Winnipeg Health Region
Wave, September / October 2012
Helena Stanicevic jumps off the city bus and checks the time.
It's 8 a.m. and she's just arrived at her school, Glenlawn Collegiate. Classes don't start for another 30 minutes. That's just enough time for the 17-year-old to squeeze in a short 15 or 20 minute run on a treadmill at the South YMCA-YWCA next door on Fermor Avenue.
In minutes, she's going through her paces and working up a good sweat. By 8:30 a.m., she's cleaned up, back in her school clothes and ready to take on the day.
"I try to get a quick run in before school on most days," says Stanicevic. "It just makes me feel energized."
Stanicevic's commitment to being active does not start and end with jogging. Today is Tuesday, which means that after dinner tonight she'll head back over to the Y to teach dance or soccer to younger kids. On Thursday nights, basketball and gymnastics are her specialty.
When she's not teaching classes, Stanicevic can be found inside the gym, working her way from one weight machine to another, concentrating on increasing muscle tone.
She doesn't stop there.
"Dance is a really big part of my life," Stanicevic says. The teen took dance classes when she was young and taught herself how to breakdance. She's also really into freestyle dance.
Clearly, Stanicevic is an active teen. When all her active time is added up, she easily hits the minimum of 60 minutes of moderate to vigorous activity a youth needs each day to maintain good health. Indeed, on her most active days, she can hit 150 minutes.
Unfortunately, not all Canadian youth can make the same claim. Most aren't even close, a point made by numerous studies. Active Healthy Kids Canada, for example, reports that only seven per cent of Canadian children and youth (six to 19 years of age) meet the recommended minimum activity requirements. Meanwhile, 63 per cent of Canadian children and youth spend their free time after school and on weekends being sedentary.
Closer to home in Manitoba, a provincial government report notes that 23.7 per cent of young people between the ages of 12 and 19 are overweight or obese, compared to the national average of 28.8 per cent. The report also notes that Manitoba's youth simply aren't getting enough exercise for proper development and growth.
Concern about inactivity among young people is growing.
"This is a very important issue," says Dr. Michael Routledge, the newly appointed Chief Provincial Public Health Officer for Manitoba. "We're learning more about the multiple benefits of physical activity, and the risks from inactivity. Being physically active is fundamental to our overall health at both an individual and population level."
That point is underscored in the Active Healthy Kids Canada report. It notes that physical activity contributes to improved aerobic fitness and motor skills. But being physically active is not just about being fit and trim looking in the here and now, it's also about longer term health and wellness. As the report notes, "Aerobic fitness in particular has been linked to a decreased risk for chronic diseases and metabolic syndrome (the simultaneous occurrence of several metabolic disorders, which increase the risk of diabetes and cardiovascular disease)."
Physical activity can also make you smarter. According to the report, "physical activity levels have been positively linked to cognitive function during development in school-aged children (aged 4 to 18). Games and exercises that require problem-solving are associated with improvements in perceptual skills, IQ, academic achievement, verbal tests, mathematics tests and developmental level. Sedentary children who begin to partake in physical activity can also benefit from enhanced cognitive developments." Physical activity can also increase self-esteem, "and children and youth who are physically active appear less likely to experience mental health problems," the report says.
Yet many health officials around the world believe inactivity has hit pandemic proportions. Name a serious health problem and in many cases it can be linked to physical inactivity.
The nature of the problem was hammered home just prior to the Olympics in London when The Lancet, a British Medical journal, published a series of articles warning that the world was in the midst of an inactivity crisis. Among other things, the authors pointed out that long-term inactivity leading to heart disease, diabetes and cancer causes about 10 per cent of deaths worldwide. They also noted that as many as eight out of 10 kids around the globe between the ages of 13 and 15 do not meet the standard of 60 minutes of moderate to vigorous activity each day.
Health experts say it is important to understand that inactivity isn't just a problem for the individual. The widespread ill-health that can be attributed to lack of activity puts an incredible and costly strain on health services. If the alarming trend of youth inactivity doesn't shift, Canada will be one sick country, populated with citizens riddled with health problems such as heart disease, strokes, cancer and diabetes.
So, why are our young people inactive? And, more importantly, what can be done about it?
Active Healthy Kids Canada, the country's leading youth activity advocacy group, says one of the main contributors to the problem is a lack of outdoor playtime.
Indeed, a recent study produced by the agency says that outdoor play time has dropped 14 per cent in the past decade. That may not seem like much, but the study's authors say free time is critical because it helps build a lifelong love of being active as well as improving a host of developmental and social skills in young people.
"Unfortunately, the structure and demands of modern Canadian life may be engineering active play out of our children's lives," the study's authors wrote. "Perhaps in a misguided bid to protect and direct them at all times, Canadian kids have lost the freedom to throw open the doors and go play."
Mark Tremblay, Director of the Healthy Active Living and Obesity research group at the Children's Hospital of Eastern Ontario, and one of Canada's foremost researchers on the effects on childhood inactivity, says another major contributor is technology.
Multiple television screens, home Internet access and computer video games all encourage more daily screen and couch time, says Tremblay. Busy lives and bursting schedules cut into free time that could be spent exercising or playing, he adds.
These sedentary habits and the reduction of free time are setting kids up for long-term health problems, diseases and, ultimately, a shortened life-span.
"The forces of society are very, very powerful and provoke us to move less," says Tremblay. Swiftly evolving technology, including remote-control devices that make it less necessary to move around, are compounding the physical inactivity crisis. "We're all seduced by these things."
Routledge agrees that technology plays a role in keeping people on the couch. But he also says society as a whole needs to take action to promote active lifestyles.
"We all need to contribute towards creating the kinds of communities that help people embrace daily physical activity."
Among the areas Routledge would like to see better addressed are our built urban environments. Neighbourhood design does not always lend itself to the use of active transportation. Changes such as bike lanes and reduced speed limits can help create residential communities that promote a safe and active lifestyle.
Routledge says none of these issues can be addressed overnight, but he is encouraged by initiatives such as a recent City of Winnipeg motion to reduce speed limits to 40 kilometres an hour in residential areas.
Other initiatives have been launched to promote activity among Manitoba's youth. For example, the provincial government acted in 2007 and 2008 to make physical education part of the mandatory curriculum for kindergarten to Grade 12 students.
Prior to that, in 2005, the province launched Manitoba in motion as part of the Healthy Kids, Healthy Futures initiative, an all-party task force that asks Manitobans to get moving. Manitoba in motion, along with Winnipeg in motion, support schools, workplaces and community groups to increase opportunities for physical activity and decrease barriers to participation.
To date, more than 600 schools across the province have registered for the healthy schools initiative. Participating schools have set a goal of getting their student populations to get at least 30 minutes of physical activity during their school day. Special events, intra-murals, physical activity breaks and other programs are all part of the plan.
Deanna Betteridge is the Chair of Winnipeg in motion. Her job is to help develop and facilitate programs and help groups, schools, organizations and companies introduce or increase physical activity within their structure or schedule.
"The focus is on being physically active to improve and maintain health and wellbeing and to prevent chronic disease."
But while the goal - to get young people moving - is simple, the path to change is not an easy one. As she explains, people's lives are busy and chaotic, so she encourages parents and kids to prioritize physical activity as a key part of their day in any way they can.
Parents can help instill a lifelong love of physical activity in their children by being active themselves, Betteridge says. As children grow older, they start to look on their peers as role models. If parents are lucky (or strategic), their kids will have friends, who she calls "champions" of physical activity in the community, who lead their peers to move and play more. Luckier still, parents will raise their own physical activity champions.
Betteridge says the key for parents is to be creative about promoting activity. Think hula hooping, dancing in the living room, BMXing, slack-lining, shooting hoops and playing Frisbee, she says. Visit local community centres to discover what programs are offered in your neighbourhood. Brainstorm ideas with your kids on a family activity white board and then let everyone take a turn picking what activity you'll all do together, she suggests.
"We can turn it around. But (parents) can't do it alone. We have to do it as a community. We have to make good decisions (about how we build our lives and neighbourhoods)."
Betteridge is also a big believer in leading by example. The former personal trainer used to spend many hours working out in the gym, an activity she is not as keen on anymore, but has found other physical activities that better fit her current lifestyle. As a working mom with a toddler, Betteridge tries to ride her bike to work most days and has found some good exercise videos that she enjoys, using active transportation and home exercise as her ways to stay physically active.
Meanwhile, educators, parents and experts grapple with how to explain the importance of physical activity to young people. Just how to communicate with youth and deliver the message about the health risks associated with physical inactivity is a challenge, says Routledge. Telling a young person that if they don't get active now, they may face serious health problems two or more decades later may not get through, he says.
Real change is going to require a shift in societal attitudes away from blaming inactive individuals, and towards creating built environments that promote physical activity, Routledge says.
The public policy changes that have occurred over the past few decades with respect to tobacco provide a helpful template for how to address physical inactivity. Tobacco use went out of favour as the public recognized the connection between smoking and disease, and pushed for actions that steered people away from smoking, such as no smoking policies for restaurants and public places. The same thing has to happen now with our efforts towards supporting people to be more physically active, Routledge suggests.
In addition, an approach that promotes improved self-esteem through physical activity may also prove helpful.
Stanicevic is a case in point. Although she is active now, that wasn't always the case. "I had always been a little bit chubby throughout childhood," she explains. "Not overweight, but chubby."
In 2009 as she entered Grade 9, Stanicevic started feeling a little insecure about her body and not super confident in her own skin. So she decided to make a change. She cut all her meals in half and made sweets and desserts a treat rather than a daily occurrence. She ate more fruits and vegetables. She started moving more and eating less. Getting exercise, in whatever form, became a daily habit she grew to love. As the number on the scale dropped, Stanicevic was energized. "Once I started, I really didn't want to stop," she says.
And parents do have a role to play in encouraging physical activity, says April Limosinero. "(Adults) just can't say it, they have to do it, too," says the 17-year-old.
Limosinero's dad, Henry, is the perfect example. Twice a week during the school year, father and daughter play badminton inside the Maples Collegiate gymnasium. "We're buddies in badminton," she says.
Winnipeg teen Patricia Polden also thinks there's an easy way to motivate kids. Her advice to parents: "Try to do things with them and not just tell them what to do."
Walk, play and get moving with your kids, says Polden, who loves to dance, run track, walk and work out at the gym to keep active.
Polden also believes there's a big barrier for many kids wanting to get active: organized sports are very expensive and many families can't afford to pay the fees. "If (the government) could subsidize more programs, I think that would help people out a lot," she says.
Stanicevic, Polden and Limosinero are examples of physically active teens, and researchers have already learned a lot from their demographic.
But understanding inactive and sedentary children and youth is also very important, researchers believe.
Tremblay and his team at HALO are in the midst of a major study about sedentary youth. They want to understand cardio-metabolic reaction of sedentary behaviour, like sitting for long stretches. The team wants to know how small movements, like standing up after lengthy periods of inactivity, act at a metabolic level in the body. It's all part of the bigger picture of understanding physical inactivity and sedentary behaviour in kids, he says. The team hopes to have their manuscripts ready for peer review by Christmas.
The study is a significant shift in how Tremblay approaches the issue of childhood obesity. "We can't continue to just harp on getting more active, so we're also trying to reduce sedentary behaviour."
For Winnipeg teen Helena Stanicevic, sedentary behaviour is not part of her routine. Other kids can learn from her success. Her advice is direct. "Do what you love and be what you want to be," she says. "And don't stop. Just keep going and don't let anyone tear you down."
Robin Summerfield is a Winnipeg writer.
A wealth of studies over the last few years suggests that the majority of today's teens are not as active as they need to be in order to maintain good health. Nonetheless, many teens interviewed by Wave do manage to pack some activity into their lives. Here is how they do it:
Age 17, Grade 12
Patricia Polden has a newfound passion. The 17-year-old loves to dance.
"I love how it helps keep my legs toned and my stomach toned and it's making me feel better about myself."
The Grade 12 student is a relative newcomer to the dance world. She first started taking classes just two years ago at her high school. "I'm not the greatest, but I love being active," she says.
Polden also loves to run on the track, and on Wednesday and Thursday nights throughout the year, she helps her boyfriend hand-deliver flyers in the neighbourhood.
The couple walk briskly and cover the route in 60 to 90 minutes. Although she is fairly active, Polden acknowledges that she doesn't necessarily get 60 minutes of moderate to vigorous activity each day during a school year, unless she has dance during a semester. "It's hard to work out that much every day while juggling school work, the course I am currently taking outside of school, helping out around the house, and still having a normal 17-year-old's social life."
She will, however, continue trying.
Age 15, Grade 10
Sixty minutes every day.
That's how much physical activity every Canadian teen needs to maintain good health. And walking from the living room to the kitchen and back again won't cut it. We're talking about moderate to vigorous, heart-pumping, sweat-inducing action.
Fifteen-year-old Matthew Martin knows the drill.
The Grade 10 student in Winnipeg is a passionate sports lover. He plays basketball, baseball, floor hockey and tackle football. He can't wait for gym class so he can get moving and he joins lots of intramural sports, too.
Playing sports "makes me feel energized," Martin says.
His active life has also given him another gift. "I feel pretty confident about myself."
He would love to help other kids get hooked on sports and exercise.
As Martin says: "I could help teach them different sports.
Age 12, Grade 7
Shasta-Kelly Nimubona starts every day with the same routine.
After she jumps out of bed, she shakes out her arms and legs, stretches up to the ceiling, then down to the floor and side to side.
She wakes up her limbs and works out any little kinks she's acquired overnight.
Once she's warmed up, the tween, who was born in Tanzania, then pops down to the floor and does the splits. Her mom, Christine, has also started teaching Nimubona other gymnastic moves like cartwheels and backbends. The daily routine takes just a few minutes but is well worth the time.
Nimubona loves to dance jazz and hip hop and play soccer after school, too.
This summer, while at Camp Manitou for a couple of days with Helping Hands Immigrant Society, Nimubona played basketball for the first time. Now she's hooked.
While she doesn't worry a lot about keeping track of how much time she is active - she's too busy - she does believe she meets the minimum standard for children and youth of 60 minutes of moderate to vigorous physical activity each day to maintain good health. And that, she says, "makes me feel good."
Age 17, Grade 12
There's one place you'll never find Winnipeg teen Helena Stanicevic: the couch.
She's not into watching television or spending hours in front of a computer screen.
"I'm pretty active every day."
That's an understatement.
Every day before school, she hits the treadmill at the Fermor YM/YWCA for a quick 20-minute run before classes start next door at Glenlawn Collegiate.
The 17-year-old Grade 12 student plays pick-up basketball, soccer and taught herself to freestyle and breakdance. This year, she's trying out for the volleyball, basketball and ultimate frisbee teams at school.
Stanicevic has also become a mentor for other kids trying to stay active, embrace exercise and learn new sports. She also teaches gymnastics, basketball and dance to younger kids at the YMCA-YWCA, where she works.
When she's not participating or teaching sports, Stanicevic runs on the treadmill and works out with weights whenever her schedule permits. She also spends a lot of time chasing after her two younger brothers, ages six and two. Being active has also changed her life. Two years ago, she lost 65 pounds after completely changing her diet and adding more physical activity to her daily routine.
"I feel amazing about myself and what I've accomplished."
Age 17, Grade 12
About three years ago, April Limosinero discovered she had a new talent: running.
And she was pretty good at it, too.
The Winnipeg teenager liked nothing more than lacing up and hitting the track.
She's been hooked ever since.
Today, the Grade 12 student and track member trains every other day after school, running indoors and outdoors. "I love it," she says. "It's your endurance, your shape, your health."
Limosinero is an active teen. Through her new-found passion, she manages to get in about 60 minutes of vigorous exercise every other day. She complements that by participating in other activities, including badminton, lacrosse and swimming, which she started when she was 10.
She also took up weight training in Grade 10 and recently joined a dragon boat team. To top it all off, she walks to and from her bus stop on her daily commute to school.
Her dad, Henry, is a big influence. On Tuesday and Thursday evenings from September to June, Limosinero and her father play badminton as part of a recreational league. She says her dad "is really sporty," and a great example of how adults can keep and stay active.
Besides loving the competition of playing sports, paddling and running track, Limosinero has also learned to love something else: herself.
"I have a lot of self-confidence," she says. And it's a message she hopes other young people learn, too. "If you're active, you're going to have confidence in yourself."
Age 16, Grade 11
Even while watching a friend play computer games, Amin Bangura is rolling a basketball around in his hands.
Basketball is his chosen sport, one he plays on a team at his high school, as well as on a local outdoor court.
"Sports give me quicker reflexes," he says, tossing the ball to John Doherty, a co-ordinator of the Going Places club in Amin's neighbourhood. "Playing keeps me in shape, gives me strength."
Doherty reminds Amin about how they talk about Canada's Food Guide and eating healthful food in order to fuel an athletic body. "Yes," agrees Amin. "We learn about that in school. And about not smoking."
Amin grew up playing soccer as a kid, and now plays football with his friends, although he says most kids his age would rather be indoors, playing video games. He also goes out walking with his father, and horses around with his younger brother, Ali.
"I like basketball the most," he says, adding that he works out in the neighbourhood gym, using the weight machines to build up muscle. "I think I get in 30 minutes a day, on top of the team practice at school. I have great friends on the team."
What is moderate aerobic activity?
Moderate-intensity aerobic activity makes you breathe harder and your heart beat faster. You should be able to talk, but not sing.
Examples of moderate activity include:
- walking quickly
- bike riding
What is vigorous aerobic activity?
Vigorous-intensity aerobic activity makes you breathe so hard, you won't be able to say more than a few words without needing to catch your breath.
Examples of vigorous activity include:
- cross-country skiing
Source: Health Canada
The importance of sleep
Sleep - or the lack of it - has a direct connection to the health of young people.
According to a recent study, the pattern of "early to bed and early to rise" seems to help keep kids leaner and more physically active than their night-owl peers, even with the same total amount of sleep.
Body weight and the use of free time over a four-day period were compared in 2,200 nine- to 16-year-olds. Those who went to bed late and got up late were 1.5 times more likely to be obese than those who went to bed early and got up early.
Further, late-nighters were almost twice as likely to be physically inactive and 2.9 times more likely to sit in front of the television and computer or play video games for more than two hours, which exceeds the Canadian Sedentary Behaviour Guidelines for School- Aged Children and Youth of no more than two hours of screen time per day.
Therefore, it appears that children should be aiming for 10 to 11 hours of sleep daily, preferably between the hours of 10 p.m. and 8 a.m., to lower their risk of obesity and excessive screen time.
How much sleep do you really need?
|Newborns (0 to 2 months)|| 12 to18 hours |
|Infants (3 to 11 months)||14 to 15 hours|
|Toddlers (1 to 3 years)||12 to 14 hours|
|Preschoolers (3 to 5 years)||11 to 13 hours|
|School-age children (5 to 10 years)||10 to 11 hours|
|Teens (10 to17 years)||8½ to 9¼ hours|
|Adults||7 to 9 hours|
Sources: Active Healthy Kids Canada and the National Sleep Foundation