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Children

If Pokémon Go Doesn’t Keep People Moving, What Chance Does Public Health Have?

Posted May 31, 2017 by Yoni Freedhoff

You remember Pokémon Go, right? I remember when it launched I was giving a talk in LA, and honestly it seemed as if the entire city was trying to catch Pokémon. Flash forward a year or so and I can’t remember that last time I saw anyone trying to catch one.

I was curious about whether or not people were still playing and so I hunted around online a bit and found a few articles.

What I learned was, during that launch time last summer there were 28.5 million global daily users. That same article has it that by January, just 5 months later, the number of daily players had dropped by 80%.

Or has it dropped even further than that? Certainly if this Reddit thread can be believed, it has, as the thread asserts that a large percentage of active players now are

  • “Bots used by scanners — Who knows how many bot accounts are out there.
  • Multi-account players — Based on concerns of gym shaving, this appears to be prevalent, but there is no way to determine how many “alt” accounts are out there.
  • Account Sellers — Overlapping 1 and 2, there are many accounts that are floating around out there for sale that have been either leveled by bots or by hand.”

All this to say, that the 5 month drop off rate of the most viral and widely launched augmented reality game is somewhere between 80 and 90%, strikes me as more evidence that rather than promoting flashy, feel-good, new online tools and commercials that stand virtually no chance at inspiring sustained behaviour changes, we need to spend our energies and efforts on environmental engineering to squeeze more activity out of our normal lives (eg. cycling and walking infrastructure, tax incentives or disincentives, stairwell renovations and signage, etc.), forcefully building the opportunity for exercise back into our kids’ lives (eg. the return of proper school recess), and lobbying our politicians for same.

And maybe it’s just my cynicism, but I do find it odd that despite our global and possibly total failings at inspiring intentional, because-it’s-good-for-you, behaviour change, both with food and fitness, that as a society we still seem to be clinging to the notion somehow, someone, somewhere, will figure out the golden message, app, or website that will set us all straight. At this point, and certainly in the developed world, it’s hard to imagine that the problem is a lack of education as to the benefits of exercise and/or a healthful diet.

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Exercise

Forks vs. Feet for Obesity: The Great Debate Part II (Next Week in #Toronto)

Posted May 29, 2017 by Yoni Freedhoff

Which is more critical to obesity treatment and prevention – our forks, or our feet?

That’s the subject of my upcoming debate with the inimitable Dr. Bob Ross.

It’s actually a redo of our prior debate from 2011 on the same topic (which you can watch here if you’d like).

It’s being presented by the Toronto chapter of the Canadian Obesity Network (CON) and it’s taking place at 5pm on Tuesday June 6th in the Ben Sadowski Theatre of Mount Sinai Hospital.

Tickets are just $15 with proceeds going towards the support of the chapter’s activities (and you can buy them in advance by clicking here).

My prediction?

There’s going to be far more agreement than you might imagine.

Also?

It should be a lot of fun.

Hope to see you there!

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Children

Childhood Obesity, Bullying, Shame and Inactivity (In That Order?)

Posted May 8, 2017 by Yoni Freedhoff

Last week, while attending the Canadian Obesity Network’s biennial Summit, I attended a lecture about childhood obesity and physical activity. One of the slides presented demonstrated a strong correlation between weight and inactivity – and the thrust of the lecture was that there was likely a strong element of causality to it.

That correlation certainly fits with the findings of the Coca-Cola funded ISCOLE trial, which examined the relationships between lifestyle and weight among over 6,000 9-11 year olds from 12 different countries and found the strongest correlation with weight was with physical activity.

But I do wonder about directionality.

Working for the past 4 years with the parents of children with obesity, I can tell you that it’s an incredibly common story to hear about the kid who used to love dance, or hockey, or soccer, or swimming – who suddenly stopped wanting to participate. Why’d they stop? Maybe because they no longer felt comfortable.

What do I mean? Take a moment and consider how you might feel about physical activity as a child if:

  • Someone had made fun of how you looked in your gym clothes or uniform
  • Someone had laughed at how you jiggled when you ran
  • Whether anyone had ever said anything, you were self-conscious about those two points above
  • You had experienced weight-related bullying in the past that made the likelihood of being bullied while exercising a credible possibility
  • You were one of the slowest kids on your team, or on the track, or in the pool
  • No one ever passed the ball to you

And that’s just regarding organized play and sport. The same questions would apply to active play, and so too would the question of whether or not you had friends to play with, as sadly, especially among kids with the highest weights, many don’t.

Research on the impact of childhood bullying on physical activity exists, but it’s scant. That said, it definitely supports the notion that children who are victims of bullying are less likely to be physically active (Study 1, Study 2, Study 3). Given that weight is the number one source of childhood bullying (by a substantial margin), I would love to see bullying explored as a co-variable in studies like ISCOLE, where their findings are often utilized to infer that inactivity leads kids to develop obesity, and not that obesity leads kids to become inactive. That latter directionality was found in the study Fatness predicts decreased physical activity and increased sedentary time, but not vice versa: support from a longitudinal study in 8- to 11-year-old children, which concluded,

Our results suggest that adiposity is a better predictor of physical activity and sedentary behavior changes than the other way around.

The ISCOLE trial, in its introduction, speaks to the existence of bullying consequent to childhood obesity, as well as obesity related social isolation – but neither are considered by the authors as possible confounding variables when it comes to inactivity. In fact, in the study’s entire discussion, this is the only mention of correlation not necessarily representing causation (for any of the examined associations)

Finally, given the cross-sectional study design, cause-and-effect inferences cannot be made, and we cannot exclude the possibility that unmeasured confounding variables may explain some of the observed relationships.

But given the plausible path from obesity to inactivity, along with the impact these sorts of studies have on public health and policy discussions, I sure wish it had included a more fulsome discussion therein.

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