset is important for human functioning. Disruptions of the circadian clock can result in melatonin suppression, sleep and mood disorders, and increased risks of cancer in adults. Current measures of intra-urban variation in NTL are based on costly in-person or coarse satellite image-based assessments. The central objective of the current study is to validate a novel low-cost measure of intra-urban NTL variation. Estimates of red, green and blue NTL intensity were derived from a cloud-free night time image of the city of Montreal, Canada, taken from the International Space Station (ISS). The new measures are shown to converge with in-person assessed NTL and to predict known child health-related outcomes. Specifically, the results suggest that ISS-assessed blue NTL is associated with feelings of safety and self-reported health. In conclusion, ISS-based measures of NTL, particularly of blue NTL, are valid indicators of intra-urban variation in NTL for applications in public health. Limitations of, and future directions for, the method are discussed.
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Affiliation(s)
- Carolyn Côté-Lussier
- Centre Urbanisation Culture Société, Institut National de la Recherche Scientifique, 385 Sherbrooke East, Montreal, Quebec, H2X 1E3, Canada; Department of Criminology, University of Ottawa, 120 University, Ottawa, Ontario, K1N 6N5, Canada.
| | - Anders Knudby
- Department of Geography, Environment and Geomatics, University of Ottawa, 120 University, Ottawa, Ontario, K1N 6N5, Canada
| | - Tracie A Barnett
- Department of Family Medicine, McGill University, 5858, Chemin de la Côte-des-Neiges, Suite 300, Montréal, QC, H3S 1Z1, Canada; Unité d'épidémiologie et de biostatistique, Centre INRS-Institut Armand-Frappier Santé Biotechnologie, 531 Boul. des Prairies, Laval, Quebec, H7V 1B7, Canada; Centre de recherche du CHU Sainte-Justine, 5757 Avenue Decelles, Montréal, Québec, H3S 2C3, Canada
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Reid RER, Fillon A, Thivel D, Henderson M, Barnett TA, Bigras JL, Mathieu ME. Can anthropometry and physical fitness testing explain physical activity levels in children and adolescents with obesity? J Sci Med Sport 2019; 23:580-585. [PMID: 31926870 DOI: 10.1016/j.jsams.2019.12.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 11/29/2019] [Accepted: 12/05/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVES As time with patients and resources are increasingly limited, it is important to determine if clinical tests can provide further insight into real-world behaviors linked to clinical outcomes. The purpose of this study was to determine which aspects of anthropometry and physical fitness testing are associated with physical activity (PA) levels among youth with obesity. DESIGN Cross-sectional study. METHOD Anthropometry [height, waist circumference, bodyweight, fat percentage], physical fitness [muscular endurance (partial curl-ups), flexibility (sit-and-reach), lower-body power (long-jump), upper-body strength (grip), speed/agility (5×5-m shuttle), cardiorespiratory fitness (VO2-max)], and PA [light (LPA), moderate (MPA), vigorous (VPA), MVPA] was assessed in 203 youth with obesity. RESULTS The sample was stratified by age <12 yrs (children); 12 yrs (adolescents) and sex. Stepwise regression evaluated associations between PA with anthropometry and physical fitness. Children (57% male) and adolescents (45% male) had a BMI Z-score of 3.5(SD:0.94) and 3.1(SD:0.76) respectively. Long-jump explained 19.5% [(Standardized) Beta=0.44; p=0.001] of variance in VPA for childhood girls and 12.6% (Beta=0.35; p=0.025) of variance in MPA for adolescent boys. 5×5-m shuttle explained 8.4% (Beta=-0.29; p=0.042) of variance in MVPA for childhood girls. Body mass explained 6.3% (Beta=-0.25; p=0.007) of variance in LPA in childhood boys. Fat percentage explained 9.8% (Beta=0.31; p=0.03) of variance in MPA in adolescent girls. CONCLUSIONS In conclusion, tests of lower body power, body mass and fat percentage provide limited information concerning PA levels in youth with obesity. Activity monitoring should be considered in addition to clinical assessments to more fully understand youth health.
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Affiliation(s)
- Ryan E R Reid
- School of Kinesiology and Physical Activity Science, Université de Montréal, Canada; Research Center, Sainte-Justine University Hospital Research Center, Canada
| | - Alicia Fillon
- Metabolic Adaptation to Exercise Under PhyioPathological Condition Laboratory (AME2P), Center for Human Nutrition Research (CRNH Auvergne), Clermont Auvergne University, France
| | - David Thivel
- Metabolic Adaptation to Exercise Under PhyioPathological Condition Laboratory (AME2P), Center for Human Nutrition Research (CRNH Auvergne), Clermont Auvergne University, France
| | - Mélanie Henderson
- Research Center, Sainte-Justine University Hospital Research Center, Canada; Department of Pediatrics, Université de Montréal, Canada
| | - Tracie A Barnett
- Research Center, Sainte-Justine University Hospital Research Center, Canada; Department of Family Medicine, McGill University, Canada
| | - Jean-Luc Bigras
- Research Center, Sainte-Justine University Hospital Research Center, Canada
| | - Marie-Eve Mathieu
- School of Kinesiology and Physical Activity Science, Université de Montréal, Canada; Research Center, Sainte-Justine University Hospital Research Center, Canada.
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Barnett TA, Kelly AS, Young DR, Perry CK, Pratt CA, Edwards NM, Rao G, Vos MB. Sedentary Behaviors in Today's Youth: Approaches to the Prevention and Management of Childhood Obesity: A Scientific Statement From the American Heart Association. Circulation 2019; 138:e142-e159. [PMID: 30354382 DOI: 10.1161/cir.0000000000000591] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This scientific statement is about sedentary behavior and its relationship to obesity and other cardiometabolic outcomes in youth. A deleterious effect of sedentary behavior on cardiometabolic health is most notable for screen-based behaviors and adiposity; however, this relation is less apparent for other cardiometabolic outcomes or when sedentary time is measured with objective movement counters or position monitors. Increasing trends of screen time are concerning; the portability of screen-based devices and abundant access to unlimited programming and online content may be leading to new patterns of consumption that are exposing youth to multiple pathways harmful to cardiometabolic health. This American Heart Association scientific statement provides an updated perspective on sedentary behaviors specific to modern youth and their impact on cardiometabolic health and obesity. As we reflect on implications for practice, research, and policy, what emerges is the importance of understanding the context in which sedentary behaviors occur. There is also a need to capture the nature of sedentary behavior more accurately, both quantitatively and qualitatively, especially with respect to recreational screen-based devices. Further evidence is required to better inform public health interventions and to establish detailed quantitative guidelines on specific sedentary behaviors in youth. In the meantime, we suggest that televisions and other recreational screen-based devices be removed from bedrooms and absent during meal times. Daily device-free social interactions and outdoor play should be encouraged. In addition, parents/guardians should be supported to devise and enforce appropriate screen time regulations and to model healthy screen-based behaviors.
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O'Loughlin EK, Barnett TA, McGrath JJ, Consalvo M, Kakinami L. Factors Associated with Sustained Exergaming: Longitudinal Investigation. JMIR Serious Games 2019; 7:e13335. [PMID: 31368440 PMCID: PMC6786850 DOI: 10.2196/13335] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 03/31/2019] [Accepted: 04/03/2019] [Indexed: 11/16/2022] Open
Abstract
Background Exergaming is technology-driven physical activity (PA) which, unlike traditional video game play, requires that participants be physically active to play the game. Exergaming may have potential to increase PA and decrease sedentary behavior in youth, but little is known about sustained exergaming. Objective The objectives of this study were to describe the frequency, correlates, and predictors of sustained exergaming. Methods Data were available in AdoQuest (2005-11), a longitudinal investigation of 1843 grade 5 students in Montréal, Canada. This analysis used data from grade 9 (2008-09) and 11 (2010-11). Participants at Time 1 (T1; mean age 14 years, SD 0.8 ) who reported past-week exergaming (n=186, 19.1% of AdoQuest sample) completed mailed self-report questionnaires at Time 2 (T2; mean age 16 years, SD 0.8). Independent sociodemographic, psychological, and behavioral correlates (from T2)/predictors (from T1 or earlier) were identified using multivariable logistic regression. Results Of 186 exergamers at T1, 81 (44%) reported exergaming at T2. Being female and having higher introjected regulation (ie, a type of PA motivation indicative of internalizing PA as a behavior) were independent correlates. None of the predictors investigated were associated with sustained exergaming. Conclusions Almost half of grade 9 exergamers sustained exergaming for 2 years. Exergaming may be a viable approach to help adolescents engage in and sustain PA during adolescence. Sex and PA motivation may be important in the sustainability of exergaming.
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Affiliation(s)
- Erin Kathleen O'Loughlin
- Concordia University, Montreal, QC, Canada.,Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Tracie A Barnett
- Concordia University, Montreal, QC, Canada.,Le Centre L'Institut National de la Recherche Scientifique-Institut Armand-Frappier, Laval, QC, Canada
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Pagani LS, Harbec MJ, Barnett TA. Prospective associations between television in the preschool bedroom and later bio-psycho-social risks. Pediatr Res 2019; 85:967-973. [PMID: 30587848 DOI: 10.1038/s41390-018-0265-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 11/07/2018] [Accepted: 11/09/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND North American child media guidelines suggest screen-free zones without offering clear evidence and alternative harm-reduction strategies. Our hypothesis is that having a bedroom television during the preschool years will be prospectively associated with mental and physical health risks in adolescence. METHODS Participants are from a prospective-longitudinal birth cohort of 907 girls and 952 boys from the Quebec Longitudinal Study of Child Development. Child outcomes at ages 12 and 13, measured by multiple sources, were linearly regressed on having a bedroom television at age 4. RESULTS Bedroom television at age 4 predicted a higher body mass index at age 12 (standardized B = 0.10, p < 0.001), more unhealthy eating habits at age 13 (B = 0.10, p < 0.001), higher levels of emotional distress (B = 0.12, p < 0.001), depressive symptoms (B = 0.08, p < 0.001), victimization (B = 0.07, p < 0.001), physical aggression (B = 0.09, p < 0.001), and lowers levels of sociability (B = -0.09, p < 0.001) at age 12, above and beyond pre-existing individual and family factors. CONCLUSION The bedroom as a screen-based preschool zone does not bode well for long-term cardio-metabolic wellness, mental health, and social relationships.
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Affiliation(s)
- Linda S Pagani
- School of Psycho-Education, Université de Montréal, Montréal, Canada.
| | - Marie Josée Harbec
- School Environment Research Group, Université de Montréal, Montréal, Canada
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Longo C, Bartlett G, Schuster T, Ducharme FM, MacGibbon B, Barnett TA. Influence of weight status in the response to Step-2 maintenance therapies in children with asthma. BMJ Open Respir Res 2019; 6:e000401. [PMID: 31179003 PMCID: PMC6530505 DOI: 10.1136/bmjresp-2019-000401] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 02/26/2019] [Indexed: 11/24/2022] Open
Abstract
Introduction Overweight children with asthma may display impaired response to inhaled corticosteroids (ICS), possibly due to non-eosinophilic inflammation or weight-related lung compression; these mechanisms may differentially affect response to ICS and leukotriene receptor antagonists (LTRAs). We assessed whether weight status modified the response to low-dose ICS and LTRA Step-2 monotherapy. Methods A historical cohort study from clinical data linked to administrative databases was conducted among children aged 2–18 years with specialist-diagnosed asthma who were initiating or continuing a Step-2 monotherapy from 2000 to 2007 at the Montreal Children’s Hospital Asthma Centre. The outcome was time-to-management failure defined as any step-up in therapy, acute care visit, hospitalisation or oral corticosteroids for asthma, whichever occurred first. The independent and joint effects of weight status (body mass index [BMI] percentile) and time-varying treatment on time-to-management failure were estimated with marginal structural Cox models. The likelihood ratio test (LRT) and relative excess risk due to interaction (RERI) were computed to assess treatment effect modification by weight status on the multiplicative and additive scales. Results Of the 433 and 85 visits with a low-dose ICS and LTRA prescription, respectively, 388 management failures occurred over 14 529 visit-weeks of follow-up. Children using LTRA compared with low-dose ICS tended to have an overall higher risk of early management failure (HR 1.52; 95% CI 0.72 to 3.22). Irrespective of treatment, the hazard of management failure increased by 5% (HR 1.05; 95% CI 1.01 to 1.10) for every 10-unit increase in BMI percentile. An additional hazard reduction of 17% (HR 0.83; 95% CI 0.70 to 0.99) was observed for every 10-unit increase in BMI percentile among LTRA users, but not for ICS (HR 0.95; 95% CI 0.86 to 1.04). The LRT indicated a departure from exact multiplicativity (p<0.0001), and the RERIs for ICS and LTRA were −0.05 (95% CI −0.14 to 0.05) and −0.52 (95% CI −1.76 to 0.71). Conclusions Weight status was associated with earlier time-to-management failure in children prescribed Step-2 therapy. This hypothesis-generating study suggests that LTRA response increases in children with higher BMI percentiles, although further research is warranted to confirm findings.
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Affiliation(s)
- Cristina Longo
- Family Medicine, McGill University, Montreal, Québec, Canada.,Respiratory Medicine, Academic Medical Center, Amsterdam, The Netherlands
| | | | - Tibor Schuster
- Family Medicine, McGill University, Montreal, Québec, Canada
| | - Francine M Ducharme
- Pediatrics and Social and Preventive Medicine, Université de Montréal, Montreal, Québec, Canada.,Pediatrics, Centre de recherche du CHU Sainte-Justine, Montreal, Québec, Canada
| | | | - Tracie A Barnett
- Pediatrics, Centre de recherche du CHU Sainte-Justine, Montreal, Québec, Canada.,Epidemiology and Biostatistics, INRS-Institut Armand-Frappier, Laval, Québec, Canada
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Longo C, Bartlett G, Schuster T, Ducharme FM, MacGibbon B, Barnett TA. Weight status and nonadherence to asthma maintenance therapy among children enrolled in a public drug insurance plan. J Asthma 2019; 57:627-637. [PMID: 30912698 DOI: 10.1080/02770903.2019.1590593] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Objective: The pediatric obese-asthma phenotype is associated with poor control, perhaps because of medication nonadherence. This study aimed to assess whether weight status is associated with nonadherence in children prescribed new asthma maintenance therapies.Methods: A historical cohort was constructed from a clinical database linking individual patient and prescription data to Quebec's prescription claims registry. Children aged 2-18 years with specialist-diagnosed asthma who were newly prescribed one of the following maintenance controllers: leukotriene receptor antagonists (LTRA); low-dose inhaled corticosteroids (ICS); medium/high-dose ICS; or combination therapy (ICS with long-acting beta-2 agonists and/or LTRA), at the Asthma Center of the Montreal Children's Hospital from 2000-2007 were included. Primary nonadherence was defined as not claiming any prescriptions, whereas secondary nonadherence was measured with the proportion of prescribed days covered (PPDC ≤ 50%) among primary adherers over a 6-month follow-up period. A modified Poisson regression model served to estimate the effect of excess weight (BMI > 85th percentile) on primary and secondary nonadherence.Results: Approximately one third of patients were primary nonadherers and 60% took less than 50% of prescribed therapy. Excess weight was associated with a trend toward increased risk of primary nonadherence in children newly prescribed low-dose ICS (RR 1.53, 95%CI 0.94-2.49), and of secondary nonadherence in children initiating medium/high-dose ICS (RR 1.24; 95%CI 0.98-1.59).Conclusions: Excess weight status is a possible determinant of primary nonadherence in children initiating low-dose ICS and secondary nonadherence to higher-dose ICS regimens. This hypothesis-generating study suggests that nonadherence may be a potential contributor to higher morbidity in children with obese-asthma.
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Affiliation(s)
- Cristina Longo
- Department of Family Medicine, McGill University, Montréal, Québec, Canada
| | - Gillian Bartlett
- Department of Family Medicine, McGill University, Montréal, Québec, Canada
| | - Tibor Schuster
- Department of Family Medicine, McGill University, Montréal, Québec, Canada
| | - Francine M Ducharme
- Centre de recherche du CHU Sainte-Justine, Montréal, Québec, Canada.,Department of Pediatrics, University of Montreal, Montreal, Quebec, Canada.,Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Brenda MacGibbon
- Département de Mathématiques, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Tracie A Barnett
- Centre de recherche du CHU Sainte-Justine, Montréal, Québec, Canada.,Unité d'Épidémiologie et Biostatistiques, INRS-Institut Armand-Frappier, Laval, Québec, Canada
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Belanger M, Katapally TR, Barnett TA, O'Loughlin E, Sabiston CM, O'Loughlin J. Link between Physical Activity Type in Adolescence and Body Composition in Adulthood. Med Sci Sports Exerc 2019; 50:709-714. [PMID: 29210917 DOI: 10.1249/mss.0000000000001503] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE We investigated whether type of physical activity (PA) (sports, running, and fitness/dance) engaged in during adolescence is associated with body composition in late adolescence or early adulthood. METHODS Data were drawn from 631 participants in the Nicotine Dependence in Teens study, a prospective investigation of students ages 12-13 yr at inception. Self-report PA data were collected at baseline, in grade 7, and every 3-4 months thereafter during the 5 yr of high school (1999-2005). Anthropometric indicators (height, weight, waist circumference, triceps, and subscapular skinfold thickness) were measured at ages 12, 16, and 24 yr. On the basis of prior exploratory factor analysis, PA was categorized into one of three types (sports, running, and fitness/dance). Regression models estimated the association between number of years participating in each PA type (0-5 yr) during high school and body composition measures in later adolescence or early adulthood. RESULTS In multivariable models accounting for age, sex, and parent education, more number of years participating in running during adolescence was associated with lower body mass index, waist circumference, and skinfold thickness in later adolescence and early adulthood (all P < 0.01). This association was no longer apparent in models that accounted for body composition at age 12 yr. The number of years participating in sports was positively associated with body mass index in early adulthood (P = 0.02), but fitness/dance was not statistically significantly associated with any outcome. CONCLUSION Sustaining participation in running, but not in other PA types, during adolescence was related to lower body composition in later adolescence and adulthood. However, more research is needed to determine whether this association is attributable to a relationship between PA and body composition in early adolescence.
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Affiliation(s)
- Mathieu Belanger
- Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Sherbrooke, QC, CANADA.,Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Sherbrooke, QC, CANADA.,Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Sherbrooke, QC, CANADA
| | - Tarun R Katapally
- Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Sherbrooke, QC, CANADA.,Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Sherbrooke, QC, CANADA
| | - Tracie A Barnett
- Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Sherbrooke, QC, CANADA.,Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Sherbrooke, QC, CANADA
| | - Erin O'Loughlin
- Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Sherbrooke, QC, CANADA.,Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Sherbrooke, QC, CANADA
| | - Catherine M Sabiston
- Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Sherbrooke, QC, CANADA
| | - Jennifer O'Loughlin
- Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Sherbrooke, QC, CANADA
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Roberge JB, Van Hulst A, Barnett TA, Drapeau V, Benedetti A, Tremblay A, Henderson M. Lifestyle Habits, Dietary Factors, and the Metabolically Unhealthy Obese Phenotype in Youth. J Pediatr 2019; 204:46-52.e1. [PMID: 30366774 DOI: 10.1016/j.jpeds.2018.08.063] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 07/30/2018] [Accepted: 08/22/2018] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To determine whether lifestyle habits and dietary factors at age 8-10 years predict the development of metabolically unhealthy obesity 2 years later among children who were previously metabolically healthy obese. STUDY DESIGN The QUebec Adipose and Lifestyle InvesTigation in Youth cohort comprises 630 youth with a parental history of obesity. Metabolically healthy obesity and metabolically unhealthy obesity were defined using cut-offs for the components of pediatric metabolic syndrome. Dietary factors, physical activity, fitness, sedentary behavior, screen time, and sleep duration were measured. Multivariable logistic regressions were used to examine associations. RESULTS At baseline, 48 participants with metabolically healthy obesity were identified; 2 years later, 19 became metabolically unhealthy obese and 29 remained metabolically healthy obese. Every additional daily portion of fruits and vegetables decreased the risk of converting to metabolically unhealthy obesity by 39% (OR 0.61, 95% CI 0.40-0.94). Cumulating more hours of screen time and diets high in saturated fat and sugar-sweetened beverages and low in protein were associated with a tendency to develop metabolically unhealthy obesity. CONCLUSIONS Fruit and vegetable intake and possibly screen time, saturated fat, sugar-sweetened beverages, and protein intake may be important targets for the prevention of cardiometabolic complications in obese children. TRIAL REGISTRATION ClinicalTrials.gov: NCT03356262.
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Affiliation(s)
- Jean-Baptiste Roberge
- Centre de Recherche du Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montréal, Québec, Canada; Department of Pediatrics, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Andraea Van Hulst
- Ingram School of Nursing, McGill University, Montreal, Québec, Canada
| | - Tracie A Barnett
- Centre de Recherche du Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montréal, Québec, Canada; Epidemiology and Biostatistics Unit, Institut national de la recherche scientifique (INRS)-Institut Armand-Frappier, Laval, Québec, Canada
| | - Vicky Drapeau
- Department of Physical Education, Université Laval, Québec, Québec, Canada
| | - Andrea Benedetti
- Ingram School of Nursing, McGill University, Montreal, Québec, Canada; Department of Medicine, McGill University, Montréal, Québec, Canada; Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montréal, Québec, Canada
| | - Angelo Tremblay
- Department of Kinesiology, Université Laval, Québec, Québec, Canada
| | - Mélanie Henderson
- Centre de Recherche du Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montréal, Québec, Canada; Division of Endocrinology, Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine and Université de Montréal, Montréal, Québec, Canada.
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Van Hulst A, Paradis G, Benedetti A, Barnett TA, Henderson M. Pathways Linking Birth Weight and Insulin Sensitivity in Early Adolescence: A Double Mediation Analysis. J Clin Endocrinol Metab 2018; 103:4524-4532. [PMID: 30137396 PMCID: PMC6220441 DOI: 10.1210/jc.2018-00525] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 08/15/2018] [Indexed: 01/02/2023]
Abstract
PURPOSE We examined pathways linking birth weight, weight gain from 0 to 2 years, and adiposity during childhood with insulin sensitivity in early adolescence. METHODS Data were from a longitudinal cohort of 630 Quebec white children with a parental history of obesity (Quebec Adipose and Lifestyle Investigation in Youth study). In a subsample of children born at term (n = 395), weight-for-length z score (zWFL) from 0 to 2 years were computed. At 8 to 10 years, the percentage of body fat was assessed using dual energy X-ray absorptiometry. At 10 to 12 years, the Matsuda insulin sensitivity index (ISI) and the homeostasis model assessment for insulin resistance were determined. A linear regression-based approach for mediation analysis was used to estimate the distinct pathways linking zWFL at 0 to 2 years to insulin sensitivity. RESULTS Every additional unit in zWFL at birth was associated with a 10% (95% CI, 5.26% to 14.85%) increase in the Matsuda ISI in early adolescence, independently of the weight at 0 to 2 years and in childhood. An indirect effect of zWFL at birth on the Matsuda ISI was also observed but in the opposite direction (-4.44; 95% CI, -7.91 to -1.05). This relation was mediated by childhood adiposity but not by weight gain from 0 to 2 years. The indirect effect of weight gain from 0 to 2 years, via childhood adiposity, also led to lower insulin sensitivity (-4.83%, 95% CI, -7.34 to -2.53). The findings were similar for the homeostasis model assessment for insulin resistance or when restricted to children with appropriate-for-gestational-age birth weights. CONCLUSIONS A greater birth weight-for-length resulted in improved insulin sensitivity in early adolescence. However, in the presence of excess childhood adiposity, both a greater birth weight and a faster rate of weight gain from 0 to 2 years resulted in lower insulin sensitivity.
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Affiliation(s)
- Andraea Van Hulst
- Ingram School of Nursing, McGill University, Montreal, Quebec, Canada
- Centre de Recherche du CHU Sainte-Justine, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Gilles Paradis
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
- Department of Medicine, McGill University, Montreal, Quebec, Canada
- Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, Quebec, Canada
| | - Tracie A Barnett
- Centre de Recherche du CHU Sainte-Justine, Montreal, Quebec, Canada
- INRS-Armand-Frappier Institute, Laval, Quebec, Canada
| | - Mélanie Henderson
- Centre de Recherche du CHU Sainte-Justine, Montreal, Quebec, Canada
- Department of Pediatrics, University of Montreal, Montreal, Quebec, Canada
- Correspondence and Reprint Requests: Mélanie Henderson, MD, PhD, Division of Endocrinology, Centre Hospitalier Universitaire Sainte-Justine, 3175 Chemin Côte Sainte-Catherine, Montreal, Quebec H3T 1C5, Canada. E-mail:
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Fitzpatrick C, Alexander S, Henderson M, Barnett TA. Prospective Associations Between Play Environments and Pediatric Obesity. Am J Health Promot 2018; 33:541-548. [PMID: 30354254 DOI: 10.1177/0890117118807211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To identify school typologies based on the availability of play equipment and installations. We also examined the associations between availability of play items and child adiposity. DESIGN Secondary analysis of longitudinal data. SETTING Elementary schools in Montreal, Canada. PARTICIPANTS We used data from the Quebec Adipose and Lifestyle Investigation in Youth study (QUALITY), an ongoing investigation of the natural history of obesity and type 2 diabetes in Quebec children of Caucasian descent. MEASURES The presence of play items was assessed in each child's school. A trained nurse directly assessed child anthropometric measurements to derive body mass index and waist circumference. Body fat composition was measured using DEXA Prodigy Bone Densitometer System. ANALYSES The final analytic sample comprised 512 students clustered in 296 schools (81% response). We used K-cluster analyses to identify school typologies based on the variety of play items on school grounds. Generalized estimation equations were used to estimate associations between school clusters and outcomes. RESULTS We identified 4 distinct school typologies. Children in schools with the most varied indoor play environments had lower overall body fat, B = -1.26 cm (95% confidence interval [CI], -2.28 to -0.24 cm), and smaller waist circumference, B = -4.42 cm (95% CI, -7.88 to -0.96 cm), compared to children with the least varied indoor play environment. CONCLUSION Our results suggest that policies regulating the availability of play items in schools may enrich comprehensive school-based obesity prevention strategies. Extending research in this area to diverse populations is warranted.
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Affiliation(s)
- Caroline Fitzpatrick
- 1 Department of Social Sciences, Université Sainte-Anne, Church Point, Nova Scotia, Canada
- 2 PERFORM center, Concordia University, Montreal, Quebec, Canada
- 3 Departement of Childhood Education, University of Johannesburg, Johannesburg, South Africa
| | - Stephanie Alexander
- 4 Collège d'étude mondiale, Fondation Maison des Sciences de l'Homme, Paris, France
| | - Melanie Henderson
- 5 Department of Pediatrics, Université de Montréal, Montreal, Quebec, Canada
- 6 Sainte-Justine Children's Hospital Research Centre, Montreal, Quebec, Canada
| | - Tracie A Barnett
- 6 Sainte-Justine Children's Hospital Research Centre, Montreal, Quebec, Canada
- 7 Epidemiology and Biostatistic Unit, INRS-Institut Armand-Frappier, Laval, Quebec, Canada
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Kakinami L, Wissa R, Khan R, Paradis G, Barnett TA, Gauvin L. The association between income and leisure-time physical activity is moderated by utilitarian lifestyles: A nationally representative US population (NHANES 1999-2014). Prev Med 2018; 113:147-152. [PMID: 29753806 DOI: 10.1016/j.ypmed.2018.05.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 04/23/2018] [Accepted: 05/09/2018] [Indexed: 11/28/2022]
Abstract
The objective of this study was to determine whether the relationship between income and leisure-time physical activity (LTPA) persists after accounting for a person's utilitarian PA (all non-LTPA), sociodemographic characteristics and transportation PA. Data were from eight cycles (1999-2014) of the nationally representative samples of the US adult population from the National Health and Nutrition Examination Survey (n = 35,239). Whether the poverty income ratio (0-1.3, 1.3-1.86, 1.86+ [reference]) was associated with minutes of LTPA (moderate, vigorous) after stratifying for utilitarian PA (sedentary, light, moderate, and vigorous) was assessed in multiple linear regressions adjusted for age, sex, race, education, marital status, weight status, hours worked, and minutes of transportation-related PA in the past week. Likelihood of meeting national physical activity recommendations was also assessed in multiple logistic regressions adjusting for the covariates described. For both sedentary and light utilitarian PA levels, compared to the reference, persons living in households of the lowest poverty income ratio were consistently associated with approximately 17-30 less minutes of moderate LTPA minutes per week, and 20-25 less minutes of vigorous LTPA across all survey cycles. Compared to the reference, the likelihood of meeting national PA recommendations was approximately 31-55% less for these households. The known association between lower income and lower LTPA persist, but is the most persistent and consistent for those with less active utilitarian (such as sedentary) lifestyles. Interventions aimed at increasing LTPA among people with low income and sedentary utilitarian lifestyles whether or not they are in the workforce are particularly needed.
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Affiliation(s)
- Lisa Kakinami
- Department of Mathematics and Statistics, Concordia University, 1455 de Maisonneuve Blvd West, Montreal, QC H3G 1M8, Canada; PERFORM Centre, Concordia University, 7200 Sherbrooke St West, Montreal, QC H4B 1R6, Canada.
| | - Rita Wissa
- Department of Mathematics and Statistics, Concordia University, 1455 de Maisonneuve Blvd West, Montreal, QC H3G 1M8, Canada
| | - Rahid Khan
- Department of Economics, Concordia University, 1455 de Maisonneuve Blvd West, Montreal, QC H3G 1M8, Canada
| | - Gilles Paradis
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, 1020 Pine Ave West, Montreal, QC H3A 1A2, Canada
| | - Tracie A Barnett
- Centre de recherche du CHU Sainte-Justine, 5757 Ave Decelles, Montréal, QC H3S 2C3, Canada; INRS-Armand-Frappier Institute, 531 Boul des Prairies, Laval, QC H7V 1B7, Canada
| | - Lise Gauvin
- Research Centre of the Centre Hospitalier de l'Université de Montréal (CRCHUM), 900 St Denis St, Montreal, QC H2X 0A9, Canada; École de santé publique, Université de Montréal (ESPUM), PO Box 6128, Downtown Station, Montreal, QC H3C 3J7, Canada
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Ghenadenik AE, Kakinami L, Van Hulst A, Henderson M, Barnett TA. Neighbourhoods and obesity: A prospective study of characteristics of the built environment and their association with adiposity outcomes in children in Montreal, Canada. Prev Med 2018; 111:35-40. [PMID: 29462654 DOI: 10.1016/j.ypmed.2018.02.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 01/23/2018] [Accepted: 02/12/2018] [Indexed: 12/13/2022]
Abstract
This paper examined prospective associations between built environment features assessed at baseline using direct audits and adiposity outcomes two years later in Montreal, Canada. Data stem from the Quebec Adipose and Lifestyle Investigation in Youth study of 630 children aged 8-10 years with a parental history of obesity. Baseline measurements took place between 2005 and 2008. Follow-up took place between 2008 and 2011. Built environment features were assessed at baseline in up to 10 contiguous street segments around participants' residential addresses using on-site audits. Analyses were restricted to participants who reported the same address both at baseline and follow-up. Prospective associations between adiposity outcomes at follow-up (BMI z-score and waist-height ratio) and built environment features at baseline (traffic-calming features, pedestrian aids, disorder, physical activity facilities, convenience stores, and fast-food restaurants) were examined using multivariable regression models. 391 children were included in the analyses. In fully-adjusted models, children living in residential areas with presence of pedestrian aids had lower BMI z-score, and lower waist-height ratio. Also, children residing in residential areas with at least one convenience store had lower BMI z-score, and lower waist-height ratio at follow-up. Findings provide evidence of the potential role of street-level urban design features in shaping childhood adiposity. To better inform policy and intervention, future research should explore the possibility of reducing obesogenic neighbourhoods by enhancing street-level design features.
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Affiliation(s)
- A E Ghenadenik
- Département de médecine sociale et préventive, École de santé publique (ESPUM), Université de Montréal. 7101, avenue du Parc 3(e) étage, Montréal, Quebec H3N 1X9, Canada; Institut de recherche en santé publique de l'Université de Montréal (IRSPUM), 7101, avenue du Parc 3(e) étage, Montréal, Quebec H3N 1X9, Canada; Centre de recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM). 900, rue Saint Denis, Montreal, Quebec H2X 0A9, Canada.
| | - L Kakinami
- Department of Mathematics and Statistics, Concordia University. 1455, boulevard de Maisonneuve O., Montreal, Quebec H3G 1M8, Canada; PERFORM Centre, Concordia University. 7141, rue Sherbrooke O., Montreal, Quebec H4B 1R6, Canada.
| | - A Van Hulst
- Research Centre of the Sainte-Justine University Hospital, 3175, chemin de la Côte-Sainte-Catherine, Montreal, Quebec H3T 1C5, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, 1020, avenue des Pins O., Montreal, Quebec H3A 1A2, Canada
| | - M Henderson
- Research Centre of the Sainte-Justine University Hospital, 3175, chemin de la Côte-Sainte-Catherine, Montreal, Quebec H3T 1C5, Canada; Department of Pediatrics, Université de Montréal, 3175, chemin de la Côte-Sainte-Catherine, Montreal, Quebec H3T 1C5, Canada
| | - T A Barnett
- Department of Pediatrics, Université de Montréal, 3175, chemin de la Côte-Sainte-Catherine, Montreal, Quebec H3T 1C5, Canada; Institut National de la Recherche Scientifique (INRS) - Institut Armand Frappier, 531, boulevard des Prairies, Laval, Québec H7V 1B7, Canada.
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Häcker AL, Bigras JL, Henderson M, Barnett TA, Mathieu ME. Motor Skills of Children and Adolescents With Obesity and Severe Obesity-A CIRCUIT Study. J Strength Cond Res 2017; 34:3577-3586. [PMID: 29210956 DOI: 10.1519/jsc.0000000000002213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Häcker, A-L, Bigras, J-L, Henderson, M, Barnett, TA, and Mathieu, M-E. Motor skills of children and adolescents with obesity and severe obesity-a CIRCUIT study. J Strength Cond Res 34(12): 3577-3586, 2020-During childhood, excessive weight is negatively associated with the development of motor skills, with overweight children or children with obesity having poorer motor skills compared with children with normal weight. The objectives of the current study are to identify the differences in motor skills between children and adolescents with obesity and severe obesity and the extent of this difference. To do so, we examined cross-sectionally 165 subjects. Physical fitness was analyzed in both subjects with obesity (>97th to 99.9th body mass index [BMI] percentile) and severe obesity (>99.9th BMI percentile) using 8 standardized tests: sit-and-reach, grip force, sit-ups, push-ups, balance, hand-eye coordination, standing long jump and 5-m shuttle run. Poorer performance were observed in subjects with severe obesity in sit-ups (children: 59%; 18.6 ± 17.0 vs. 29.5 ± 23.2 percentile value, p = 0.008), balance (adolescent: 59%; 12.1 ± 12.2 vs. 19.3 ± 13.9 seconds, p = 0.034), and in the 5-m shuttle run (children: 49%; 14.0 ± 13.9 vs. 20.8 ± 19.4 percentile value, p = 0.046; adolescents: 11%; 13.2 ± 2.2 vs. 11.8 ± 1.6 seconds, p = 0.008) compared with obese counterparts. In conclusion, although physical performance was found to be similar between the different obesity levels for most tests, youth with severe obesity demonstrated impairments ranging from 11 to 59% in specific tests.
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Affiliation(s)
- Anna-Luisa Häcker
- Chair of Preventive Pediatrics, Technical University of Munich, Munich, Germany
| | - Jean-Luc Bigras
- Research Center, Sainte-Justine University Hospital Research Center, Montréal, Québec, Canada
| | - Mélanie Henderson
- Research Center, Sainte-Justine University Hospital Research Center, Montréal, Québec, Canada.,Department of Pediatrics, University of Montreal, Montréal, Québec, Canada
| | - Tracie A Barnett
- Research Center, Sainte-Justine University Hospital Research Center, Montréal, Québec, Canada.,Epidemiology and Biostatistics Unit, INRS: Armand-Frappier Institute, Laval, Québec, Canada; and
| | - Marie-Eve Mathieu
- Research Center, Sainte-Justine University Hospital Research Center, Montréal, Québec, Canada.,Department of Kinesiology, University of Montreal, Montréal, Québec, Canada
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Van Hulst A, Barnett TA, Paradis G, Roy-Gagnon MH, Gomez-Lopez L, Henderson M. Birth Weight, Postnatal Weight Gain, and Childhood Adiposity in Relation to Lipid Profile and Blood Pressure During Early Adolescence. J Am Heart Assoc 2017; 6:JAHA.117.006302. [PMID: 28778942 PMCID: PMC5586463 DOI: 10.1161/jaha.117.006302] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Background Different pathways likely underlie the association between early weight gain and cardiovascular disease risk. We examined whether birth weight for length relationship and weight gain up to 2 years of age are associated with lipid profiles and blood pressure (BP) in early adolescence and determined whether childhood adiposity mediates these associations. Methods and Results Data from QUALITY (Quebec Adipose and Lifestyle Investigation in Youth), a cohort of white children with parental history of obesity, were analyzed (n=395). Sex‐specific weight for length z scores from birth to 2 years were computed. Rate of postnatal weight gain was estimated using individual slopes of weight for length z‐score measurements. Percentage of body fat was measured at 8 to 10 years. Fasting lipids and BP were measured at 10 to 12 years. Using path analysis, we found indirect effects of postnatal weight gain, through childhood adiposity, on all outcomes: Rate of postnatal weight for length gain was positively associated with childhood adiposity, which in turn was associated with unfavorable lipid and BP levels in early adolescence. In contrast, small beneficial direct effects on diastolic BP z scores, independent of weight at other time points, were found for birth weight for length (β=−0.05, 95% CI, −0.09 to −0.002) and for postnatal weight gain (β=−0.02, 95% CI, −0.03 to −0.002). Conclusions Among children with at least 1 obese parent, faster postnatal weight gain leads to cardiovascular risk factors in early adolescence through its effect on childhood adiposity. Although heavier newborns may have lower BP in early adolescence, this protective direct effect could be offset by a deleterious indirect effect linking birth weight to later adiposity.
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Affiliation(s)
- Andraea Van Hulst
- Department of Epidemiology Biostatistics and Occupational Health, McGill University, Montreal, Canada.,Centre de recherche du CHU Sainte-Justine, Montreal, Canada
| | - Tracie A Barnett
- Centre de recherche du CHU Sainte-Justine, Montreal, Canada.,INRS-Armand-Frappier Institute, Laval, Canada
| | - Gilles Paradis
- Department of Epidemiology Biostatistics and Occupational Health, McGill University, Montreal, Canada
| | | | - Lilianne Gomez-Lopez
- Centre de recherche du CHU Sainte-Justine, Montreal, Canada.,Division of medical genetics, CHU Sainte-Justine, Montreal, Canada
| | - Mélanie Henderson
- Centre de recherche du CHU Sainte-Justine, Montreal, Canada .,Department of Pediatrics, University of Montreal, Canada
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Alexander SA, Barnett TA, Fitzpatrick C. Are inequalities produced through the differential access to play opportunities at school? A call to level the playing field. Can J Public Health 2017; 107:e583-e585. [PMID: 28252379 DOI: 10.17269/cjph.107.5471] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 09/01/2016] [Accepted: 07/15/2016] [Indexed: 11/17/2022]
Abstract
Children's play is characterized as pleasurable, but it is also viewed as critical for child health and well-being. Yet over the past decade, play researchers and advocates from various disciplines have suggested that there are decreasing opportunities for children to play, particularly at school. One concern is that the changing play environment in schools is reducing children's active play options and is thereby contributing to increases in childhood obesity. Building on findings from the QUébec Adipose and Lifestyle InvesTigation in Youth (QUALITY), this commentary suggests that while opportunities to engage in physical activity may indeed be differentially shaped by school play environments, physical health may not be the only factor at stake in unequal play environments in schools. While this is not an altogether new concern, we argue that it is nevertheless important to highlight within physical activity research settings that children's overall well-being, including their experience of pleasure, creativity, imagination and sociability, is also shaped by a school's play environment. Addressing possible inequalities in children's experience of play in schools, we propose several questions and future research directions for addressing children's health and well-being in the school environment.
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Affiliation(s)
- Stephanie A Alexander
- Collège d'études mondiales, Fondation Maison des Sciences de l'Homme, Paris, France.
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Cutumisu N, Barnett TA, Smargiassi A, Ducharme FM, Tétreault LF. Influence of neighbourhood characteristics on asthma outcomes in an asthma clinic cohort of youths. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw171.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Bird M, Datta GD, van Hulst A, Cloutier MS, Henderson M, Barnett TA. A park typology in the QUALITY cohort: Implications for physical activity and truncal fat among youth at risk of obesity. Prev Med 2016; 90:133-8. [PMID: 27374945 DOI: 10.1016/j.ypmed.2016.06.042] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 05/31/2016] [Accepted: 06/27/2016] [Indexed: 02/04/2023]
Affiliation(s)
- Madeleine Bird
- L'École de santé publique de l'Université de Montréal, Département de médecine sociale et préventive, Université de Montréal, Montreal, Quebec, Canada; Research Centre of the Sainte-Justine University Hospital, Montreal, Quebec, Canada; Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montreal, Quebec, Canada
| | - Geetanjali D Datta
- L'École de santé publique de l'Université de Montréal, Département de médecine sociale et préventive, Université de Montréal, Montreal, Quebec, Canada; Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montreal, Quebec, Canada
| | - Andraea van Hulst
- Research Centre of the Sainte-Justine University Hospital, Montreal, Quebec, Canada; Department of Epidemiology Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Marie-Soleil Cloutier
- Institut National de la Recherche Scientifique (INRS) - Centre Urbanisation Culture Société, Montreal, Quebec, Canada
| | - Mélanie Henderson
- Research Centre of the Sainte-Justine University Hospital, Montreal, Quebec, Canada; Department of Pediatrics, Université de Montréal, Montreal, Quebec, Canada
| | - Tracie A Barnett
- Research Centre of the Sainte-Justine University Hospital, Montreal, Quebec, Canada; Institut National de la Recherche Scientifique (INRS) - Institut Armand Frappier, Laval, Quebec, Canada.
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