Healthy Active Living and Obesity (HALO)

The focus of the HALO group’s research is to:

Promote and assess healthy active living among children and youth.
Identify, examine and address environmental, behavioural, psychosocial, and biological factors related to healthy active living and obesity in children and youth.
Develop, implement, and evaluate strategies to prevent, manage, and treat obesity and lifestyle-related diseases in children and youth.

To learn more about HALO’s research, please visit the HALO Research web page http://www.haloresearch.ca/.

Research Projects

First sleep health guidelines for Canadian adults: implications for clinicians.
02/02/2021

Canada, marks an important step towards a better recognition of “sleep health” as a critical component of health and wellness. Clinicians are well positioned to discuss sleep health with their patients and initiate treatment options. It is hoped it will now be part of routine medical examinations.
Do fit kids have fit parents?
20/01/2021

A significant and positive association was evident in measured physical fitness among parents and children. Some variation in the presence and strength of associations existed according to child and parent sex.
Poor adherence to sleep and physical activity guidelines among children with epilepsy
12/01/2021

To assess physical activity and sleep rates in a cohort of children with epilepsy (CWE) and determine if there is a relationship between physical activity and sleep time.
Association between 24‐hour movement guidelines and physical fitness in children
22/12/2020

In order to enhance children’s physical fitness, public health recommendations should primarily target MVPA.
Regional differences in access to the outdoors and outdoor play of Canadian children and youth during the COVID-19 outbreak
18/12/2020

It is unsurprising that in the provinces that have had the highest number of COVID-19 cases, there have been the most stringent restrictions on access to the outdoors. It is also unsurprising that these same provinces have had the greatest decline in time spent outdoors and in outdoor play among children and youth.
The whole day matters: Understanding 24-hour movement guideline adherence and relationships with health indicators across the lifespan
11/12/2020

The purpose of this systematic review was to examine the associations between the 24-h time-use composition of movement behaviors, or adherence to 24-h movement guidelines, and multiple health indicators across the lifespan.
Sedentary Behavior Research Network members support new Canadian 24-Hour Movement Guideline recommendations
11/12/2020

The new Canadian 24-Hour Movement Guidelines for Adults aged 18 to 64 years and Adults aged 65 years and older are grounded in evidence from a variety of research sources, unanimously endorsed by the Guideline Development Panel4 and strongly supported by stakeholders, including many SBRN members.
Obesity-related behaviors of students at historically black colleges and universities and students at non-historically black colleges and universities
10/12/2020

Findings suggest the need for implementation of aggressive overweight and obesity prevention strategies for students at HBCUs.
Psychological Correlates of Sedentary Screen Time Behaviour Among Children and Adolescents: a Narrative Review
09/12/2020

Practitioners, parents, policy makers and researchers should collectively identify and evaluate strategies to reduce screen time, or to use screens more adaptively, as a means of promoting better mental health among children and adolescents.
How should we move for health? The case for the 24-hour movement paradigm
07/12/2020

Although the current evidence informing movement guidelines is and may always be imperfect, the creators of the Canadian guidelines consider that interpretation of that evidence must lead to advice that has the best chance of preserving and promoting people’s health by providing practitioners with more options to explore with patients in a patient-centred way, in an effort to improve health through modification of movement behaviour.
Cross-validation of the Canadian Assessment of Physical Literacy Second Edition (CAPL-2): the case of a Chinese population
04/12/2020

This study was the first to cross-validate the CAPL-2 into the Chinese population. CAPL-2 (Chinese) offers the possibility of assessing physical literacy for researchers and practitioners and Chinese children’s physical literacy development could be easily tracked in school settings.
World Health Organization 2020 guidelines on physical activity and sedentary behaviour
26/11/2020

These guidelines should be used to inform national health policies aligned with the WHO Global Action Plan on Physical Activity 2018-2030 and to strengthen surveillance systems that track progress towards national and global targets.
Advancing the global physical activity agenda: recommendations for future research by the 2020 WHO physical activity and sedentary behavior guidelines development group
26/11/2020

Although the 2020 WHO Guidelines for Physical Activity and Sedentary Behavior were informed by the most up-to-date research on the health effects of physical activity and sedentary time, there is still substantial work to be done in advancing the global physical activity agenda.
2020 WHO guidelines on physical activity and sedentary behaviour for children and adolescents aged 5-17 years: summary of the evidence
26/11/2020

Addressing the identified research gaps will better inform guideline recommendations in children and adolescents, and future work should aim to prioritize these areas of research. In the meantime, investment and leadership is needed to scale up known effective policies and programs aimed at increasing activity in children and adolescents.
Relationships among children’s independent mobility, active transportation and physical activity: a multi-site cross-sectional study
15/10/2020

Keywords: active travel; children’s autonomy; pedometers; urbanization; multilevel models
Introduction to the Canadian 24-Hour Movement Guidelines for Adults aged 18-64 years and Adults aged 65 years or older: An Integration of Physical Activity, Sedentary Behaviour, and Sleep
15/10/2020

Support for the development of the Canadian 24-Hour Movement Guidelines for Adults aged 18–64 years and Adults aged 65 years or older: an integration of physical activity, sedentary behaviour, and sleep was provided by the Canadian Society for Exercise Physiology, the Public Health Agency of Canada, Queen’s University, and ParticipACTION.
Sedentary behaviour and health in adults: an overview of systematic reviews
15/10/2020

Our findings suggest that high levels of sedentary behaviour are unfavourably associated with cognitive function, depression, function and disability, physical activity levels, and physical health-related quality of life in adults. Our results also suggest that reducing or breaking up periods of prolonged sitting may have beneficial effects on markers of cardiometabolic risk and body composition. Although sedentary behaviour was generally associated with negative health outcomes, there may be favourable associations between computer and Internet use and cognitive function in older adults. Our findings have important public health implications and suggest that adults should avoid accumulating high levels of sedentary behaviour. Future work is needed to identify whether a dose–response relationship exists between sedentary behaviour and these health outcomes, and whether these relationships are consistent across sex, race/ethnicity, and socioeconomic status.
Canadian 24-Hour Movement Guidelines for Adults aged 18-64 years and Adults aged 65 years or older: An Integration of Physical Activity, Sedentary Behaviour, and Sleep
15/10/2020

The Canadian 24-Hour Movement Guidelines for Adults aged 18–64 years and Adults aged 65 years or older: An Integration of Physical Activity, Sedentary Behaviour, and Sleep completes the set of 24-Hour Movement Guidelines that together provide recommendations for healthy movement behaviours for the whole day for all Canadians. The Guidelines were generated based on the best available evidence with extensive consultation and stakeholder feedback. The CP recognized that to adopt and sustain any movement behaviour in today’s environment presents very real challenges for all adults. It is hoped that the shift in focus from movement behaviours in isolation to the integration of all movement behaviours over the whole day will provide movement options for adults, treatment options for practitioners, and greater opportunities for public health promotion.
Sedentary Behaviour Research Network members support new Canadian 24-hour Movement Guideline recommendations
15/10/2020

The authors are grateful to Dr. Jennifer Tomasone and her students, who were responsible for the administration of the Canadian 24-Hour Movement Guidelines for Adults Stakeholder Survey from which the Sedentary Behavior Research Network sub-analysis was drawn.
Sex and racial/ethnic differences in sleep quality and its relationship with body weight status among US college students
11/10/2020

Understanding sex and racial/ethnic sleep differences and the association between sleep and body weight status is important for colleges to promote college students' healthy sleep.
Physical inactivity as a risk factor for all-cause mortality in Brazil (1990-2017)
30/09/2020

It could be concluded that physical inactivity contributed to a substantial number of deaths in Brazil and in the different Brazilian states from 1990 to 2017. From 1990 to 2017, a decrease in standardized death rate from all causes attributable to physical inactivity was observed in Brazil. Brazilian states with the highest social inequalities showed lower reductions (from 1990 to 2017) in age-standardized mortality rate for all causes attributable to physical inactivity. The results of the present study show the importance of preventing risk factors for noncommunicable chronic diseases in all Brazilian states, and greater effort in combating social and economic inequities related to the living conditions of the population is needed, so that the adoption of active and healthy lifestyle has greater reach in all regions of Brazil.
Prevalence and sociodemographic factors associated with meeting the 24-hour movement guidelines in a sample of Brazilian adolescents
28/09/2020

Approximately 3% of the participants met the MVPA, screen-time, and sleep duration recommendations simultaneously, while this proportion was 0.2% when accelerometer data were used for MVPA and sleep duration. Adherence to the sleep duration recommendation was higher than to the screen-time or MVPA recommendations. Boys were more likely to meet the MVPA recommendations, but less likely to meet sleep duration and scree-time recommendations, and age was positively associated with adhering to the screen-time recommendation. Future policies and interventions should promote adherence to 24-hours movement behaviors in an integrated manner.
Association between lifestyle behaviors and health-related quality of life in a sample of Brazilian adolescents
22/09/2020

This study identified that adolescents who spent more time on sports but not on non-sports physical activities had higher scores of HRQoL. The time spent in work-related screen activities was inversely associated with HRQoL score. However, this association was not observed for recreational screen time indicators (i.e., watching videos, playing videogames, or using social media). In addition, girls, adolescents who experimented with drugs in their life course, those with higher consumption of ultra-processed foods, and those who sleep insufficiently reported lower scores of HRQoL. These findings suggest that promoting sports and adequate sleep, and preventing the use of drugs and excessive workloads among adolescents may be effective strategies to improve HRQoL.
Association of screen time and cardiometabolic risk in school-aged children
21/09/2020

Highlights • No evidence of an association between children’s parental-reported screen time and total cardiometabolic risk score. •Weak association between increased screen time and reduced HDL cholesterol in children. •No sex or age interactions detected between parental-reported screen time and cardiometabolic risk.
Healthy movement behaviours in children and youth during the COVID-19 pandemic: Exploring the role of the neighbourhood environment
16/09/2020

To conclude, this study provides important insights into the movement patterns of children and youth, and our findings highlight the importance of the neighbourhood environment in enabling healthier behaviours during the COVID-19 pandemic. These findings will inform public health policies as we recover from this current crisis and prepare for future pandemics. The results will also inform urban planning policy and design guidelines in the post-COVID-19 period. As we continue to gain novel insights from our experiences during the pandemic, these learnings will be important for creating stronger, healthier, and more resilient communities.
Healthy movement behaviours in children and youth during the COVID-19 pandemic: Exploring the role of the neighbourhood environment
01/09/2020

This paper explores patterns of increased/ decreased physical activity, sedentary and sleep behaviours among Canadian children and youth aged 5-17 years during the COVID-19 pandemic, and examines how these changes are associated with the built environment near residential locations.
Profiles of active transportation among children and adolescents in the Global Matrix 3.0 initiative: a 49-country comparison
18/08/2020

This work allowed for a deeper exploration of the active transportation information reported by all the countries participating in the Global Matrix 3.0. Based on our findings, we identified the need to standardize definitions of active transportation to be able to make more meaningful comparisons. The LPA conducted allows for the inference that countries belonging to a specific profile have a greater probability of sharing certain characteristics among them compared to the countries belonging to other profiles. Given the variation by geographic region and even HDI, this approach is useful for identification of more meaningful groupings that can facilitate the cross-fertilization of efforts to promote active transportation, and therefore, to “power the movement to get kids moving”, as is intended by the Global Matrix initiative [171]. The Active Healthy Kids Global Alliance can contribute to improving active travel surveillance providing guidance to countries involved in future versions of the Global Matrix. A more comprehensive approach to active transportation surveillance that considers duration, distance, frequency, direction, other destinations than school and the contribution of active transportation to school to overall active transportation, could improve the understanding of this behaviour and its potential to increase overall physical activity.
Canadian children’s and youth’s adherence to the 24-h movement guidelines during the COVID-19 pandemic: A decision tree analysis
08/07/2020

Our results show that specific characteristics interact to contribute to (non)adherence to the movement behavior recommendations. Results highlight the importance of targeting parents’ perceived capability for the promotion of children's and youth's movement behaviors during challenging times of the COVID-19 pandemic, paying particular attention to enhancing parental perceived capability to restrict screen time.
Impact of the COVID-19 virus outbreak on movement and play behaviours of Canadian children and youth: a national survey
06/07/2020

This study provides evidence of immediate collateral consequences of the COVID-19 outbreak, demonstrating an adverse impact on the movement and play behaviours of Canadian children and youth. These findings can guide efforts to preserve and promote child health during the COVID-19 outbreak and crisis recovery period, and to inform strategies to mitigate potential harm during future pandemics.
Associations between duration and type of electronic screen use and cognition in US children
01/07/2020

We report the relationship between cognition and screen use in 11,875 US children. Higher TV and video watching were negatively associated with cognition.
Comparing and assessing physical activity guidelines for children and adolescents: a systematic literature review and analysis
01/07/2020

There is growing global interest in physical activity and sedentary behaviour guideline development. More recently some countries have included sleep in their guidelines focusing on movement behaviours during a 24 h period.. The findings from this review indicate extensive variability in the quality of country guidelines.
Sleep and screen time are more linked with academic achievement than physical activity
04/06/2020

High school students who met the screen time and sleep guidelines showed better academic performance than those who did not meet any guidelines.
New Data regarding decreased physical activity during the Global Pandemic
01/06/2020

The time spent in places associated with physical activity such as parks, beaches, and community gardens was down by 31%, and travel by public transport, which is also associated with physical activity, was down by 59%.
Sex differences in the relationship between social media use, short sleep duration, and body mass index among adolescents
21/04/2020

Our results showed that short sleep duration is a concurrent mediator of the relationship between social media use and BMI z-scores among males. Reducing time spent using social media may be a good behavioral target to promote adequate sleep duration, which is considered as a component in childhood obesity prevention efforts.
Combinations of physical activity and screen time recommendations and their association with overweight/obesity in adolescents.
13/04/2020

Children meeting both the physical activity and screen time recommendations are less likely to be classified as overweight/obese compared with any other combination. Future efforts are needed to target both MVPA and sedentary behaviour to address public health concerns such as excess weight.
Association between dietary behaviours and weight status of school children: Results from the International Study of Childhood Obesity, Lifestyle and the Environment (ISCOLE) – Kenya
07/04/2020

Children have healthy diets rich in fruits and vegetables and low in energy-dense foods. Also, less healthy diets were observed in children with lower BMI. There is need for interventions targeting the overweight/obese children, particularly those of higher SES.
Population-level evaluation of ParticipACTION’s 150 Play List: A mass-reach campaign with mass participatory events
18/11/2019

The 150 Play List was valued by those aware of it and the campaign was related to interest in sport and physical activity in Canada. The community events had potential to augment campaign effects but adequate evaluation requires sufficient resources.
Body mass index and movement behaviors among schoolchildren from 13 countries across a continuum of human development indices: A multinational cross‐sectional study
24/10/2019

Our findings show distinct differences in BMI and movement behavior profiles between urban and rural children in Mozambique. Mean BMI z‐scores, MVPA, and SED differed by country HDI. These findings support the need to include both rural and urban participants in study samples.
24-Hour Movement Behaviors and Impulsivity
01/09/2019

Data from this cross-sectional observational study were part of the first annual curated release of the Adolescent Brain Cognitive Development Study. Participants included 4524 children between the ages of 8 and 11 years.
Understanding parent perceptions of healthy physical activity for their child with a chronic medical condition: A cross-sectional study
01/06/2019

Over one-third of parents reported having questions about physical activity for their child with a chronic medical condition, suggesting substantial uncertainty even among children reported as active. Presence of parent uncertainty is associated with parent reports of the child being unwell or a history of cardiac arrhythmia
Higher screen time, lower muscular endurance, and decreased agility limit the physical literacy of children with epilepsy
01/01/2019

Children with epilepsy demonstrate poor physical literacy levels, with potential immediate and long-lasting negative impacts on general health and psychosocial well-being. Programs promoting physical literacy in children with epilepsy should be encouraged, specifically interventions decreasing screen time and enhancing muscular endurance and motor skills, thereby facilitating healthier lifestyles.
Sensitivity, specificity, and reliability of the Get Active Questionnaire for identifying children with medically necessary special considerations for physical activity
03/11/2018

The sensitivity, specificity, and reliability of the Get Active Questionnaire (GAQ) for identifying children needing special considerations during physical activity was evaluated among parents of 207 children aged 3 to 14 years
Canadian Assessment of Physical Literacy Second Edition: a streamlined assessment of the capacity for physical activity among children 8 to 12 years of age
02/10/2018

Regardless of the assessment selected, scores are available to interpret the performance of each child relative to Canadian children of the same age and sex.
Revising the motivation and confidence domain of the Canadian assessment of physical literacy
02/10/2018

The revised and much shorter questionnaire of 12 items that aggregate to four subscales within the domain of Motivation and Confidence is recommended for use in the CAPL-2.
Refining the Canadian Assessment of Physical Literacy based on theory and factor analyses
02/10/2018

The scores from the revised and much shorter 14-indicator model of CAPL can be used to assess the four correlated domains of physical literacy and/or a higher-order aggregate physical literacy factor.
Associations between domains of physical literacy by weight status in 8- to 12-year-old Canadian children
02/10/2018

All of the domains of the CAPL correlate positively with each other regardless of weight status, with a trend for these correlation coefficients to be slightly stronger in the healthy-weight children.
The relationship between physical literacy scores and adherence to Canadian physical activity and sedentary behaviour guidelines
02/10/2018

These cross-sectional findings demonstrate important associations between physical literacy and guideline adherence for physical activity and sedentary behaviour.
Cardiorespiratory fitness is associated with physical literacy in a large sample of Canadian children aged 8 to 12 years
02/10/2018

This study identified strong favourable associations between CRF and physical literacy and its constituent components in children aged 8–12 years.
Influence of the relative age effect on children’s scores obtained from the Canadian assessment of physical literacy
02/10/2018

Collectively, our results suggest that the RAE bias is mainly negligible with regard to the domain scores and overall CAPL scores in this large sample of children.
Associations between teacher training and measures of physical literacy among Canadian 8- to 12-year-old students
02/10/2018

Children taught by PE specialists were more likely than those taught by generalists to demonstrate recommended levels of motivation and confidence, and to have better movement skills, which are hypothesized to be critical prerequisites for the development of a healthy lifestyle.
A cross-sectional study exploring the relationship between age, gender, and physical measures with adequacy in and predilection for physical activity
02/10/2018

These findings suggest that practitioners should consider the physiological and psychological makeup of the child, and ways to enhance adequacy and predilection among children with limited cardiorespiratory fitness, in order to create the best possible environment for all children to participate in physical activity.
Video Evaluation of Self-Regulation Skills in Preschool Aged Children with Developmental Delays: Can the impact of Tumbling TogetherTM be Measured?
27/08/2018

Research comparing Tumbling participants to children not offered the program, and examining whether the self-regulation skills improved during Tumbling participation would generalize to other settings is required.
Y Kids Academy Program Increases Knowledge of Healthy Living in Young Adolescents
27/06/2018

These findings support the suitability of the Y Kids Academy for improving and evaluating knowledge of healthy living in young adolescents.
The mental health of adolescents and pre-adolescents living with inherited arrhythmia syndromes: A systematic review of the literature
01/05/2018
Insulin Resistance and Hypertension in Obese Youth With Sleep-Disordered Breathing Treated With Positive Airway Pressure: A Prospective Multicenter Study
01/09/2017

In youth with obesity and SDB, metabolic dysfunction and hypertension were highly prevalent. Larger, longer-term studies are needed to determine whether PAP improves cardiometabolic outcomes in obese youth.
Brain on Fire: Incentive Salience, Hedonic Hot Spots, Dopamine, Obesity, and Other Hunger Games
21/08/2017

The surgical and pharmacological treatments of obesity are discussed, and evidence is presented for the selective use of DA-class drugs in obesity treatment.
Exercise Capacity and Self-Efficacy are Associated with Moderate-to-Vigorous Intensity Physical Activity in Children with Congenital Heart Disease
12/06/2017

Of 172 patients who were recruited, 137 (80%) had complete MVPA data and were included in the analysis.
Conceptual Critique of Canada’s Physical Literacy Assessment Instruments Also Misses the Mark
09/06/2017
Canadian Agility and Movement Skill Assessment (CAMSA): Validity, objectivity, and reliability evidence for children 8-12 years of age
01/06/2017

The Canadian Agility and Movement Skill Assessment is a feasible measure of selected fundamental, complex and combined movement skills, which are an important building block for childhood physical literacy.
Resistance Training, Alone Or In Combination With Aerobic Training, May Provide Psychological Benefits In Adolescents With Overweight Or Obesity
04/12/2015

Resistance training, alone or in combination with aerobic training, may provide psychological benefits in adolescents with overweight or obesity, and therefore could be an alternative to aerobic training for some individuals in the biological and psychological management of adolescent obesity
Effects of aerobic training, resistance training, or both on psychological health in adolescents with obesity: The HEARTY randomized controlled trial
31/08/2015

Resistance training, alone or in combination with aerobic training, may provide psychological benefits in adolescents with overweight or obesity, and therefore could be an alternative to aerobic training for some individuals in the biological and psychological management of adolescent obesity.
The Canadian Assessment of Physical Literacy: Methods for Children in Grades 4 to 6 (8 to 12 years)
11/08/2015

CAPL offers a comprehensive assessment of engagement in physical activity, physical competence, motivation and confidence, and knowledge and understanding as components of childhood (grades 4 to 6, 8 to 12 years) physical literacy. Monitoring of these measures enhances our understanding of children’s physical literacy, and assists with the identification of areas where additional supports are required.
New concepts in the assessment of exercise capacity among children with congenital heart disease: Looking beyond heart function and mortality
10/02/2015

Physically active lifestyles are important for the physical and mental health of children with congenital heart defects.
Does Neck-to-Waist Ratio Predict Obstructive Sleep Apnea in Children?
01/12/2014

Neck-to-waist ratio, an index of body fat distribution, predicts OSA in older children and youth, especially in those who were overweight/obese.

Researchers

Annick Buchholz

Investigator, CHEO Research Institute

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Jean-Philippe Chaput

Senior Scientist, CHEO Research Institute

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Gary Goldfield

Senior Scientist, CHEO Research Institute

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Sherri Katz

Senior Scientist, CHEO Research Institute

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Patricia Longmuir

Senior Scientist, CHEO Research Institute

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Mark S. Tremblay

Senior Scientist and Director, Healthy Active Living and Obesity, CHEO Research Institute

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Richard Webster

Investigator, CHEO Research Institute

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Roger Zemek

Senior Scientist, CHEO Research Institute

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