Platform, Information, Ideas and Avenues for

PLATFORM
Information, Ideas
and Avenues for Action
Editorial committee
Steeve Ager, Main Advisor, Physical Activity
Lucie Lapierre, Main Advisor, Knowledge Transfer
Chantal de Montigny, Nutrition Advisor
Manon Paquette, Main Advisor, Nutrition
Julie Strecko, Nutrition Advisor
Copy editor
Andrée LeMay
External reviewers
Mireille Blais
Ministère de l’Éducation, du Loisir et du Sport
Yovan Fillion, Lyne Mongeau, Martine Pageau
Ministère de la Santé et des Services sociaux
Véronique Martin
Ministère de la Famille, des Aînés et de la Condition féminine
Silvio Manfredi
Direction de Santé publique, Agence de la santé et des services sociaux de Laval
Guy Thibault
Direction du sport, du loisir et de l’activité physique, Ministère de l’Éducation, du Loisir et du Sport
Monique Dubuc
Kino-Québec
Sophie Desfossés
City of Trois-Rivières
Karine Gauthier
Table sur les saines habitudes de vie, City of l’Ancienne-Lorette
Nathalie Hébert
Le cheval sautoir childcare centre
Stéphanie Leblanc
Maison des enfants le Dauphin
Catherine Lizotte
Youth in Motion Brome-Missisquoi
Élise Paradis
Regroupement des CPE des régions de Québec et Chaudière-Appalaches
Luc Potvin
CSSS Baie des Chaleurs / Regroupement Baie-des-Chaleurs Active et en santé
Sandra Vigneault
CLD de l’Érable
Claudia Bennicelli
Vivre en Ville
Denis Cormier, Agronomist
Agri-food consultant
Marie-Pierre Arsenault, Marc Bernier, Claire Chouinard,
Diane Le May, Hélène Potvin, Laurélie Trudel, Mathieu Vallet
Québec en Forme
Published by
Québec en Forme
This document is the intellectual property of Québec en Forme.
The document is available in electronic format at:
quebecenforme.org
ISBN : 978-2-9813316-0-1
Legal deposit
- Bibliothèque et Archives nationales du Québec, 2012
- Library and Archives Canada, 2012
All rights reserved for all countries. This document
may not be reproduced by any means, or translated
or distributed, in whole or in part, without prior authorization from Québec en Forme. However, the
partial or full reproduction of this document for
personal, non-commercial purposes is permitted,
provided such reproduction includes a full citation
of the source.
© Québec en Forme, 2012
QUEBEC EN FORME
.org
TABLE OF CONTENTS
3
5
Preamble
Introduction
1. PORTRAIT
OF OUR SOCIETY
9
12
13
1.1 Recognizing and
understanding a new reality
1.2 Existing initiatives
1.3 Positive, quantifiable outcomes
2. ELEMENTS TO BUILD ON
18
19
2.1 Recommendations on
young people’s diet and
physical activity levels
2.2 Sound guidelines for action
3. IDEAS ON HOW
TO TAKE ACTION
23
24
26
27
28
29
3.1 Cornerstones of the Platform
3.2 The many factors
influencing young people’s diet
and physical activity levels
3.3 Three objectives, seven strategies:
as simple as ABC!
3.4 Examples of actions according
to different levels of intervention
3.5 One issue, many strategies
Conclusion: Olivia’s world
REFERENCES
33
36
37
39
Bibliography
Suggested reading
Glossary
Statistics
1
2
LIST OF TABLES
19
25
26
27
FOLD-OUT
Table 1.
Action Guidelines
Table 2.
Factors Associated with Young People’s Diet and Physical Activity Levels
Table 3.
Objectives and Strategies to Promote a Healthy Diet and Physically Active
Lifestyle Among Youth
Table 4.
Objectives, Strategies and Examples of Actions Promoting a Healthy Diet
and Physically Active Lifestyle Among Youth
QUEBEC EN FORME
.org
Preamble
This Platform is an updated version of a framework
prepared for Québec en Forme staff in 2008.
Since then, the organization has evolved and developed its knowledge
base. Following its merger with the Société de gestion du Fonds pour la
promotion des saines habitudes de vie, Québec en Forme no longer acts
on an exclusively local basis. Furthermore, since 2002, local partners have
asked us to keep them regularly informed about promising strategies for
sustainable change.
Several studies, events and partners have contributed to our reflection
process: the working group that updated our scientific data; the 2010
Forum on the quality of local interventions; the 2007–2010 report by local
partner groups; the experience gained through our efforts to mobilize local
communities over the past seven years; province-wide projects and various
collaborative projects at different levels, to name but a few.
We’ve focused on data and statistics from Québec,
but also use data from external sources that can be
applied to the Québec context.
We recognize the important role played by parents in encouraging young
people to adopt and maintain healthy eating habits and a physically active
lifestyle. However, in the population approach we have adopted, the family is
not seen as an intervention setting in the same way as schools, childcare programs or neighbourhoods. Campaigns, policies and programs specifically
targeting families can be developed to educate parents and help them access
the opportunities and resources they need to act as role models and support
their children.
3
QUEBEC EN FORME
.org
Introduction
Québec en Forme’s Platform complements the organization’s 2011–2014 Strategic Plan.
Not surprisingly, the contents of the Platform reflect the Strategic Plan’s three main
guidelines for action: mobilizing communities, modifying environments
and changing social norms.
The Platform is a document designed to provide the organization, its staff and its partners (particularly local and regional partners) with common guidelines for strategic, concerted action. This
document aims to clarify—for the many players already working
with youth and those who would like to get involved—the types
of changes Québec en Forme would like to see in young people’s
eating habits and levels of physical activity.
(to which Québec en Forme contributed), and also complements
the Plan d’action gouvernemental de promotion des saines habitudes de vie et de prévention des problèmes reliés au poids 20062012, entitled Investir pour l’avenir [Investing in the future].
This document provides an overview of many of the changes that have taken place in Québec society over the past 20 to
30 years and the various aspects of young people’s environments
that are closely associated with physical activity and nutrition, as
More precisely, in order to increase the percentage of youth,
well as statistics and current/future outcomes. To counter domiparticularly in disadvantaged areas, who adopt and maintain
nant trends and their anticipated effects on
a healthy diet and physically active lifestyle
youth, the Platform includes a series of strateconducive to their healthy development and
This document
gic objectives and examples of actions that can
academic success, all are invited to adopt the
presents a series
be taken by partners in different areas and at difsame short- and medium-term objectives, straferent levels. The many tools offered by Québec
tegies and actions. To successfully respond to
of strategic objectives en Forme to its partners—including coaching,
a challenge of this magnitude requires partexpertise, knowledge transfers, partnerships,
nerships and cooperation among the various
and examples
communication and evaluation support, and
players involved, including youth and parents.
of actions that
financial assistance—are aimed at reversing
There are already a multitude of initiatives
trends that are negatively impacting the lifestycan be taken.
promoting healthy eating and active lifestyles
les of youth and their parents.
in Québec and elsewhere, most of which draw
on the same reference material. Like many of these initiatives,
Our Platform is essentially a canvas on which all are invited to
Québec en Forme’s actions are based on an ecological approach1,
paint an image of the present and future in which young people
which sees young people’s nutrition and physical activity as laracross Québec have a healthy diet and physically active lifestyle.
gely influenced by both individual and environmental factors2.
To make this vision for change a reality, we need to reach a critical
The Platform is in line with the vision for supportive environments
mass of individuals, policy-makers, key players and stakeholders
developed by the Ministère de la Santé et des Services sociaux
dedicated to our youth.
1
The ecological approach toward health promotion and education views health as the dynamic result of interactions between individuals
and their environments or settings (Green et al., 1999).
2
Environments can be analyzed from physical, economic, political and socio-cultural perspectives.
5
1.
PORTRAIT
OF OUR SOCIETY
1.1 Recognizing and understanding
a new reality
1.2 Existing initiatives
1.3 Positive, quantifiable outcomes
1. PORTRAIT
OF OUR SOCIETY
1.1
Recognizing and
understanding a new reality
Most of the people seeking to promote active, healthy living among youth grew up
in a very different world from that of today’s young people. The disappearance
of several frames of reference has altered young people’s eating habits and levels
of physical activity. These trends can be observed in different social sectors
and must be factored into our efforts to find innovative, lasting solutions.
DAILY LIFE FOR PARENTS AND CHILDREN HAS CHANGED A LOT SINCE THE ’70s and ’80s.
For example:
• In 2009, 82% of mothers with at least
one child under the age of 16 were in
the workforce, compared to 33% in
1976 (ISQ, 2011);
• Time spent preparing meals went from
9 hours a week in 1986 down to 5 hours
in 2005 (Pronovost, 2007, p. 26), resulting in, among other things, a loss of
culinary knowledge (Kornelsen, 2009)
and fewer opportunities to develop
cooking skills at home (Health Canada,
2010);
• One in two (213,000) children in Québec
attend childcare programs, where 89%
of their time is spent on sedentary pursuits (Pate et al., 2008);
• Between 37% and 50% of youth regularly eat in front of a television or computer (Desrosiers et al., 2005), which
tends to lead them (boys especially)
to eat low-nutrient foods (Marquis and
Wright, 2007);
• Teens spend an average of over 30 hours
per week watching television or in front
of a computer screen (Barnett et al.,
2010).
9
10
Did you know?
There is a convenience
store located within
a 15-minute walk of
two-thirds of Québec
schools5 and a
fast-food restaurant
near one-third of
schools (Robitaille et
al., 2009). In urban
areas, the likelihood
of fast-food
restaurants being
near high schools
is 30 times greater
in disadvantaged
neighbourhoods
(Kestens and Daniel,
2010).
YOUNG PEOPLE CAN BUY FOOD ANYWHERE, ANYTIME,
WHICH MAKES THEM A PRIME TARGET FOR THE FAST-FOOD INDUSTRY.
In addition:
•Young people, particularly teens, skip meals (especially breakfast) and tend
to snack on soft drinks3 or fruit-flavoured drinks, cookies, candy and chips
(Sebastian et al., 2008);
• 14% to 29% of foods eaten by young people are high in fat and salt, and low in
fibre, calcium and phosphorus (Bédard et al., 2010);
• 34% of children aged 6 to 8, and 44% of youth aged 15 to 16, consume snack
foods, candy and soft drinks on a daily basis (Desrosiers et al., 2005);
• More than 60% of adolescents consume energy drinks4. Of this group, 12% drink
them at least once a week (Gaudreault et al., 2008);
• More than 50% of youth consume fewer than 5 servings of fruit and vegetables
per day (Bédard et al., 2010);
• Even though nutrition is covered in health and physical education classes in elementary and high school, many teachers don’t have a clear idea of their role in
this regard, or sufficient time or resources to devote to the topic. In both school
and childcare programs, foodservice employees and youth workers don’t receive adequate nutrition training.
3
Drinks represent almost 20% of calories consumed by children and teenagers
aged 4 to 18 years (Garriguet, 2008).
4
In addition to dependency and sleep disorders, youth are at risk of intoxication or adverse
effects (from simple nausea to serious heart problems) associated with the consumption
of caffeine in these drinks (Dubé et al., 2010).
5
77% in the case of high schools and schools in urban areas or disadvantaged neighbourhoods.
1. PORTRAIT
OF OUR SOCIETY
CHILDREN AS YOUNG AS THREE TO FIVE YEARS OLD DON’T GET
ENOUGH DAILY PHYSICAL ACTIVITY.
And that’s just the tip of the iceberg:
•Free play, which stimulates motor development and is a key learning tool,
continues to decline6, delaying the acquisition of basic motor skills, a predictor
of current and future engagement in sports and physical activity (Barnett et al.,
2009; Lopes et al., 2010);
• In Québec, physical and health education is a compulsory subject for students
at both the elementary and high school levels. However, the time devoted to it7
varies according to the decisions of each school’s governing board (the same
applies to recess and extracurricular physical activities);
• 49% of girls and 26% of boys aged 6 to 11 do less than 60 minutes of moderateto-vigorous physical activity each day (the recommended daily minimum)
(Nolin and Hamel, 2008);
• 65% of teenage girls and 47% of teenage boys don’t reach the recommended
daily minimum (Nolin and Hamel, 2008);
• 34% of children walk or cycle to their elementary school, compared to 80% in
1971, even though 83% of children live within a 1.6-km radius of their school
(Lewis et al., 2009).
As a result of Western influences, Inuit and First Nation communities have
lost many of their culinary traditions, have enormous difficulty obtaining access
to fresh and affordable foods, and are food insecure. In many places, there are
insufficient facilities and activities promoting physical activity, thus favouring
sedentary leisure pursuits.
Another key factor is the evolution of information technologies and marketing
techniques, which reinforce advertising and help to shape social norms that
support or discourage a healthy diet and physically active lifestyle.
Did you know?
The probability of an inactive
10-year-old girl becoming an active
25-year-old is no more than . . . 10%8.
ACCORDING TO RECENT RESEARCH,
CHILDREN FROM LOW-INCOME
FAMILIES:
• Are three times more likely to have never
participated in physical activities or organized sports (Ifedi, 2008);
•Eat less fruits and vegetables than those
from higher-income families (Blanchet et
al., 2009).
In Québec, 4.2% of children under 18
are food insecure (Blanchet and Rochette,
2011).
This brief overview portrays
a worrisome situation,
particularly given the extent
to which physical inactivity
and poor diet are known to have
a negative impact on young
people’s development and health.
Some of these effects are already
evident (weight, self-esteem,
attention, etc.) while others
will become apparent in several
years’ time (cardiovascular
diseases, diabetes, cancer, etc.).
In addition, diet and physical
activity are linked to other
important aspects of young
people’s development,
including social and cognitive
skills, academic success
and well-being.
6
Between 1981 and 1997, free playtime dropped
by 25% due to increased time spent in structured,
often sedentary activities, and less
time spent outdoors (Burdette and Whitaker, 2005).
7
The elementary school curriculum states that
two hours per week should be devoted to health
and physical education. High schools are required
to devote 50 hours per year to health and physical
education for each of the five years of secondary
education.
8
On the Move Handbook. Retrieved May 31, 2011,
from: http://www.caaws.ca/onthemove/pdfs/
stats_2004.pdf.
11
12
1.2
Existing initiatives
Compared to many places around the world, Québec has made great strides
over the past 20 to 30 years.
Although Québec’s population statistics have not improved
much in the past 20 years, important actions have been taken
to promote healthy eating habits and physical activity among
young people. Combined, these initiatives have helped to
moderate the effects of a lifestyle that tends to lessen energy
expenditure and encourage, in more or less subtle ways, an
intake of empty calories. While the following initiatives are
important milestones, we still have a sizeable challenge ahead
of us:
Themed activities and promotional campaigns have also reached a large section of the population, for example: the 5/30
Health and Wellness Challenge (Acti-Menu), the Grand défi
Pierre Lavoie, Nutrition Month (Dietitians of Canada), the Mois
de l’éducation physique et du sport étudiant [Physical education and student sports month] (Réseau du sport étudiant du
Québec), Heart Month (Heart and Stroke Foundation), International Walk to School Month (Vélo-Québec), International No Diet
Day (ÉquiLibre), Kino-Québec and ParticipAction campaigns, etc.
• The Kino-Québec9 program;
• The Bicycle Policy10;
• The Québec Public Health Program 2003-201211;
•The Plan d’action gouvernemental de promotion des saines
habitudes de vie et de prévention des problèmes reliés
au poids 2006-2012, Investir pour l’avenir [Investing in the
future]12;
•Framework Policy on Healthy Eating and Active Living
Going the Healthy Route at School13;
—
• The Healthy Schools approach14;
•The Québec Government’s “vision for a healthy diet,” aimed
at creating health-promoting food environments15;
• Sections 248 and 249 of the Consumer Protection Act prohibiting advertising directed at persons under 13 years;
•The shared vision of environments conducive to healthy
eating and active living, and the prevention of weight-related
problems16.
9
10
11
12
13
14
15
16
Jointly managed by the Ministère de l’Éducation, du Loisir et du Sport, the Ministère
de la Santé et des Services sociaux and health and social service agencies.
Transport Québec, From Fun to Functional: Cycling – A Mode of Transportation in its Own Right, 2008.
Ministère de la Santé et des Services sociaux, 2003.
Ministère de la Santé et des Services sociaux, 2006.
Ministère de l’Éducation, du Loisir et du Sport, 2007.
Initiative geared toward concerted action among schools across the province to promote students’ health, well-being and academic success.
MELS-MESS Agreement, 2003.
Ministère de la Santé et des Services sociaux, 2010.
Ministère de la Santé et des Services sociaux (forthcoming).
1. PORTRAIT
OF OUR SOCIETY
1. PORTRAIT DE
NOTRE SOCIÉTÉ
1.3
Positive,
quantifiable
outcomes
SIGNIFICANT BUT LESS WELL-KNOWN BENEFITS . . .
Sedentary lifestyles and poor nutrition, closely linked with several chronic
diseases, place a heavy financial burden on Québec’s healthcare system. It is
therefore quite natural to want to quantify the eventual financial benefits of
initiatives aimed at re-introducing physical activity and healthy eating habits
into young people’s lives. The gains can be analyzed in terms of healthcare
savings as well as their impact on society and our collective well-being (Ball
et al., 2009). It should be noted that only one-fifth of economic studies target
the creation of health-promoting environments, and those that do tend to
provide insufficient time frames. We know, however, that:
• The $137 million invested since 1991 in the Portland cycling network will
result in healthcare savings of $470 million and savings of up to $218 million
in fuel costs by 2040 (Gotschi, 2011).
• Efforts to increase physical activity in schools can produce 16% of the daily
recommended amount of activity (Wu et al., 2011).
•Urban and waterfront redevelopment (which usually promote walking and
cycling) also generates tax benefits. Within 10 years of the completion of
this type of redevelopment project, Trois-Rivières will receive $1.5 million
per year in tax benefits. The city will also generate an estimated $54 million
per year in tourism revenues (Société de développement économique de
Trois-Rivières, 2005).
•The Véloroute des Bleuets in the Lac-Saint-Jean region attracts 200,000 visitors, generating over $8 million in revenues (Infrastructure Canada, 2010).
•Traditional campaigns, multimedia campaigns and other initiatives are all
helping to change social norms (Dalziel and Segal, 2007).
• Domestic food demand represents nearly $34 billion (12% of total employment in Québec and nearly 7% of Québec’s GDP attributable to bio-food
(MAPAQ Green Paper, 2011)). This sector of the Québec economy has the
potential to make a huge impact on young people’s eating habits.
Promoting a healthy diet and physically active lifestyle is not limited to
these initiatives, which are simply provided as examples to encourage stakeholders who are still hesitant to come on board. Québec en Forme’s Platform
has far more ambitious goals.
13
14
2.
ELEMENTS
TO BUILD ON
2.1 Recommendations on young people’s diet
and physical activity levels
2.2 Sound guidelines for action
2. ELEMENTS
TO BUILD ON
2.
Elements to build on
Stakeholders who are
likely to influence the eating
habits and physical activity
of young people should apply
existing policies, along with
the recommendations
and suggestions put forth
by various parties, including
the Kino-Québec scientific
committee17, the Association
pour la santé publique du
Québec18 and the Ministère
de la Santé et des Services
sociaux19. These players
should also be familiar
with guidelines on nutrient
intake and the amount of
physical activity necessary
for youth. Their interventions
should be based on a clear
set of guidelines and
key markers.
17
18
19
L’activité physique, le sport et les jeunes – Savoir et agir [Physical activity, sports and youth – knowledge and action]. Advisory report by
the Kino-Québec scientific committee (2011).
Weight-Related Problems in Québec: A Call for Action (2005).
Plan d’action gouvernemental de promotion des saines habitudes de vie et de prévention des problèmes de reliés au poids 2006-2012, Investir pour l’avenir
[Investing in the future].
17
18
2.1
Recommendations on
young people’s diet and
physical activity levels
Obviously, young people’s needs vary according to their
age group. These recommendations are primarily aimed at the
adults in charge of young people’s living environments and
the authorities that issue guidelines. Youth aged 0 to 17 years
should be able to:
• eat a variety of foods, with an emphasis on grain products,
vegetables and fruits (rather than juice);
•choose lower-fat dairy products (except for toddlers), leaner
meats and foods prepared with little or no fat;
• limit intake of beverages high in calories and low in nutrients,
and consume salt and coffee20 in moderation (Health Canada,
2007);
• engage in as much physical activity possible; the greater the
amount, intensity and variety of activity, the more beneficial
the effects (Kino-Québec scientific committee, 2011).
20
Energy drinks contain a substantial amount of caffeine.
2. ELEMENTS
TO BUILD ON
2.2
Sound guidelines
for action
Once we decide to take action, it is important to follow basic guidelines, drawn from
experiences here and elsewhere. Some of these guidelines are general in nature,
while others support youth-targeted actions or initiatives in Aboriginal communities.
TABLE 1. Action Guidelines
General21
• Work simultaneously on environments,
society and individuals.
• Form lasting multi- and intersectoral partnerships
at the provincial, regional and local levels
for maximum impact.
• Adopt a multidisciplinary and participatory approach.
• Choose an equitable approach to reduce
social inequalities.
• Ensure that interventions are sustainable.
• Adapt national strategies to local and regional
cultures and realities.
• Base actions on scientific facts and top-quality
research.
• Document, monitor and evaluate strategies
and actions.
• Integrate programs into existing initiatives.
• Develop or support a policy for healthy eating
and active lifestyles.
• Convince decision-makers and the general public
of the importance of increasing political commitment
and resources allocated to healthy, active living.
Youth-targeted22
• Adapt activities to young people’s stage
of development, the context in which they live
and their interests.
• Diversify activities in terms of type, location, times,
contexts, supervision, registration methods, etc.
• Ensure adequate frequency, intensity and continuity.
• Ensure that activities are led by qualified individuals.
• Involve the family in activities to encourage continuity.
• Utilize and optimize existing programs to avoid
duplication.
• Help young people develop knowledge, skills and
a positive attitude, and intervene before problems arise
(i.e., from early childhood).
• Adopt an approach emphasizing young people’s
accountability, responsibility and autonomy
(i.e., develop life habits).
• Focus on fun.
For Aboriginal communities23
• Develop a solid understanding of the history and issues.
• Understand the governance structure of communities.
• Be open to other ways of life.
21
22
23
• Foster identity building.
• Build partnerships with community stakeholders.
• Support communities in their efforts to bring about
sustainable change.
These guidelines are drawn from an analysis of the following documents: the World Health Organization’s Action Plan for Prevention and Control
of Noncommunicable Diseases (2008) and Global Strategy on Diet, Physical Activity and Health (2004); the Toronto Charter for Physical Activity (2010);
Ritenbaugh’s principles (1999); the Plan d’action gouvernemental de promotion des saines habitudes de vie et de prévention des problèmes reliés
au poids 2006-2012, Investir pour l’avenir [Investing in the future] (2006); Curbing Childhood Obesity: A Federal, Provincial and Territorial Framework
for Action to Promote Healthy Weights (2010); and other international health promotion charters.
Malcuit, G. and Pomerleau, A. (2005). Les principes qui se retrouvent dans les pratiques efficaces pour le développement optimal des jeunes enfants
[Principles behind effective practices for the optimal development of young children] Montreal, LEN-UQAM, 17 pages.
Québec en Forme (2011). Résultats préliminaires : Apprentissages en lien avec les communautés autochtones
[Preliminary results: lessons learned with regard to Aboriginal communities].
19
3.
IDEAS ON HOW
TO TAKE ACTION
3.1 Cornerstones of the Platform
3.2 The many factors influencing
young people’s diet and
physical activity levels
3.3 Three objectives, seven strategies:
as simple as ABC!
3.4 Examples of actions according
to different levels of intervention
3.5 One issue, many strategies
3. IDEAS ON HOW
TO TAKE ACTION
3.1
Cornerstones
of the Platform
Québec en Forme’s Platform has several cornerstones: expert models and
recommendations; our experience in mobilizing communities around healthy
nutrition and physical activity for youth; our desire to innovate; and the many
partnerships we’ve established over the years with community organizations,
associations, government agencies, schools, etc.
Québec en Forme recognizes that:
•Initiatives to be developed according to different sectors (transport, education,
agri-food, urban planning, etc.) or living environments (childcare programs,
schools, municipalities, etc.) must be adapted to stakeholders’ ability to act and
the relationships among them.
•Individual factors such as beliefs, attitudes, values and knowledge influence
young people’s behavior, as do their physical, economic, political and sociocultural environments. It is therefore imperative to address both individual and
environmental factors. In both cases, youth are the main focus of our concerns.
All of these elements went into the
creation of the Platform, which sets out,
in a non-prescriptive manner, the range
of strategies to be implemented at different levels, as well as examples of supportive actions. These strategies can help
local communities and project sponsors
adopt a vision for change. Our goal in
Québec is for communities to become
more mobilized and for environments
and social norms to be changed in order
to promote a healthy diet and physically
active lifestyle for youth from birth to
age 17.
• Many of the factors influencing diet and physical activity are interconnected in a
complementary or reciprocal way. It is therefore very important to identify these
factors.
• Physical inactivity and nutrition are complex issues and potential solutions need
to be considered from several angles. We must therefore adopt a multidimensional approach, using more than one strategy to achieve a particular objective.
•The Québec Government has developed a vision of supportive environments24
on which it is important to build. For this vision to become a reality, all parties
(consortiums, promoters, intersectoral committees, local partner groups, etc.)
must have a similar understanding of the factors associated with a healthy diet
and physically active lifestyle.
• Once we have assessed the issues and decided how to address them, we need to
prioritize actions according to their impact, relevance in a given context and potential to bring about change (including timing and opportunities). If the context
in question does not meet these criteria, we need to think in terms of promising
interventions. To facilitate cooperation and avoid reinventing the wheel, all parties must be informed of tools, resources, policies and programs available at the
provincial level and elsewhere.
24
Pour une Vision commune des environnements favorables à l’alimentation, à un mode de vie physiquement actif et à la prévention des problèmes reliés
au poids [For a shared vision of environments conducive to healthy eating and active living, and the prevention of weight-related problems] (forthcoming).
Ministère de la Santé et des Services sociaux.
23
24
3.2
The many factors
influencing young
people’s diet and
physical activity levels
Young people’s diet and physical activity: two lifestyle habits subject
to many influences.
Québec en Forme’s Platform takes into account the many factors likely to influence young people’s diet and physical activity
levels. Some may be modified in the short to medium term,
while others require a more long-term approach, but must still
be factored into planning. The following table presents some
of these factors.
The factors are divided into two types: those related to individuals and those concerning the environment in which they
live. Environmental factors are categorized as physical, economic, political and socio-cultural.
3. IDEAS ON HOW
TO TAKE ACTION
TABLE 2.
Factors Associated with Young People’s Diet and Physical Activity Levels
Individual Factors
• Sex
• Age
• Weight
• Genetics
• Attitudes
• Knowledge
• Beliefs
• Skills
• Stage of development
• Perceived self-efficacy
• Values
• Preferences
• Etc.
Environmental Factors
Physical
• Walkways
• School routes
• Gardens
• Public or seasonal markets
• Supermarkets
• Grocery stores
• Convenience stores
• Restaurants
• Concession stands
• Street vendors
• Vending machines
• Diversity
• Neighbourhood density
and permeability
• Equipment
• Facilities
• Classrooms
• Gyms
• Parks
• Green spaces
• Schoolyards
• Sports facilities
• Bike paths
• Variety and quality of foods
• Portion size
• Frequency on the menu
• Kitchens
• Water fountains
• Dining rooms
• Shelf space
• Etc.
Economic
COST OF:
• Services
• Foods
• Activities
• Programs
• Registration
• Bus passes
• Infrastructure
• Cost of producing, processing
and promoting foods
• Discount coupons
• Taxes
• Tax credits
• Dietary measures
• Financial incentives
• Grants
• Assistance programs
• Etc.
Political
• Legislation
• Policies and regulations related
to food and physical activity
(e.g., local sourcing)
• Parking
• Pedestrian facilities
• Signage
• Leisure and recreation
• Zoning and subdivision
• Schedules
• Public transportation
• Speed limits
• Food policy
• Agricultural policy
• Regional development plan
• Urban planning
• Cycling policy
• Family policy
• Policy on sports and physical activity
• Student code of conduct
• Labelling
• Etc.
Socio-cultural
• Attitudes, beliefs, values of individuals and peers;
community customs and traditions, etc.
• Qualification of youth workers; training and
education programs, etc.
• Social support (support networks, associations, clubs,
groups, leagues, committees, social norms, charters,
social networks, etc.)
• Media campaigns, promotion, advertising, marketing,
soap operas, communication plans, etc.
• Perceived safety (risk of accidents or attacks,
food security, etc.)
• Parental support and guidance, qualified instruction
(school, sports, etc.)
• Available services and activities (relevance, variety
and accessibility)
25
26
3.3
Three objectives,
seven strategies:
as simple as ABC!
Québec en Forme’s Platform will act as a lever when all stakeholders’ objectives
— and corresponding strategies and actions — are focused on a common goal.
It is in this way that our combined efforts are most likely to have far-reaching effects.
The contents of this Platform are
based on an analysis of milestones
reached by our partners over the past
three years, on opportunities identified
through a review of the scientific literature, and on our desire to find innovative solutions for the benefit of young
people.
The Platform proposes three main
objectives with a view to increasing the
percentage of young people, particularly from disadvantaged backgrounds,
who adopt and maintain a healthy diet
and physically active lifestyle, conducive to their full development and academic success.
Each objective includes two or three
strategies to which local, regional and
provincial partners can contribute.
TABLE 3.
OBJECTIVES AND STRATEGIES TO PROMOTE A HEALTHY
DIET AND PHYSICALLY ACTIVE LIFESTYLE AMONG YOUTH
Objectives
Strategies
1. Develop young
people’s skills.
• Give young people and their parents
opportunities to learn and experiment.
• Ensure the quality of initiatives
and activities.
2. Increase access to quality
resources that promote
a healthy diet and
physically active lifestyle.
• Improve service offerings, including
the food supply.
• Improve the built environment.
3. Contribute to the
development of positive
social norms.
• Communicate and raise awareness.
• Actively influence organizations,
networks and decision-makers.
• Mobilize key players across
multiple sectors.
QUEBEC EN FORME
.org
Conclusion:
Olivia’s world
If we all get involved, the daily life of thousands of children could look like
Olivia’s in the near future. This is the story about a little girl named Olivia.
Olivia has plenty of space in her daycare to play, climb and romp
young at heart! For short trips, Olivia and her family either walk
around, no matter the weather or season. Her teachers love taking
or cycle. The village of Saint-Élie-de-Caxton has an elf crossing,
the kids outdoors and Olivia has already developed a strong bond
but Olivia’s neighbourhood has it all: children’s crossings, paths,
with nature. Playing is a key part of her development. She’s taught
roads and strict speed limits, so everyone feels safe! Olivia’s
to listen to her body and feel good about herself. Bees and worms
neighbourhood is well-planned with strict speed limits so people
are the faithful companions of this little gardener who, at the
feel safe. You can always find an excuse to step out for fresh
tender age of four, is adept at using a shovel and rake. What a joy
produce. Olivia and her parents buy plenty of local foods: Mrs.
to pick tomatoes, herbs and other delicious foods in the garden!
Beauregard’s strawberries and Mr. Pépin’s apples are the best!
They’re fresh, smell wonderful and are very colourful. From day
There are plenty of exciting new flavourful foods on offer at local
one, Olivia and her friends have had access
stores and restaurants, and also at celebrations,
to information, activities and an environment
festivals and other public events.
As the days go by,
that naturally leads them to make healthy
At every step, Olivia is accompanied by adults
choices. They don’t just look at pictures—they
she grows, develops who adjust their actions according to her stage
taste, experiment and cook. Olivia already
of development, because they understand that
and masters
knows how to use a potato masher, whisk and
the physical activities she likes are different
vegetable peeler!
from those that appeal to boys, particularly
new skills through
As the days go by, she grows, develops
during adolescence. They turn meal time into
play, fun and
and masters new skills through play, fun and
a fun break, a delight for the senses! No more
discovery, under the watchful eye of wellhurried or distracted eating; people take the
discovery.
trained teachers who know when to intervene
time to savour, talk and enjoy.
and when not to. The adults in Olivia’s life want
Of course, behind all these players lies an invisible web of rules,
her to be involved in choosing activities. With all the time, space,
codes, political and support measures, and other tools which,
equipment and services she needs in her daily life, Olivia can eat
once understood, adopted and implemented, make it increasingly
well, drink water and be physically active.
normal and simple for kids to make healthy choices. In short,
In her neighbourhood, all the places she likes to visit are within
we’ve adapted Olivia’s schedules to today’s family realities and
walking or cycling distance. Drivers know there are lots of children
we’ve overcome major obstacles to the adoption of healthy
and make sure to slow down and respect the rules to ensure
lifestyle habits, such as cost, access, and so on. At school and
their safety. Olivia’s neighbourhood is full of life—in fact, it’s the
in her neighbourhood, opportunities for healthy living abound
greatest neighbourhood in the world! Here, people don’t hesitate
and staff are qualified. Day camps, extracurricular activities,
to greet one another. Moms can easily find areas to breastfeed
scheduled activities, it’s all there! Olivia is happy, healthy and
their babies. In the winter, Olivia’s alleyway is cleared and the
bright as a button. The adults in her life know her future is taking
adults organize carpooling for activities like skating and sledding
shape right now.
between 3 and 6 p.m. It’s lots of fun—for both the young and
29
REFERENCES
QUEBEC EN FORME
.org
Bibliography
Abath A. and G. Demers (2008). Sports collectifs dans le milieu
de l’éducation – Pour recruter et garder les officiels, rouage
essentiel de la pratique sportive [Group sports in educational
settings: recruiting and retaining officials an essential
component]. Report from a study conducted for the Ministère
de l’Éducation, du Loisir et du Sport (MELS). Québec City:
Université Laval.
Active Healthy Kids Canada (2011). 2011 Report Card Overview.
Retrieved May 31, 2011, from: http://www.activehealthykids.ca/
ReportCard/2011ReportCardOverview.aspx.
Dupuis, R. and Doyon, M. Agriculture and Agri-Food Canada,
Agri-Food Trade Service. (2002). The Impact of Bio-Food
Industry Activities in Canada.
Alliance sherbrookoise pour des jeunes en santé (2009).
Portrait des jeunes sherbrookois de 4 à 16 ans en matière
d’alimentation et d’activité physique et sportive – principaux
constats issus du rapport final. [Portrait of Sherbrooke youth
aged 4 to 17 years in terms of eating habits and physical
activity/sports. Final report]. Retrieved August 1, 2011, from:
http://www.quebecenforme.org/a-propos/publications/
portrait-des-jeunes-sherbrookois.aspx.
Auditor General of Québec (2008). “Chapitre 8 : Services de
garde en milieu scolaire“ in the Rapport général à l’Assemblée
nationale pour l’année 2007-2008 [“Chapter 8: School childcare
services” in the National Assembly’s general report 2007-2008].
Retrieved May 31, 2011, from: http://www.sepb.qc.ca/librairies/
sfv/telecharger.php?fichier=1199.
Ball J., M. Desmeules, A. Kwan, L. Jacobsen, W. Luo and
B. Jackson (2009). Investing In Prevention – The Economic
Perspective. Public Health Agency of Canada. Retrieved August
1, 2011, from: www.phac-aspc.gc.ca/ph-sp/pdf/preveco-eng.pdf.
Barnett T.A., J. O’Loughlin, C.M. Sabiston, I. Karp, M. Bélanger,
A. Van Hulst and M. Lambert (2010). “Teens and Screens:
The Influence of Screen Time on Adiposity in Adolescents.“
American Journal of Epidemiology, vol. 172, no 3, pp. 255-262.
Bédard B., L. Dubois, R. Baraldi, N. Plante, R. Courtemanche and
M. Boucher (2010). Les jeunes Québécois à table : regard sur les
repas et collations. Enquête sur la santé dans les collectivités
canadiennes — nutrition 2004 [What are young Quebecers
eating? A look at meals and snacks]. Institut de la statistique du
Québec (ISQ). Retrieved August 1, 2011, from: www.stat.gouv.
qc.ca/publications/sante/pdf2010/nutrition_jeunes_queb.pdf.
Bergeron J.-F., C. Batailler, S. Dostie and V. Lamarche (2007).
Portrait des réseaux de distribution des fruits et légumes
frais du Québec [Portait of the distribution of fresh fruits and
vegetables in Québec]. Agéco Group. Retrieved August 1,
2011, from: www.mapaq.gouv.qc.ca/fr/.../Rapport_Distribution_
Fruitslegumes.pdf.
Bergeron P., S. Rayburn, J. Laguë, Y. Jen, L. Lapierre, E.
Robitaille and J. Stecko (2010). L’impact de l’environnement
bâti sur l’activité physique, l’alimentation et le poids – Avis
scientifique [Impact of the built environment on physical
activity, diet and weight – scientific opinion]. Institut national
de santé publique du Québec (INSPQ). Retrieved August
1, 2011, from: www.inspq.qc.ca/pdf/publications/1108_
ImpactEnvironBati.pdf.
Blanchet, C. (2009). “Coup d’œil sur l’alimentation des
adultes québécois – Résumé du rapport La consommation
alimentaire et les apports nutritionnels des adultes québécois“
[A look at the diet of Québec adults – summary of the report
Food consumption and nutrient intakes of Québec adults].
Institut national de santé publique du Québec (INSPQ).
Retrieved August 1, 2011, from: www.agrireseau.qc.ca/
bovinslaitiers/.../983_NutritionResume_FNL.pdf.
Blanchet, C., C. Plante and L. Rochette (2009). La consommation
alimentaire et les apports nutritionnels des adultes québécois
[Food consumption and nutrient intakes of Québec adults].
Institut national de santé publique du Québec (INSPQ).
Retrieved August 1, 2011, from: www.inspq.qc.ca/pdf/
publications/931_RapportNutritionAdultes.pdf.
Blanchet, C. and Rochette, L. (2011). Sécurité et insécurité
alimentaire chez les Québécois [Food security and insecurity in
Québec]. Institut national de santé publique du Québec (INSPQ).
Brown, W., K. Pfeiffer, K. McIver, M. Dowda, C. Addy and R.
Pate (2009). “Social and environmental factors associated with
preschoolers’ nonsedentary physical activity.”
Child Development, no 80, pp. 45-58.
Building Canada. Job Creation. Profils of Projects in Québec.
Optimization of the Véloroute des Bleuets. Retrieved
November 8, 2010 from: http://www.buildingcanadachantierscanada.gc.ca/regions/qc/qc-proj-fra.html.
Burdette L. and R. Whitaker (2005). “Resurrecting free play
in young children.” Archives of Pediatric Adolescent Medicine,
no 159, p. 46-50.
Caraher, M. and K. Angus (2003). Review of Research on
the Effects of Food Promotion to Children. Glasgow: Center
for Social Marketing, University of Strathclyde. Retrieved
August 1, 2011, from: www.food.gov.uk/multimedia/pdfs/
foodpromotiontochildren1.pdf.
Colley, R., M. Tremblay, S. Cragg, C. Craig, I. Janssen, J. Spence
and D. Willms (2010). 2010 Report Card on Physical Activity
for Children and Youth. Active Healthy Kids Canada. Retrieved
August 1, 2011, from: http://www.activehealthykids.ca/Home.
aspx.
Colman, R. and D. Colin (2000). Cost of Obesity in Quebec.
Retrieved April 21, 2011, from: http://www.gpiatlantic.org/pdf/
health/obesity/que-obesity.pdf.
33
34
Conseil québécois du loisir, Alliance de recherche universitéscommunautés en économie sociale (ARUC-ES) (2007).
“Le loisir accessible : un droit pour tous. Cadre de référence
pour l’accessibilité au loisir” [Access to leisure: everyone’s
right. Framework for leisure access].
Conseil régional de développement de l’île de Montréal
(2003). Rapport d’analyse de la problématique entourant les
services de garde en milieu scolaire pour les 5 à 12 ans lors
des périodes de fermeture scolaire [Analysis of problems
surrounding childcare in schools for children aged 5 to
12 during after-school periods].
Dalziel, K. and L. Segal (2007). “Time to give nutrition interventions a higher profile: cost effectiveness of 10 nutrition interventions.” Health Promotion International, vol. 22, no 4, pp. 271-283.
Demers, S. (2007). Étude sur les activités de promotion de
sports et d’activités physiques menées par les fédérations
sportives québécoises et leurs proches partenaires [Study on
the promotion of sports and physical activities by Québec sports
federations and their partners]. Sports, recreation and physical
activity branch, Ministère de l’Éducation, du Loisir et du Sport.
Desrosiers H, Bédard B, Dubois L, Gray-Donald K and Lachance
B. (2005). Enquête de nutrition auprès des enfants québécois
de 4 ans [Nutritional survey of Québec four-year-olds]. Québec,
Institut de la statistique du Québec (ISQ), 163 pages.
Desrosiers, H. and H. Eid (2007). La pratique d’activités
physiques et sportives en dehors des heures de classe chez
les enfants de 6 ans [The practice of sport and physical
activity outside school hours among 6-year-olds]. Institut de la
statistique du Québec. Retrieved August 1, 2011, from: www.stat.
gouv.qc.ca/publications/sante/pdf2007/portrait_oct07_fr.pdf.
Dubé, P. A. , L. Plamondon and P.Y. Tremblay (2010) Boissons
énergisantes : risques liés à la consommation et perspectives
de santé publique [Energy drinks: risks related to consumption
and public health perspectives]. Institut national de santé
publique du Québec (INSPQ). Retrieved August 1, 2011,
www.inspq.qc.ca/pdf/publications/1167_BoissonsEnergisantes.pdf.
Garriguet, D. (2008). Beverage Consumption of Children and
Teens. Statistics Canada. Retrieved April 7, 2011, from: http://
www.statcan.gc.ca/pub/82-003-x/2008004/article/6500820-eng.pdf.
Gaudreault M, Gagnon M, Arbour N. (2009). Être jeune
aujourd’hui : habitudes de vie et aspirations des jeunes des
régions de la Capitale-Nationale, du Saguenay–Lac-Saint-Jean et
des Laurentides. Série Enquête interrégionale 2008. [Being young
today: lifestyles and aspirations of youth from the CapitaleNationale region, Saguenay–Lac-Saint-Jean and the Laurentians].
Inter-regional study series. ÉCOBES, Cégep de Jonquière.
Gotschi, T. (2011). “Costs and Benefits of Bicycling Investments
in Portland, Oregon.” Journal of Physical Activity and Health,
vol. 8, sup. 1, pp. S49-S58.
Green, L., I. Rootman and B. Poland (1999). Settings for Health
Promotion: Linking Theory and Practice. Thousand Oaks: Sage
publication.
Health Canada (2010). Improving Cooking and Food Preparation
Skills: A Synthesis of the Evidence to Inform Program and Policy
Development. Retrieved August 1, 2011, from: http://www.hc-sc.
gc.ca/fn-an/nutrition/child-enfant/cfps-acc-synthes-eng.php.
Ifedi, F (2005). Sport Participation in Canada, 2005. Statistics
Canada. Retrieved August 1, 2011, from: www.statcan.gc.ca/
pub/81-595-m/81-595-m2008060-eng.pdf.
Institut de la statistique du Québec (ISQ) (2011). Chapter 4:
“Les familles et le marché du travail” [Families and the job
market] in Un portrait statistique des familles au Québec
[A statistical portrait of families in Québec]. Retrieved
April 5, 2011, from: http://www.mfa.gouv.qc.ca/fr/publication/
Documents/SF_Portrait_stat_chapitre4_11.pdf
Kestens, Y. and M. Daniel (2010). “Social inequalities in food
exposure around schools an urban area.” American Journal
of Preventive Medicine, no 39, pp. 33-40.
Kornelsen, S. (2009). “Is that the way the cookie crumbles?
Consumer deskilling in food systems and the journey
toward food sovereignty.” 28th Annual Organic Agriculture
Conference, January 22-25, Guelph. Retrieved August 1, 2011,
from: printfu.org/deskilling.
Labonté, J.F. (2009). Les services de garde en milieu scolaire
(SGMS), de leur création en 1979 au comité ministériel de 2009
[Childcare services in schools, from their creation in 1979 to
the ministerial committee of 2009]. Le Cœur militant, Journal
du personnel en service de garde en milieu scolaire de la FTQ
[FTQ newspaper for school childcare staff].
Lavallée, C. (2004). Enquête sociale et de santé auprès des enfants
et des adolescents québécois — volet nutrition [Social and health
survey of Québec children and youth] Institut de la statistique du
Québec (ISQ). Retrieved August 1, 2011, from: http://www.stat.
gouv.qc.ca/publications/sante/pdf2004/Enq_nutrition.pdf.
Ledoux, M., L. Mongeau and M. Rivard (2002). “Chapitre 14 :
Poids et image corporelle” in Enquête sociale et de santé
auprès des enfants et des adolescents québécois 1999
[“Chapter 14: weight and body image” in the 1999 Social and
health survey of Québec children and youth], Institut de la
statistique du Québec (ISQ). Retrieved August 1, 2011, from:
http://www.stat.gouv.qc.ca/publications/sante/enfant-ado.htm.
Lemieux, M., G. Thibeault, G. Godin, F. Bowen, F. Croteau,
P. Gauthier, L. Gauvin, M. Juneau, S. Laberge, J. Laguë, L.
Lapierre, B. Nolin, A. Tremblay and F. Trudeau (2011). L’activité
physique, le sport et les jeunes – Savoir et agir [Physical
activity, sports and youth – knowledge and action]. Advisory
report by the Kino-Québec scientific committee. Retrieved
August 1, 2011, from: http://www.kino-quebec.qc.ca/avis.asp.
Lewis, P., Y. Bussière, M. Carlier, M. C. Côté, K. Fortin-Lacasse,
S. Gagné, L. Lapierre, M. Lessard, M.J. Thivierge and J. Torres
(2009). Le transport actif et le système scolaire à Montréal et
à Trois-Rivières. Analyse du système d’acteurs concernés par
le transport actif des élèves des écoles primaires du Québec
[Active transportation and the school system in Montreal and
Trois-Rivières. Analysis of stakeholders involved in the active
transportation of elementary school students in Québec].
Retrieved August 1, 2011, from: http://mapageweb.umontreal.
ca/lewisp/GVM rapport final.pdf.
Lopes, V.P., L. Rodrigues, J. Maia and R. Malina (2010). “Motor
coordination as a predictor of physical activity in childhood.”
Scandinavian Journal of Medecine and Science in Sports,
March issue.
QUEBEC EN FORME
.org
Mainville, S., N. Batiotila, B. Bérubé, C. Gilbert, D. Lacasse, C.
Lebossé et al. (2006). Les services de garde en milieu scolaire :
inscrire la qualité au coeur des priorités [Childcare in schools:
making quality a top priority]. Advisory report prepared for
the Ministère de l’Éducation, du Loisir et du Sport. Retrieved
August 1, 2011, from: www.cse.gouv.qc.ca/fichiers/documents/
publications/Avis/50-0452.pdf
Marquis, M. and J. Wright (2007). “Choices and eating
behaviors of children in Québec.” Canadian Journal of Dietetic
Practice and Research, April 2007 issue.
Martinez, S. (2007). The U.S. Food Marketing System: Recent
Developments, 1997-2006. U.S. Department of Agriculture.
Nesle, M. (2002). Food Politics: How the Food Industry
Influences Nutrition and Health. London: University of
California Press.
Nolin, B. and D. Hamel (2008). L’activité physique au Québec
de 1995 à 2005 : gains pour tous… ou presque [Physical activity
in Québec from 1995 to 2005: gains for just about everyone],
under the supervision of M. Fahmy, L’État du Québec 2009 :
tout ce qu’il faut savoir sur le Québec d’aujourd’hui
[The State of Québec 2009: everything you need to know about
contemporary Québec]. Montréal: Fides, pp. 271-277.
Pate, R., K. McIver, M. Dowda, W. H. Brown and C. Addy
(2008) “Directly observed physical activity levels in preschool
children.”Journal of School Health, vol. 78, no 8, pp. 438-444.
Pronovost, G. (2007). Le temps dans tous ses états : temps de
travail, temps de loisirs et temps pour la famille à l’aube du
XXIe siècle [Time in all its forms: working time, leisure time
and family time at the turn of the century]. The Institute for
Research on Public Policy. Retrieved August 1, 2011 from
www.irpp.org/fr/pm/archive/pmvol8no1.pdf.
Pronovost, G., J. Robitaille and C. Payer (2010). Sondage sur
les attitudes des jeunes en regard de la nature et des activités
de plein air. [Survey of young people’s attitudes with regard to
nature and outdoor activities]. Fondation Monique-Fitz-Back
pour l’éducation au développement durable and Établissements
verts Brundtland. Retrieved August 1, 2011, from: www.csq.
qc.net/sites/1676/Rapportpreliminaire.pdf.
Québec Government, ministère de la Famille, des Aînés et de
la Condition féminine (2011). Portrait des services de garde
[Portrait of childcare services]. Retrieved March 31, 2011, from:
http://www.mfa.gouv.qc.ca/fr/services-de-garde/portrait/pages/
index.aspx.
Québec Government (2008). “Regulation to amend the Basic
school regulation for preschool, elementary and secondary
education.” Education Act.
Québec Government (2010). 2010-2011 Budget. For a More
Efficient and Better-Funded Health-Care System. Retrieved
May 6, 2011, from: http://www.budget.finances.gouv.qc.ca/
Budget/2010-2011/en/documents/MoreEfficient.pdf.
Ramsay, J., M. Boisvert and V. Dumas (2010). Analyse
économique du système sportif fédéré québécois [Economic
analysis of Québec’s federated sport system]. Diobri Gestion
Marketing.
Robitaille, E. (2009). Indicateurs géographiques de
l’environnement bâti et de l’environnement des services
influant sur l’activité physique, l’alimentation et le poids
corporel [Geographic indicators of the built environment and
environmental services that affect physical activity, diet and
body weight]. Institut national de la santé publique du Québec
(INSPQ). Retrieved August 1, 2011, from: http://www.inspq.
qc.ca/publications/notice.asp?E=p&NumPublication=1001.
Sebastian, R. S., L. E. Cleveland and J. D. Goldman (2008).
“Effect of snacking frequency on adolescents’ dietary
intakes and meeting national recommendations.”
Journal of Adolescent Health, vol. 42, no 5, pp. 503-511.
Société de développement économique de Trois-Rivières (2005).
Trois-Rivières sur Saint-Laurent : un aménagement urbain et
riverain pour les gens d’ici et d’ailleurs [Trois-Rivières on the St.
Lawrence: urban design and waterfronts for locals and visitors].
Sutton, S. F. and S. Kemp. “Children as partners in neighborhood
placemaking: Lessons from intergenerational design charrettes.”
Journal of Environmental Psychology, no 22, pp. 171-189.
Thibault, A. (2007). Les camps de jour publics : un programme
en révision [Public day camps: a program under review].
Observatoire québécois du loisir. Retrieved May 31, 2011, from:
http://www.loisirmunicipal.qc.ca/userfiles/file/oql_4_13.pdf.
Torres, J. (2009). Children and Cities: Planning to Grow
Together. Contemporary Family Trends. The Vanier Institute
of the Family. Retrieved August 1, 2011, from: http://www.
vanierinstitute.ca/include/get.php?nodeid=317.
Tremblay, D-G. (2003). “Avons-nous besoin de temps?”
[Do we need time?] Policy Options, August 2003, p. 53-57.
Turcotte, M. (2008). Time spent with family during a typical
workday, 1986 to 2005. Statistics Canada. Retrieved August
1, 2011, from: http://www.statcan.gc.ca/pub/11-008-x/2006007/
pdf/9574-eng.pdf.
Turcotte, M. (2005). General Social Survey on Time Use:
Cycle 19. The Time it Takes to Get to Work and Back.
Statistics Canada. Retrieved August 1, 2011 from
http://www.statcan.gc.ca/bsolc/olc-cel/olc-cel?catno=89-622X&CHROPG=1&lang=eng.
World Health Organization (2010). Set of recommendations
on the marketing of foods and non-alcoholic beverages to
children. Retrieved May 31, 2011, from: http://whqlibdoc.who.
int/publications/2010/9789241500210_eng.pdf.
Wrotniak, B. H. , L. Epstein, J. Dorn, K. Jones and V. Kondilis
(2006). “The relationship between motor proficiency and
physical activity in children.” Pediatrics, vol 118, no 6, pp.
1758-1765.
Wu, S., D. Cohen, S. Yuyan, M. Pearson and R. Sturm (2011).
“Economic analysis of physical activity interventions.”
American Journal of Preventive Medicine, vol. 40, no 2, pp.
149-158.
Young, L. and M. Nestle (2007). “Portion sizes and obesity:
Responses of fast-food companies.” Journal of Public Health
Policy, no 28, pp. 238-248.
35
36
Suggested reading
Action Strategies Toolkit (2011). Robert Wood Johnson
Foundation. Retrieved August 1, 2011, from: http://www.
leadershipforhealthycommunities.org/images/stories/LHC_
Action_Strategies_Toolkit_100222[1].pdf.
Curbing Childhood Obesity: A Federal, Provincial and Territorial
Framework for Action to Promote Healthy Weights (2010).
Public Health Agency of Canada. Retrieved August 1, 2011,
from: http://www.phac-aspc.gc.ca/hp-ps/hl-mvs/frameworkcadre/pdf/ccofw-eng.pdf.
Global Strategy on Diet, Physical Activity and Health (2004).
World Health Organization. Retrieved August 1, 2011, from:
http://www.who.int/dietphysicalactivity/strategy/eb11344/
strategy_french_web.pdf.
Le rapport du groupe de travail sur l’amélioration des saines
habitudes de vie chez les jeunes (2005) [Report of the working
group on how to improve young people’s lifestyle habits].
Perreault Report.
Local Government Actions to Prevent Childhood Obesity (2009).
Institute of Medicine of the National Academies. Retrieved
August 1, 2011, from: http://www.iom.edu/Reports/2009/LocalGovernment-Actions-to-Prevent-Childhood-Obesity.aspx.
Pan-Canadian Physical Activity Strategy (2004). Coalition for
Active Living. Retrieved August 1, 2011, from: http://www.
activeliving.ca/pdf/PAStrategy%20_Feb%202004.pdf.
Plan d’action gouvernemental de promotion des saines
habitudes de vie et de prévention des problèmes reliés au
poids 2006-2012, Investir pour l’avenir [Government action
plan to promote healthy lifestyles and prevent weight-related
problems – Investing in the future]. Retrieved August 1,
2011, from: http://publications.msss.gouv.qc.ca/acrobat/f/
documentation/2006/06-289-01.pdf.
Policy and Decision Maker Perspectives on Youth Health and
the Built Environment (2009). ENACT project. Retrieved August
1, 2011, from: http://www.ahprc.dal.ca/pdf/enact/Focusgroups_
Sumthemes_12Mar09.pdf.
Pour une vision commune des environnements favorables
à l’alimentation, à un mode de vie physiquement actif et à la
prévention des problèmes reliés au poids (forthcoming). [For
a shared vision of environments conducive to a healthy diet, a
physically active lifestyle and the prevention of weight-related
problems]. Ministère de la Santé et des Services sociaux.
Stratégies éprouvées et prometteuses pour promouvoir la
pratique régulière d’activités physiques au Québec [Proven
and promising strategies to promote regular physical activity
in Québec] (2004). Kino-Québec’s scientific committee.
Retrieved August 1, 2011, from: http://www.kino-quebec.qc.ca/
publications/avisstrategies.pdf.
The Québec Charter for a Healthy and Diverse Body Image
(2010). Québec Government. Retrieved August 1, 2011, from:
http://www.ijoinonline.com/en/.
The Toronto Charter for Physical Activity: A Global Call for
Action (2010). Global Advocacy Council for Physical Activity,
International Society for Physical Activity and Health. Retrieved
August 1, 2011, from: http://www.globalpa.org.uk/pdf/
torontocharter-eng-20may2010.pdf.
Vision de la saine alimentation [Vision for a healthy diet] (2010).
Ministère de la Santé et des Services sociaux. Retrieved August
1, 2011, from: http://msssa4.msss.gouv.qc.ca/fr/document/
publication.nsf/4b1768b3f849519c852568fd0061480d/62c2cf260
b418eab852576e400736b7b?OpenDocument.
Weight-Related Problems in Québec: A Call to Action (2005).
Association pour la santé publique du Québec. Retrieved
August 1, 2011, from: http://client.k3media.com/PDF%20
final%20Un%20appel%20%E0%20l’action.pdf.
QUEBEC EN FORME
.org
Glossary
ACCESSIBILITY25: is a term that has several meanings.
For example, in a geographic sense, it refers to:
· the distance between a person’s residence and
the nearest facility;
· the number of sports and recreational facilities
in a given sector or radius;
· the average distance between a person’s residence
and all, or a certain number of facilities.
Accessibility can also be seen from a variety of perspectives:
economic, practical (a set of benefits ), equal opportunity and,
in terms of leisure activity, quality of communication and the
ability to understand and engage in the activity.
STAKEHOLDERS: Professionals, managers, elected officials,
owners, suppliers, researchers etc. Any person who, at a given
time, may be involved in promoting a physically active lifestyle
and healthy diet for young people.
PHYSICAL ACTIVITIES26: All forms of movement accompanied
involving energy expenditure such as supervised and
unsupervised sports, games, recreation, active transportation,
physical education, daily chores, outdoor activities, etc.
HEALTHY FOODS27: Foods of high nutritional value. A healthy
diet emphasizes these foods in terms of frequency and
quantity. There is no such thing as a “healthful” food.
A food in itself cannot contribute significantly to health,
nor can it pose a major risk.
BUILT ENVIRONMENT28: All of the human-built structures and
elements making up our cities and towns, ranging from large
urban areas, to rural development to personal space (includes
indoor and outdoor places).
DIAGNOSIS29: “A diagnosis establishes what you need to know
in order to act. It involves listing a number of observations
without making decisions. The strengths, weaknesses and
potential for development identified during a diagnosis help
to pinpoint the issues that will serve as a reference when
identifying action priorities... A diagnosis of environments
conducive to a healthy diet and physically active lifestyle for
youth focuses on the following aspects: physical (what is
available), economic (costs), political (policies, regulations)
and socio-cultural (norms and beliefs).”
AVAILABILITY: The availability of foods, activities, services
or facilities refers to their presence in a place at a given time,
but not necessarily to their accessibility. Availability is in fact
a prerequisite for accessibility.
ENVIRONMENTS CONDUCIVE TO HEALTHY LIFESTYLE
CHOICES AND THE PREVENTION OF WEIGHT-RELATED
PROBLEMS30: “All of the physical, socio-cultural, political
and economic factors that have a positive influence on diet,
physical activity, body image and self-esteem. These factors
can be part of the micro- or macro-environment and should
be considered in terms of their objective or perceived reality,
as well as the complexity of their interrelationships.”
[Translation]
BODY IMAGE31: “The automatic perception—cognitive and
emotional, conscious and unconscious—that individuals have
of their body, acquired during the course of their development
and through social relationships. To the extent that body image
helps shape people’s self-concept, changing that image will
influence how people see themselves.” [Translation]
YOUTH: Girls and boys aged 0 to 17.
MERCHANDISING: All the methods and techniques relating
to the presentation and promotion of products at points of sale.
PHYSICALLY ACTIVE LIFESTYLE32: “A lifestyle that includes
the safe practice of physical or sports activities for recreation
or transportation.” [Translation]
25
Adaptation from Robitaille (2009) and the Conseil québécois du loisir (2007).
http://www.kino-quebec.qc.ca/publications/PlanActionKino.pdf
27
Inspired by the Vision de la saine alimentation [Vision for a healthy diet], Ministère de la Santé et des Services sociaux (2010).
28
Shum, M. (2010). National Collaborating Centre for Environmental Health. http://ncceh.ca/sites/default/files/CIPHI_NL_2010_Built_Environment_Workshop.pdf
29
Cadre de référence en mobilisation [Mobilization framework] (2011). Québec en Forme.
30
MSSS (2011) – Working paper/ for consultation only.
31
Lachance B, Pageau M and Roy S. (2006). Plan d’action gouvernemental de promotion des saines habitudes de vie et de prévention
des problèmes reliés au poids 2006-2012, Investir pour l’avenir [Investing in the future] .
32
http://www.kino-quebec.qc.ca/publications/PlanActionKino.pdf
26
37
38
SOCIAL NORMS33: “Rules or criteria governing our conduct in
society. A norm is always attached to a behaviour that results
from one or several values, and imposes rules of conduct
with respect to this behaviour. These rules are the object of
consensus in society (or in a particular social group), are rooted
in one or several values (freedom, time-saving, economic
profit, etc.) and make a given form of behaviour acceptable,
desirable or accessible in the eyes of the majority. It is therefore
considered ‘normal’ to behave in such a way. In the case
of a social norm, the behaviour is expected, and this is also
reflected by the existence of positive or negative sanctions.
For example, if individuals or organizations act according
to the expected behaviour, they will receive benefits, rewards
or encouragement from society (or a social group). Conversely,
if they act otherwise, they may be ignored, judged, boycotted,
rejected, etc.” [Translation]
FOOD SUPPLY: All of the available foods in a given setting or
region and their characteristics (quality, quantity, accessibility,
variety, price, taste, psychological and social value, etc.). These
foods are offered by various suppliers: producers, distributors,
importers, parallel food support networks, etc.
SERVICE OFFERINGS: All activities and services in a given
setting or region and their characteristics (type of activities,
conditions of use, animation, facilities and equipment, etc.).
These services are offered by various community stakeholders:
municipality, schools, childcare programs, sports associations,
community organizations, etc. In this document, the food
supply is included in the definition of service offerings.
LOCAL PARTNER GROUPS: Multi-sector groups supported and
funded by Québec en Forme to carry out a strategic plan based
on an assessment of the community’s needs.
HEALTHY DIET34: “A healthy diet consists of a variety of foods
and gives priority to nutrient-dense foods in terms of frequency
and quantity. In addition to their nutritional value, foods have
a pleasurable, cultural or emotional value. A healthy diet refers
to daily, occasional and exceptional foods, as well as portions
adapted to people’s needs. Different environments must have a
food supply in line with their mission, where the proportion of
daily, regular and exceptional foods may vary.” [Translation]
33
Media and health research group, directed by Lise Renaud (2010). Les médias et la santé : de l’émergence à l’appropriation des normes sociales
[Media and health: from the emergence to the appropriation of social norms]. Québec: Presses de l’Université du Québec, 429 pages.
Retrieved February 2010. http://www.grms.uqam.ca/Pages/docs/Livres/Medias_sante_normes_soc_GRMS_2010.pdf
34
Ministère de la Santé et des Services sociaux (2010). Vision de la saine alimentation pour la création d’environnements alimentaires favorables
la santé [Vision for a healthy diet and environments conducive to health]. Québec.
QUEBEC EN FORME
.org
Statistics
SOCIETAL TRENDS
• From 1986 to 2005, the standard
workday increased by an average
of 30 minutes while non-standard
working hours, split shifts and on-call
work became increasingly common
(Turcotte, 2008).
• During school vacations,
202,000 children attend day camps
(Thibault, 2007).
• More than three-quarters of
children (80%) attending after-school
childcare programs spend at least
2.5 hours per day and 3 days
per week there (Conseil régional
de développement de l’Île de Montréal,
2003). These programs employ
12,500 educators and technicians
and staff turnover adversely affects
the quality of childcare service
development (Labonté, 2009).
• The proportion of adults saying they
are pressed for time rose from 23%
in 1992 to 29% in 2005
(Pronovost, 2007).
DIET AND ENVIRONMENT
• A portion of fries in certain fast-food
restaurants increased from 2.4 oz
in 1955 to 6 oz in 2006
(Young and Nestle, 2007).
• The number of processed and
prepared foods has experienced
unprecedented growth since the early
1980s. In 2001, there were 782 new
products in the “quick-to-prepare/
single serving” segment. In 2005,
the industry had almost doubled its
production (Martinez, 2007).
• Young people, especially teenagers,
are eating out more often, especially
in fast-food restaurants where they
consume more calories, fat, sugar
and salt and fewer fruits, vegetables
and dairy products.
• In order to maintain or control their
weight, 15% of young people aged
13 to 16, mostly girls, have skipped
meals (Ledoux and coll., 2002).
• 45% to 60% of youth aged 9 to 16 are
dissatisfied with their body image,
while the majority of them have
a normal or below-normal weight
(Ledoux et al., 2002).
PHYSICAL ACTIVITY
AND ENVIRONMENT
• After school, between 3 and 6 p.m.,
young people spend 92% of their time
in engaged in low-intensity physical
activity or sedentary pursuits. The
majority of parents (72%) say that their
children don’t have access to
supervised physical activity programs
after school (Active Healthy Kids
Canada, 2011).
• More than half (56%) of 6-year-olds
participate less than once a month or
hardly ever in sports with a coach or
instructor (Desrosiers and Eid, 2007).
• In 2006, 20% of elementary schools
did not comply with the ministerial
directive35 on physical education and
health courses (Government of
Québec, 2008)
• While 57% of sports federations are
concentrated within the recreational
sphere36, half spend between 21% and
40% of their budget on competition
and excellence (Ramsey et al., 2010)
and few invest in promoting their
sport (Demers, 2007).
• The lack of referees and judges and
their high quit rates (25% to 30%)
adversely affect the development and
quality of sports, especially in high
school (Abath and Demers, 2008).
There is a similar quit rate among day
camp counsellors: 50% of day camps
don’t retain their counsellors from
one year to the next and 31% have
to accept all applicants through lack
of choice (Thibault, 2007).
• Available physical activities seem
to better meet the needs of boys than
girls; few activities correspond
to the preferences of girls, such as
individual or artistic activities
(Alliance sherbrookoise pour
des jeunes en santé, 2009).
35
A minimum of two hours per week at the elementary level. The minimum amount at the secondary level is 100 hours per year for Cycle 1 and 50 hours
per year for Cycle 2. Schools and governing boards decide whether or not to follow the government regulations.
36
Sports activities fall under four categories: beginner, recreational, competition and excellence
(Plan de développement de la pratique sportive 2009-2013, Quebec).
39