generation xl: a compromised generation in nb dr. gabriela tymowski, ph.d. associate professor &...

Generation XL: A Compromised Generation in NB

Dr. Gabriela Tymowski, Ph.D.Associate Professor & Director, LEAP!

Faculty of Kinesiology, UNB

Generation XL: NB Youth

Questions

• What does it mean to be healthy?– Unhealthy?

• What do you do that you think is considered a healthy behaviour?– Unhealthy behaviour?

• Why is “being healthy” important?– Resilience?


What does it mean to be healthy?

• "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity."

World Health Organization, 1946


Behavioural pathogens

• Personal habits and lifestyle choices

• The ways in which we live our lives has profound effects on our health– they influence the onset and progression of disease

• Changing patterns of disease– Historyically: contagious and infectious diseases– Today: heart disease, cancer &

strokes… and obesity


NB and physical (in)activity

• 59% of NB youth aged 12-19 are not active enough for optimal growth and development

• 64% of all New Brunswickers are insufficiently active for optimal health benefits

• Teenagers 15 – 19 years more likely to be inactive than those 12 – 14 years

• Decline in activity with age and gender (girls at 14-15 yrs vs boys 16-17 yrs)

• Girls less active than boys: 30% vs 50% at 5-12 yrs vs 25% vs 40% at 13-17 yrs

• Girls - less intense physical activities

(Canadian Community Health Survey, 2000/01)


Health Implications of Physical Inactivity

– Childhood obesity> Adulthood obesity

– Type 2 diabetes– Hypertension– High cholesterol– Obstructive sleep apnea– Osteoporosis– Increased fracture rates, complications of open fractures &

surgery– Depression– Smoking/alcohol/drugs– Adolescent pregnancy

• Caesarean section


©Felicia Webb/IPG

Obstructive Sleep Apnea

Jonathon Rojo, 14 years, of Galveston Beach, Houston Weight: 250 lbsMedical Conditions: obesity-related fibrosis of the liver and obstructive sleep apnea. He sleeps with a BIPAP machine which forces air into his lungs.


On the road to diabetes

• ~2 million US children 12 – 19 years are pre-diabetic• This condition is linked to obesity and inactivity• These children are at risk for full-blown diabetes and

cardiovascular problems• Atlantic Canada has the highest rates of diabetes (&

chronic disease) in Canada• The prevalence of Type 2 diabetes in children is rising

dramatically in NB– onset is linked directly to poor eating & inactivity

- consequences: blindness, amputation


Regular Physical Activity

• Improves psychological well-being and self-esteem • Increases “good” cholesterol levels• Improves cardiovascular fitness• Increases physical competence• Associated with healthy growth & development in

children• Decreases risks of obesity (and cluster of related co-

morbidities)


Body Mass

• 33% of Canadians 20 – 64 years are classified as overweight (BMI 25 – 29.9)

• 15% are classified as being obese (BMI over 30)• Men are more likely than women to be overweight or

obese• The prevalence of overweight & obesity is highest in

Atlantic Canada(Canadian Community Health Survey, 2000/01)

Underweight Healthy weight overweight obese


What does “overweight” mean?

"overweight“

-an excess amount of body weight that includes muscle, bone, fat, and water (BMI between 25 and 29.9)

“obesity”

-specifically refers to an excess amount of body fat (BMI over 30)

Waist Circumference

-increasingly used to evaluate overweight

-if waist is larger than hips, increased risk of disease

Centres for Disease Control

Canadian Paediatric Society


How does one become overweight or obese?

A

Food Intake

Food Intake

Food Intake

Physical Activity

Physical Activity

Physical Activity

ENERGY IMBALANCE

B

C


Explanation for this shift?


Today’s reality for many people:• Poor eating habits

– Processed, pre-packaged foods– insufficient fresh fruit & vegetable intake– Excessive intake of sweet drinks (pop, juice)

• Overeating– Mindless eating & snacking (tv)– Portion sizes super-sized– Frequency of eating out (restaurants & at school)

• Inadequate levels of physical activity– Desire for convenience, ease– Remote controls, power-everything

• Too much time inside… not enough time outside– High levels of screen-time (TV, computer, games)

• Insufficient sleep


Some interesting points:

• People who have TVs in their bedrooms (adults & children) lose at least 1 hour of sleep per nightImplication: since growth occurs during sleep – thus less sleep means

less time for growing, less time for body to recover from stresses of life (physical & emotional), = shorter stature?

• People who brown-bag lunches have lower rates of obesity than people who eat in cafeterias and restaurants

• Families who eat meals together have lower rates of obesity• Children & youth who are overweight rarely lose the weight as they

get older, and usually move up (from overweight to obese)


Education is critical


Lifestyle Behaviours

• A healthy lifestyle includes:– regular physical activity, eating 5 or more servings of

vegetables and fruit daily, and not smoking:– This is MOST likely the case for those living in BC, and

LEAST likely for those living in NB

• Implications:– Physical inactivity, poor nutrition and smoking are risk factors

for chronic disease and conditions like cancer, diabetes, and obesity

– This means a poorer quality of life, reduced opportunities, and the foreclosure of your future

CFLRI 2002


Is there a Magic Bullet???

• Hydroxycut? Other drugs (stimulants)???• South Beach… The Zone… diets???

• There is simply no such thing, there are no short cuts

Healthy Living = Physical Activity + Healthy Eating


Healthy choices have to be the easy choices

Healthy behaviours:-Daily physical activity (regular ↑ intensity)-Healthy diet, 90% of the time-Adequate sleep-Not smoking, avoiding SHS-No or moderate alcohol -Safe sexual practices-Stress management


What is LEAP! ?

• a multi-disciplinary programme for children (5 – 12 years) struggling with the problem of overweight, obesity, and/or obesity-related co-morbidities

• We offer healthy personal development and decision-making through education, support and positive reinforcement for children & parents

• Entry: referral from family physicians and pediatricians

• Criteria: children who are 130% of ideal body weight, or 120% of ideal body weight with obesity-related co-morbidities

• Open to all children: no geographical limitations– Some families drive from northern NB (6 hr. round-trip)– Majority within an hour’s drive


LEAP!’s History

• Year 1: Sept. 2004– 8 month pilot project (to April 2005)

• approach developed by literature and environmental scan of established clinics and programmes across Canada, consultation with regional health practitioners and academics

• Children entered from Sept. to March, so varied duration– Programme review (May/June 2005)

• Year 2: Sept. 2005– 2 year programme

• 1st Year: Orientation + 8 visits• 2nd Year: 4 mini-visits• All children from pilot invited to return (approx. 50% did)

– Funding received for 5 years (GSK), + other support


LEAP’s Components: a multi-disciplinary approach

NUTRITION-dietitian educates children & families on healthier eating-they discuss food choices, when and where meals are eaten, how they are prepared, barriers to healthful eating-They find solutions to barriers and determine goals for each month

PHYSICAL ACTIVITY-Reviews physical activity habits of child and family-Identifies barriers to participation (lives along busy highway (for NB!), long bus ride to school, $ for activities, etc.)-Evaluation of current aerobic fitness, strength, height and weight, body composition

HEALTH-nurse reviews health of each patient, and of their family-reviews medications and comorbidities-measurement of blood pressure, heart rate, blood work (lipds/glucose/etc.)-Monitors health concerns-Case consultation with physician

LEISURE EDUCATION-Reviews interests and leisure activities of child and family-Identifies resources in child’s community (parks, clubs, etc.)-Identifies barriers to participation in activities ($, transportation, anxiety, etc.)-Together, they finds solutions to barriers and create plans for participation

EDUCATION-baseline data collected, administration of learning styles questionnaire and perception of ability scales with children-Guides “webs” with children about their resources: friends, communities, etc.-Case consultation with psychologist * Dr. Bill Morrison

RESEARCHDirector


Unrealistic expectations


Opportunities

• Fredericton Healthy Active Living Challenge– www.unbf.ca/kinesiology

• Leo Hayes Walking Club

• Fredericton Marathon: May 13th:– 5 km (walk OR run)– 10 km– 21 km– 42 km– Participate with your friends, and challenge each other!– www.ccrr.ca

http://www.unbf.ca/kinesiology

http://www.ccrr.ca/


Acknowledgements:Our funders

Health & Wellness


Acknowledgements

• The LEAP! Team:– Bev Dunfield, R.N., M.SN(C)– Barb Dugas, R.D.

• Haley Keezer, Leo Hayes– Theresa Bernhardt, P.F.L.C., B.Sc. (Kin), M.Sc.(C)*– Charlene Shannon, Ph.D.

• Kate Morrison, M.A. (C)– Sandy Nickerson, B.Ed., M.Ed(C)– Roxanne Cole, CFC, B.Sc. (Kin) *– Bill Morrison, Ph.D., L.Psych.– Susan Smith, M.D.

• Cynthia Doucette, Ph.D• Greg Kealey, Ph.D., VP Research-UNB• Althea Arseneault, Development Office • Faculty of Kinesiology students and staff

• The LEAPers and their families!


Thank you!

Gabriela Tymowski, [email protected]@unb.ca

mailto:[email protected]

mailto:[email protected]

generation xl: a compromised generation in nb dr. gabriela tymowski, ph.d. associate professor &...

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