Together we can accomplish a great deal

We often hear about lifestyle being related to risk factors for chronic diseases. Recent self-reported data released from Statistics Canada on the Canadian Community Health Survey reveal the following trends.

Smoking rates
Smoking rates continue to fall and are now down to 18.1% of Canadians age 12 and older (males 21.4%, females 14.8%) but still totaling about 5.4 million people.[1] BC (14.3%) and Ontario (17.4%) are the only two provinces below the national average. The overall percentage is lower compared to 2013 (19.3%) and significantly down from 2001, when 28.2% of males and 23.8% of females smoked.

Obesity rates
Obesity rates continue to rise. The self-reported rate of obesity in men increased from 20.1% in 2013 to 21.8% in 2014, and in women from 17.4% in 2013 to 18.7% in 2014.[2] However, when compared to actual BMI measurements, rates of obesity were 27% in males and 26% in females in 2013. Thus we see significant underreporting of rates compared to actual rates. Not surprisingly, the rate of diabetes is also increasing. Data from 2014 show 7.5% of men and 5.8% of women having reported being diabetic. Manitoba, Alberta, and BC are below the national average.

Fruit and vegetable consumption
In 2014, 39.5% of Canadians reported consuming five or more fruits and vegetables per day, which is down from the peak in 2009 (45.6% reporting this level of consumption).[2] Only Quebec reported being above the national average.

Physical activity
Physical-activity levels show an even larger discrepancy between self-reported and actual rates. Self-reported rates of physical activity during leisure time for those age 12 and older decreased in 2014 to 53.7% (55.2% in 2013). BC rates were above average, second only to rates in Yukon. BC rates dropped from 65.7% to 63.5% in men and 62.3% to 60.0% in women between 2013 and 2014. However, when compared to actual measurements of moderate to vigorous physical activity with accelerometers, rates were significantly different. In 2013, only 24% of males and 21% of females met the guidelines of 150 minutes per week of moderate to vigorous physical activity. In school-age children (ages 5 to 17), only 13% of boys and 6% of girls met the guidelines of 60 minutes per day of moderate to vigorous physical activity.[3] A report released on the physical activity levels of children and youth by ParticipACTION gives a D-minus grade for this level of physical activity and for the amount of sedentary behavior.[4]

Health professionals’ response
How do health professionals respond to these data? Tobacco is a success story, and physicians played a crucial role in the reduction of smoking rates. We were the first group to reduce smoking rates as a profession when the association and causation between smoking and cancer and cardiovascular disease became clear. Asking our patients about their smoking habits has also played a significant role in helping many people quit. Is it not time to fully embrace the importance of being physically active? There are now 25 recognized health benefits, including reductions in mortality (from 15% to 33% for cardiovascular diseases, colon and breast cancer, type 2 diabetes, and osteoporosis).[5] Physical activity also gives results equal to those of medications for mild to moderate depression. 

The Council on Health Promotion encourages patients to be active through Walk With Your Doc events. This year we had 60 events with 330 docs and 3550 participants. We are growing every year, but we have a long way to go. We also encourage using the Prescription for Health prescription pads as a lead-up to the event, or at any time. Our ultimate goal is to incorporate the principles of the Exercise is Medicine initiative, which starts by using the physical activity vital sign during each patient encounter. 

This fall we once again have the opportunity to host Be Active Every Day. This involves connecting with schools to challenge kids to be active for 60 minutes each day and to talk about the Live 5-2-1-0 message. The focus of the ParticipACTION report card this year is to encourage kids to get out and play, which is the best way to achieve the goal of being active for 60 minutes daily. So far we are reaching only about 5% of school kids in BC, so we have a long way to go.

As health professionals, we still have much to do to promote these good health habits. Let’s be role models and leaders in these areas. Together we can accomplish a great deal.
—Ron Wilson, MD
Athletics and Recreation Committee

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This article is the opinion of the Council on Health Promotion and has not been peer reviewed by the BCMJ Editorial Board.


References

1.    Statistics Canada. Canadian Community Health Survey, 2014. Accessed 16 July 2015. www.statcan.gc.ca/daily-quotidien/150617/dq150617b-eng.htm.
2.    Statistics Canada. Canadian Health Measures Survey: Household and physical measures data, 2012 to 2013. Accessed 16 July 2015. http://www.statcan.gc.ca/daily-quotidien/141029/dq141029c-eng.htm. 
3.    Statistics Canada. Canadian Health Measures Survey: Directly measured physical activity of Canadians, 2012 and 2013. Accessed 16 July 2015. http://www.statcan.gc.ca/daily-quotidien/150218/dq150218c-eng.htm.
4.    ParticipACTION. Is Canada in the running? How Canada stacks up against 14 other countries on physical activity for children and youth, 2014. Accessed 16 July 2015. www.participaction.com/wp-content/uploads/2015/03/AHKC_2014_ReportCard_S....
5.    Warburton DE, Katzmarzyk PT, Rhodes RE, et al. Evidence-informed physical activity guidelines for Canadian adult. Can J Public Health 2007;98(Suppl 2):S16-68.

Ron Wilson, MD,. Together we can accomplish a great deal. BCMJ, Vol. 57, No. 7, September, 2015, Page(s) 298 - COHP.



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