Week 2 - Are Canadians Physically Healthy? Flashcards

Question

Chronic Diseases in Ontario

Answer 1

- over 7 in 10 deaths due to a chronic disease - 242,054 hospitalizations due to big four chronic diseases

Answer 2

- tobacco smoking - alcohol consumption - physical inactivity - unhealthy eating + sedentary behaviour

Answer 3

13% self-report having NONE

Answer 4

**80%** of IHD, stroke, and T2DM would be prevented **40%** of cancer

Answer 5

- MOST prevalent = physical inactivity then unhealthy eating - smoking decreases with age - obesity increases with age - physical inactivity HIGHEST 12-19 year olds

Answer 6

- 19.6% NONE - 34.8% ONE - 32.1% TWO - 11.2% THREE - 2.3% FOUR

Answer 7

ratio of body weight to height-squared = mass (kg) / height (m squared) ie. 75 kg individual 175 cm tall - 75/1.75 = 24.5kg/m squared

Answer 8

below 18.5 = underweight 18.5-24.9 = normal weight 25-29.9 = overweight 30-34.9 = obesity class I 35-39.9 = obesity class II above 40 = obesity class III

Answer 9

Increasing across the globe (Canada, USA, Sweden, Zimbabwe) - women more than men EXCEPT sweden

Answer 10

30% (1978 - 23%, increased to 35%, then decreased) - over 90% NOT meeting PA guidelines - 1 in 3 are overweight or obese - 18.6% are overweight - **12.5% are obese**

Answer 11

Equal to or less than Men SMALL 102 inch / 40 inch Women 88 cm / 35 inch Large is above

Answer 12

- Definition: chronic high blood pressure - Prevalence: **24.9% (2011/12) - 6.9 million** Canadians >20 years old **>70% of Canadians aged 65+ are affected** Diagnostics: Accurate diagnosis begins with accurate measurement

Answer 13

being more physically active, weight reduction, moderation in alcohol intake, eating healthier, relaxation therapies, smoking cessation

Answer 14

accumulation of 30-60 min of dynamic exercise of moderate intensity 4-7 days per week in addition to routine activities of daily living - higher intensities of exercise are no more effective at BP lowering but may produce other cardiovascular benefits - non-hypertensive resistance or weight training exercise does not adversely influence BP - prescribe to both normotensive and hypertensive individuals for prevention and management of hypertension, respectively

Answer 15

- healthy BMI and waist circumference is recommended for non-hypertensive individuals to prevent hypertension and for hypertensive patients to reduce BP - encourage multidisciplinary approach to weight loss, including dietary education, increased PA, and behaviour modification

Answer 16

limited consumption— 0-2 standard drinks/day men: less than 14/week women: less than 9/week - prescribe to both normotensive and hypertensive individuals for prevention and management of hypertension, respectively

Answer 17

diet HIGH in fresh fruits, vegetables, dietary fibre, non-animal protein, and low-fat dairy products - low in saturated fat in cholesterol - to decrease BP, increase dietary potassium - prescribe to both normotensive and hypertensive individuals for prevention and management of hypertension, respectively

Answer 18

individualized CBT more likely to be effective when relaxation techniques are employed - prescribe for selected patients in whom stress plays a role in elevating BP

Answer 19

abstinence from smoking; smoke-free environment - **GLOBAL cardiovascular risk reduction strategy**

Answer 20

1) SUBJECTIVELY 2) OBJECTIVELY — Accelerometer 3) OBJECTIVELY — Wearables

Answer 21

Ie, questionnaire Guthold, Stevens, Riley, Bull (2018) — worldwide trends in insufficient physical activity from 2001 to 2016: a pooled analysis of 358 population-based surveys with 1-9 million participants - Insufficient pA is a leading risk factor for noncommunicable diseases and has a negative effect on mental health and quality of life - Levels of insufficient PA across countries and estimate global and regional trends

Answer 22

Colley et al (2018) Health Reports Vol. 29, no. 12, pp. 3- 15, December 2018 Statistics Canada Comparison of self-reported and accelerometer-measured physical activity in Canadian adults Research Article

Answer 23

"Better with Age, Move more today for a healthier tomorrow" by ParticipACTION - daily behaviours; individual characteristics; settings & sources of influence; strategies & investments - assigns overall grade

Answer 24

Althoff et al. (2017) - Study of 700,000+ people, 111 countries, using smartphones with built-in accelerometry (Azumio Argus App) to track activity - Canadians walked an average of 5000 steps/day. - HALF THE RECOMMENDED - **Main finding:** Physical activity levels did not predict obesity rates as much as _**activity inequality**_ - *Walkability predicts activity inequality* More walkable city, more activity throughout the day and age - Across age groups, gender, BMI - Because of _built environment_

Answer 25

- *Female activity is reduced in areas with high gender activity inequality*

Answer 26

1. Canadians know physical inactivity is a problem. 93% said it's a more serious health problem than tobacco and alcohol use. 2. Canadians are aware people need to be more active. 3. Canadians have positive feelings about being active. 74% said they enjoy being active. 4. Canadians think that a more active life is within reach. 61% said they wouldn't need to change too much to be more active. 5. Canadians think everyone contributes to the physical inactivity problem. (social factors ie. gov, schools, industry, parents, etc.) 6. Canadians think individuals are at the heart of the issue. 88% believe individuals are the solution. 7. Canadians support public policy to encourage increased physical activity.

Answer 27

- 39% meet PA recommendations within 24 hour movement guidelines - no sig changes overtime - boys encage in more physical activity than girls and children (5-11) engage more than youth (12-17) - 25% 10-17 year olds are meeting the PA recommendations - 41% 5-9 year olds take 12 000 steps daily - meets guideline - 5-19 year olds take 11 300 steps daily

Answer 28

- ONLY 16% Canadian adults are getting the recommended amount of PA (15 min moderate-vigorous PA/week) - 84% is NOT active enough 8 in 10 Canadian adults are not active enough to reap the health benefits of a physically active lifestyle. Your neighbour, mother, brother, daughter, coworker, or maybe even you could be part of the physical inactivity crisis in Canada.

Answer 29

Sebastiano, Chulak-Bozzer, Vanderloo, and Faulkner, 2020. Don’t Walk So Close to Me: Physical Distancing and Adult Physical Activity in Canada.

Answer 30

F — Active Transportation C+ — Light Physical Activity F — Sedentary Behaviours

Answer 31

in many ways, people have never been less healthy - main reason is _physical inactivity_

Answer 32

normal weight

Answer 33

Sedentary behaviour

Answer 34

FALSE - is a risk condition

Answer 35

- Negative impacts on nearly every organ of body and reduction in overall health Trend = significant decrease in the age-standardized rate of daily or occasional smokers - Declined in all age groups but declined most in younger age groups - Greater proportion of males - Rates highest among 20-34 year olds - Older adults significantly lower - BC lowest; NWT nearly double rates and Nunavut more than 3X of Canadian average

Answer 36

- More than 3/4 are not meeting guidelines - PH concern — 4th leading cause for global mortality and linked to a number of chronic diseases including CVDs, cancer, and diabetes - Trend = no significant change in proportion of children but small decrease in mean number of steps taken - Proportion of adults not meeting had not changed sig; self-report small increase reported being active or moderately active - Greater proportion girls do not meet levels; men and women don’t differ sig - Adherence to guidelines diminishes with age

Answer 37

- Half fail to meet guidelines - Health risks — obesity and decreased fitness - Association is independent of physical inactivity - Limiting recreational screen time to no more than 2hr/day - Remained stable since 2007 — 8.5 hours per day - Younger children spend less time being sedentary than older children and youth

Answer 38

- More than 1 in five eat less than recommendation - Adult = 7-10 servings; children = 4-8 servings - Those who do not eat fruit and veg five or more times per day as a measure of unhealthy eating - More men do not consume - Proportion exceeded the national average by more than 20% in Newfoundland and Labrador and Nunavut

Answer 39

1 in 6 15+ exceeded guidelines; more than 1 in- 6 heavy drinking at least once a month - Immediate health risks are associated with “binge” or heavy - 4+ one night for women, 5+ men - Long-term linked chronic liver disease, certain cancers, CVDs, and premature death - Trend = increased - More males exceed; diff even greater heavy drinking - High among 25-34 year olds, low 50+ - No geographical difference regarding guidelines but greater NS, NB, NFL, Yukon, NWT for heavy drinking

Answer 40

Overall rates among females statistically lower in females

Answer 41

Proportion of those reporting at least one risk factor increased with age

Answer 42

- Strongest predictor of being obese as adult = being obese as a child - Dramatic increase in last few decades; no sig diff since 2007 - Obesity rate for children peaked 2007-2009 - Men and women similar - Boys higher than girls - Highest age 35-49 and 50-64

Answer 43

- Can cause heart attacks, stroke, heart failure, dementia, renal failure and blindness - Canada has the world’s highest reported national blood pressure control rate - Trends = PREVALENCE increased, INCIDENCE decreased - Similar between males and females - Increased with increasing age - Highest prevalence NFL, lowest prevalence NWT

Answer 44

- Second leading cause of death after cancer and leading cause of hospitalization - Heart muscle is damaged or works inefficiently because the absence or relative deficiency of its blood supply - IHD is number one cause of years of life lost (YLL) due to premature mortality and the second leading cause of disability-adjusted life years (DALYs) - Prevalence increased then has stayed stable - Incidence has decreased - Men more - Prevalence increases with age; white males had higher rates than females in all age groups - NB has highest; Nunavut lowest

Answer 45

- sudden loss of brain function that occurs when blood flow supplying oxygen to a part of the brain is interrupted - Stroke is third leading cause of death - Fourth leading cause of years of life lost due to premature mortality and the tenth largest contributor to disability adjusted life years (DALYs) - Hospitalizations and deaths steadily declined over the past few decades but absolute number of living with the effects of strokes is increasing - Burden is increasing among younger adults -- Mean age of stroke is decreasing; burden of stroke is likely to increase even further - Age-standardized prevalence increasing but incidence has decreased - Males and females equally affected - Increased with increasing age - Highest PEI, lowest Newfoundland and Labrador

Answer 46

- Not just one disease, but a large group of almost 100 diseases - Two main characteristics: 1) Uncontrolled growth of the cells in the human body 2) Ability of cells to migrate from the original site and spread to distant sites - Cancer has been leading cause of death in Canada - prostate, breast, colorectal cancers account for over half of all prevalent cases in Canada - 2 in 5 Canadians are expected to be diagnosed with cancer in Canada in their lifetime, and one in four will die from cancer - Age standardized prevalence increased but incidence rate decreased - Higher prevalence in men, higher incidence in men - Nearly 90% diagnosed, over the age of 50, 40% over age of 70 - Cancer incidence rates are higher in eastern Canada and lower in western Canada Lowest = Yukon

Answer 47

- Chronic and progressive condition characterized by gradual airway obstruction, shortness of breath, cough and sputum production - Cigarette smoking main cause - 7th leading cause of years of life lost due to premature mortality and 9th leading contributor to DALY - Age-standardized prevalence increased but incidence decreased - Very similar males and females - Prevalence rates steadily increase with age - High in Nunavut, NS and the three territories all had rates more than 20% higher than national average

Answer 48

- Characterized by cough, shortness of breath, chest tightness and wheezing - Two out of three Canadians with active asthma do not have good control of their condition - Age-standardized prevalence increased but incidence decreased - Slightly higher among females - Highest ages 1-19 and 20-34 declined until age 65 when began increasing again - High in Ontario; 3 territories had rates more than 20% lower than canadian average

Answer 49

- Body is either unable to sufficiently produce or properly use insulin - Age standardized prevalence increased -- Incidence increased then dropped - More males living with diabetes (type 1 and 2 combined) - Prevalence increased by age group; highest = 65-79 and 80+ - Low in Nunavut, high in Yukon but did not differ by more than 20% from national average

Answer 50

- Mood disorders = lowering or elevation of a person’s mood - Anxiety disorders = excessive and persistent feelings of apprehension, worry and even fear - Mood and anxiety disorders are most common types of mental illnesses - Major depressive disorder was ranked as second leading cause of years of life lost due to disability; anxiety 8th - Higher among females - Rates highest between 35-64, decreased slightly with increasing age - Highest in NS, lowest Nunavut, Newfoundland and Labrador, Quebec, NWT

Answer 51

- Greater risk of adverse health outcomes and have increased health care needs - 65+, prevalence rates have slightly increased - Females (65+) had significantly higher rates - Increases dramatically with age - Highest prevalence Yukon and Alberta, lowest rates BC and Manitoba - Rates differ by at least 20% from the Canadian rate

Answer 52

- Early onset of depressive and anxiety disorders has been shown to be associated with an increased risk of developing heart disease, asthma, arthritis, chronic back pain and chronic headaches in adult life - Can lead to unhealthy behaviours that increase the risk of developing or exacerbating other chronic diseases or conditions - May result from the burden of living with a chronic disease or condition - Significant increase in prevalence - Females significantly higher rates - High prevalence in 50-64 age group - Highest NS and NB; lowest BC, SK, MB

Answer 53

- Chronic diseases are at high risk from complications and death due to influenza infection -- May trigger an exacerbation and deterioration of pre-existing conditions - Vaccine rate has fluctuated over last decade - Females with chronic disease slightly higher - Immunization rate among those with chronic disease generally increased with age - NS had a rate at least 20% higher than national average

Answer 54

Infant mortality = number of deaths of live-born babies in first year (per 1000) Neonatal mortality = first 28 days - Infant mortality declined, neonatal stayed stable - Infant and neonatal higher in boys — genetic and biological makeup; boys in general are more susceptible to disease and premature death - Nunavut 3X canadian average

Answer 55

- Deaths that occur at a younger age than expected and, therefore, reflect the potential for avoidable deaths - Decrease from the four main NCDs was observed -- Mainly due to decrease in mortality from cardiovascular diseases and from cancer - Probability of dying between ages 30-64 from any of the 4 main chronic diseases was higher in males -- Particularly for cardiovascular diseases which were 2.5 times more likely for males - Nunavut 2X greater than Canadian average - Very high premature mortality for chronic respiratory diseases (8X) and cancer (2X) - NWT, Yukon, Newfoundland risk 20% higher than Canada as a whole

Answer 56

LE = describes the overall health status of a population and is defined as the average number of years a person of a certain age would be expected to live given current mortality rates Health adjusted life expectancy (HALE) = average number of years that a person is expected to live in full health - Both LE and HALE steadily increasing (due to decrease in mortality) - Females have higher LE and HALE - Nunavut and NWT low, high BC for LE - Nunavut, NWT, and Yukon lowest HALE, Quebec highest