LC: Our guest today is Dr. Mark Tremblay, Senior Scientist and Director Healthy Active Living and Obesity Research group, The Children’s Hospital of Eastern Ontario Research Institute. Thanks very much for joining us, Dr. Tremblay.

MT: My pleasure.

LC: I wanted to start first of all, 7 months into the coronavirus pandemic, what strikes you most about the impact of covid-19 on the physical health of Canadians across-the-board?

MT: Well certainly there’s an issue with people’s mental health and emotional health. I think in particular the physical health elements will manifest probably as well going forward but the different research that we’ve done has shown that the Healthy Living behaviors of families has deteriorated perhaps not surprisingly but also perhaps not necessarily in the pandemic. By that I mean, that people’s physical activity levels have generally declined not universally, but generally. Screen time and sleep time have gone up a little bit which may not be a bad thing if it’s in moderation. This balance of healthy movement behavior throughout the day like this right mix of physical activity, sedentary behaviour and sleep is something that appears to be challenged by the interpretation of the restrictions that have been placed upon people. It’s certainly not a necessary outcome from the situation.

LC: Let’s drill down a little bit more into that, what does the right mix look like?

MT: For children and youth, so this is school-age children and youth, they should achieve 60 minutes of moderate-to-vigorous physical activity per day. That’s an accumulation. They don’t have to go out and play ball hockey on the street for 60 minutes continuously although that would be wonderful for them as well. They should have several hours and in fact I would suggest most of their discretionary time should be spent in active play so in light physical activity not sitting or reclining, so not sedentary. They should limit their screen time to no more than 2 hours of recreational screen time that’s apart from school, and depending on their age they should get 9 to 11 hours sleep per night or 8 to 10 if they are in their teenage years.
LC: When you’re talking to parents who are already overwhelmed by all kinds of unprecedented things that have come upon them and they hear those kinds of numbers how would you go about saying to them it is possible, being a father of four yourself, I mean what would be your strategy in your own home to try to sort of make some of these things a reality?

MT: Well first these are not overwhelming goals. These are not to create Olympians or the healthiest people on the planet. These are very basic healthy living rules that in the past were routinely met and it’s really a manifestation of our fairly recent lifestyle
where these have been violated if you will and not just with the pandemic. Even prior to the pandemic the latest ParticipACTION report card you know said that about 15 percent of Canadian children and youth were meeting these what we call 24-hour movement guidelines. So the vast majority are not. But these are not these are not really hard to achieve but we need to be attentive to the challenges to healthy movement behaviors.

The allure of screen time, especially social media, but all the different things that are available on screens from this big to this big — everywhere. And as we are spending more time at home, they’re more available and we tend to spend more time on them.

You hear all kinds of stories about people binge watching this program or that program and you know as a special event that might be okay but as a routine behavior it’s not okay, it’s never been okay. It’s okay to have a little bit of candy at Halloween, it’s not okay to eat candy all day long and so from a movement perspective we’ve kind of drifted and propelled by the pandemic down into that where it doesn’t really matter when you go to bed because it doesn’t matter when you get up. When you get up you’re in your jammies all day, so why bother going outside, we’ll watch TV and these sorts of things, on occasion that’s okay but when it becomes routine it’s not okay, it’s not consistent with healthy growth and development of kids. It’s not consistent our own health.

We need to, I think now be particularly attentive to this. It is a challenge but there are also opportunities for many of us myself included. I’m sitting in my home office right now and I’ve got as much work to do as I ever do. I also have more flexibility, I can go out right now and walk the dog and just work a little bit more into the evening. I can do that. People that are home with their kids have some more flexibility. They still have their work to do, often there’s a lot of leniency in terms of when exactly you’re doing it, how you achieve it even spread throughout the 7-day week rather than the 5-day week. Again, for those of us that are working from home, for myself I’ve gained 50 to 60 minutes of travel time, so if I just took that time that I gained where I was just driving the car to work and put that into physical activity I would double the guidelines for adult which is 150 minutes of moderate-to-vigorous physical activity per week.

So not intervening on any other personal time I could achieve it, so I think there are ways to do it but we need to have our glass half full, not half empty and people need to believe this might be an opportunity as a family to recalibrate to being active together, to having good sleep hygiene we call it — consistent sleep routines — go to bed at a good time, you get a good night’s sleep, you wake up at a good time, you’re energized for the next day and so on. Instead of using it as a crutch to even further deteriorate our lifestyles and research that we’ve done shows that there are people on both ends of that spectrum, some are thriving under these circumstances and have accepted the challenge, they’re outside more of course there’s less organized activities. We can be outside socially distanced face masks when necessary following all the hand hygiene that’s necessary and so on but there’s opportunity to do that.

LC: For many parents, an active, healthy lifestyle for their children means organized sports now that is not happening across the board depending on what sport you’re talking about. What kind of advice for tips can you give to those parents in terms of maybe alternatives and simplifying it because it doesn’t always have to be a complex big adventure or event that’s happening. What kind of tips can you share around that?

MT: I think that’s an important point and I think it’s a relatively new phenomenon where physical activity was equated with these organized things done at a special place requiring several family members to drive someone there, expensive equipment, registration in advance, all of these sorts of things. Don’t get me wrong those are great things for sport development, but they’re not how people were physically active in the past, routinely. This is a chance to recalibrate on that, and the answer to that question is largely based on the age of the child you know what you’re going to do for your 17-year old daughter is probably a little but different than for your 6-year old son. The fact that there isn’t organized sports available is fine and doesn’t have to limit us in any way, it might save us some money and save us some more travel time and save the environment because of that.

So there are things that can be done and so your 17-year old daughter in this imaginary scenario can get outside if she likes to bike, if she likes to walk the dog, if she likes to jog, if she likes to hike, if she likes to just spend time in nature. If you can coerce her into raking the leaves in the front, if that’s a particular scenario. I think there are lots of things that can be done, and for the younger kids low organized games things that everyone, when I grew up, was what we did. We played these games. However, you need to be careful and social distance, if you’re not doing this with your family who are within your bubble and so on. There’s lots of things that can be done outside and in nature and don’t require any sort of skills or any sort of cost. Just look up low organized games on the Internet and see what opportunities are there. You can do scavenger hunts, and this is going to be a reality for Halloween and it maybe an alternative to knocking on doors and going to other people’s places which here in Ottawa we’re not supposed to give out candy to kids and we’re not supposed to take our kids door-to-door. You can have a scavenger hunt similar to what you might do on Easter for Easter eggs, for the Halloween things.

It can be inside and outside in your yard or your neighbourhood or a nearby park. You can build obstacle courses inside and outside — again I’m talking for more the younger kids now than for the teenagers and so on. But we are limited only by our own creativity.
and I think getting back to that is actually an opportunity to build some, some capacity within our children to realize that to be active, you don’t have to have mum and dad driving you to a special spot to get with a whole bunch of other people, to put on equipment, you know, to have a score clock and these sorts of things again I’ve got nothing against that and that’s a wonderful part of a healthy lifestyle, but it doesn’t need to be the only part.

LC: You talked about the 2020 ParticipACTION report on the state of physical activity and health for Canadians across different age groups. And you alluded to the fact that, you know, the scores in the report card weren’t, let’s call them, let’s call it weak. Okay, there was a, I believe it was a D plus for overall physical activity and a D plus for sedentary behaviors. As somebody is on the front lines of this research and has been for quite some time, do you see that this pandemic is just exacerbating the issue, and if so, what is it going to take to, you know, shift that once we get out of this, or even while we’re in it, to get out of it?

MT: For sure it’s exacerbating the issue. And we’ve done research on a national sample of Canadian children and youth to compare to the report card results, which were done pre COVID. And that 15% that I said that we’re meeting 24-hour movement behavior guidelines is now below 3%. So, 15 down to three. Now that was near the beginning of the pandemic. what happened over the summer, hopefully, improved that a little bit. So for sure things are getting worse and there’s two approaches we can take to this one is feel like we’re victims, and there’s nothing we can do. It is what it is, kids have to be home we’re told they have to be inside, and that’s a misinterpretation, we’re not told they have to be inside you’re supposed to stay home and that means don’t go in the car to the mall and to other places where you’re going to be at risk of violating the physical distancing rules. Be outside as much as possible, in fact the transmission of the virus is much, much less likely to occur outside. This is one thing that we’re all concerned about, the winter and darkness and the coldness comes that we’re going to cocoon inside again. That’s going to facilitate transmission of the disease — not being outside.

So we can feel like we’re victims and there’s nothing we can do or, we can embrace the challenge and see it as actually an opportunity to fix some things that have kind of been broken within families, within neighborhoods, and within communities. This reliance on [only] structured and organized activities — “well I can’t do physical activity because I can’t take the kids to the rink” — Well, come on you know it, there’s more to it, there’s more that we can do and here’s a chance to get back to that right balance of things.

The healthy balance from a movement perspective, and a good night’s sleep, which will happen if you spend time outdoors being active and if you’ve limited your screen time, you’ll be tired and you’ll sleep well. It feeds into one another. So here’s a chance to kind of regain that balance that I think that has been lost.

I would advise the people that are listening or watching this, you have a glass half full, not a glass half empty perspective about the opportunities. And I know there are challenges, they exist for everyone.

But, let’s look beyond that. Our health depends on it, the health of our kids depend on getting through this will in part depend on it. It is my hope that when we do, when we will get through this together, that we don’t return immediately back to the way things were. That we re-establish the norm of driving less, actively transporting more, spending more time outside, limiting our screen time, following consistent sleep hygiene practices and things that are associated with health, which we all aspire to.

LC: The spotlight on mental health has probably never been more, shining brighter than this pandemic, but the correlation between physical health and mental health is also gaining more traction whereas I think a lot of the time people compartmentalize them as two separate entities. What can you say about that, the correlation between physical health and mental health? And tips again for parents around how to manage that — as parents and also for themselves?

MT: For sure the mind body connection is just that it’s connected. And so our mental health and physical health are linked, to be sure. Sometimes one problem precedes or precipitates the other and so on, and I think we need to be attentive to these things. The beauty of what we’re talking about here about healthy movement behaviour, is that they are an antidote to both. And you hear this on the news constantly – you know, new study shows Alzheimer’s patients improve with physical activity, and obesity improves with healthy sleep hygiene and it just goes on and one. Right from death, cardiovascular disease, diabetes, hypertension, dementia, depression, anxiety, well-being in general across all the age spans are improved when we have more physical activity, when we have less screen time, when we control our sitting and when we have good sleep patterns. And these are not things that we should feel penalized to have to try and aspire to, this is what people like to do.

When people go on vacation, and they come back and you talk to them about what they did on their vacation — almost universally, it’s all physical activity. We went swimming and we went surfing, and snorkeling, and we did this and we did that. No one comes back and says ‘hi, we binge-watched some tv program in the hotel room. People like it and so we’ve got to give ourselves some license to like it again and now that we’ve got some flexibility in our schedule, we can actually fit it in, and maybe maintain that flexibility going forward. The rigidity of the work day and the work week has been proven to be unnecessary in many, many cases — not in all cases — and I know there are exceptions to all of these rules. And so need to be super-attentive especially as we are getting into our winter, the darkness, the cold. Let’s again use that as an opportunity. The seasons are changing, the leaves are falling now, won’t be long til the snow is falling. These are opportunities for new things to happen outside, new games to be played, new challenges for the family to take on as a group and get outside and explore and again when we do that, the literature is very clear — we’re going to sleep better at night and when we sleep better at night we feel better, our brains are better, our bodies are better and we’re going to repeat the next day. The challenges are real, they are real for all of us. We need to embrace the challenge, overcome those, overcome them together, by reaching out when we need assistance but also working together as a family to try and help each other through this and our physical and mental health will benefit.

LC: Dr. Mark Tremblay, thank you so much for your time today.

MT: My pleasure.