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Background Sleep debt is linked to poor health behaviours, and adolescents may be especially vulnerable to deficit from the mismatch of their late chronotype with socially determined sleep timing. We aimed to investigate the potential association between social jetlag and sugar-sweetened beverages (SSBs) consumption among adolescents. Methods Cross-sectional data from 1031 adolescents (13–18 years) who participated in the population-based British Columbia Adolescent Substance Use Survey in 2012. Regression analysis using interaction terms estimated the associations between social jetlag (using self-reported weekday/weekends sleep times) and odds of SSB intake in girls and boys. Results On average, adolescents reported 1.59 (SD 0.73) hours of social jetlag, but girls had significantly more social jetlag (1.64) than boys (1.52). Most adolescents (84%) reported consuming SSBs, and significantly more boys (87%) than girls (81%); median SSB intake in boys was 1–2 times per week and in girls less than once per week. Significant differences in girls consuming any SSB were seen across levels of social jetlag. The odds of any SSB intake were significantly higher in adolescents with social jetlag between 1 and 2 h [odds ratio (OR): 1.6 (1.14–2.38)] and over 2 h [OR 1.87 (1.11–3.14)], compared with 1 h or less; associations were stronger and only significant in girls. Conclusions This study is the first to show social jetlag is a common sleep deficit that is associated with SSB intake in adolescents, particularly among teen girls. [ABSTRACT FROM AUTHOR]

Objective: To quantify associations between four types of social support and measured adiposity among women and men. Design: The cross-sectional sample from the Canadian Longitudinal Study on Aging (CLSA, 2012–2015). Height, weight and waist circumference (WC) were clinically measured, and perceived availability of informational, tangible, emotional and belonging social supports was self-reported. Setting: Canada. Participants: 28 779 adults aged 45–85 years from the CLSA. Results: All social support types were associated with WC and BMI among women but not among men. Women reporting the lowest informational support had significantly higher mean BMI (28·84 kg/m2 (95 % CI 28·63, 29·05)) and WC (90·81 cm (95 % CI 90·31, 91·30)) compared with women reporting maximum support (respectively, 28·09 kg/m2 (95 % CI 27·88, 28·30) and 88·92 cm (95 % CI 88·43, 89·4)). Women's abdominal obesity was associated with low levels of informational, emotional and belonging support, and women's general obesity with informational and emotional support. Notably, informational and emotional support were associated with both obesity outcomes independent of other supports among women. Only a low level of informational support was significantly independently associated with higher odds of obesity among men. Conclusions: Our study provides novel insights into gender-specific associations between different types of social support and adiposity. Prospective studies are needed to further investigate potential causality of these associations between the specific social supports and future weight status, especially among women. [ABSTRACT FROM AUTHOR]

To gather knowledge and experiences from Squamish Nation citizens to codevelop a model of foraging walks for Indigenous women's heart health. Qualitative study (sharing circles). Vancouver, Canada (virtual). Squamish Nation community members (n = 9), Elders or Knowledge Keepers (n = 5), and researchers (n = 2). Community-led foraging walks as a culturally safe nutrition education strategy. Perspectives and experiences. Content analysis and narrative synthesis. Personal experiences of foraging walks or knowledge of traditional plants were limited for most participants, and all desired to learn more about traditional foods using land-based activities. Participants identified a lack of nutrition education surrounding heart health and common mistreatment and judgment from health professionals. Participants identified important elements of a future Squamish program, including who should be involved, how to implement it, and the most effective temporal and physical setting. All agreed foraging walks help promote 5 dimensions of heart health (physical, emotional, spiritual, mental, and social) through physical activity, purposeful nutrition, and connection to community and culture. Findings from the sharing circles were used in the creation of a template for future foraging sessions and contributed to plant identification cards for the whole community. Community-based pilot studies to test foraging walks as a culturally safe and environmental approach to nutrition education and cardiovascular health awareness for Indigenous communities are warranted. Research to examine the similarities and differences across Indigenous groups related to understanding heart health and land-based practices for nutrition education and heart health awareness is needed. [ABSTRACT FROM AUTHOR]

• Changes in close social ties were analysed by gender and socio-demographics. • Close social ties stayed stable for most aging adults, particularly men. • Alterations in close social ties were gendered and socially patterned in women and men. • Adverse marital transitions varied by gender in old and disadvantaged groups. • Adverse accommodation changes varied by gender in old and disadvantaged groups. Close social ties are important for health but these can decline as people age. Moreover, losses of close social ties may be worse for women, older age and low socioeconomic groups. We characterized alterations in both marital status or living arrangement over 6 years by gender, and assessed patterns by age, country of origin, geographic location, education, wealth, and household income. We used three waves of Canadian Longitudinal Study on Aging data on 25,327 adults (45–85 years at baseline) to construct transition variables and multinomial logistic regressions with post-estimated predicted probabilities. Close social ties were stable over time, with most Canadians remaining partnered (77 % of men and 62 % of women) or co-living (82 % of men and 72 % of women). Adverse close social ties over time were gendered and socially patterned, with women 75+ years and of low socioeconomic status (SES) having the greatest risks. Becoming widowed or remaining non-partnered was relatively more likely for women with oldest age (RRR range: 6.08–15.64) or with low SES (RRRs: 2.29–47.06), and for men with oldest age (RRRs: 1.07–8.77) or low SES (RRRs: 2.03–31.72). Becoming or remaining lone-living was relatively more likely for women of oldest age (RRRs: 5.57–8.72) or low SES (RRRs: 2.16–65.78) and also for men of oldest aged (RRRs: 2.33–2.57) or low SES (RRRs: 2.08–49.62). Tailored healthy aging strategies to foster close social connections of women or men in older and low SES groups seems warranted. [ABSTRACT FROM AUTHOR]

• Changes in social activities were examined by gender and socio-demographics. • Social activities declined (especially for women), and 14 % were socially isolated. • Risks of staying isolated varied by gender in old and low-educated adults. • Risks of becoming isolated varied by gender in old and low-educated adults. • Risks of staying less active varied by gender in old and low-income adults. Social isolation matters for health and longevity, but little research examines transitions into or out of social isolation or whether transitions are gendered or socially patterned. We described gender-specific trends in breadth and lack of social participation over 6 years overall and by age, country of origin, geographic location, education, wealth, and household income. We used three waves of CLSA data to evaluate changes in social isolation (0–1 activities) and broad social participation (5+ activities) in adults aged 45–75 (n = 24,788), by gender and socio-demographics, in linear and multinomial logistic regressions with post-estimated predicted probabilities. The number of social activities decreased over time, with greater declines for women. About half the sample (more men than women) stayed not highly socially active (<5 activities) and almost 1 in 5 became not highly socially active. Most adults (77 %) remained not socially isolated and 14 % became or remained socially isolated. Women were more likely than men to remain not highly socially active and less likely to have multiple social isolation transitions. Broad social participation changed over time for several subgroups of women and men, with gender differences notable for income levels. Social disparities in social isolation transitions differed by gender only for education. Older age and socioeconomically disadvantaged adults had higher probabilities of becoming socially isolated or becoming less socially active. Findings indicated the diversity of social activities declined as Canadians age into later life and transitions in both social isolation and social participation differed between genders, especially for specific vulnerable subpopulations. [ABSTRACT FROM AUTHOR]

This study aimed to examine the impact of employment transitions (ETs) on anthropometric changes among middle-aged and older workers (ages 45y+). Using two waves of data from the Canadian Longitudinal Study on Aging, we analyzed the impact of ETs (stayed working, entered retirement, and stopped working) on change in body weight and waist circumference (WC) on continuous scales as well as categories (≥5% cut-off). Analyses were sex/gender-stratified. Women did not show significant weight or WC change that differed across ETs, but estimated directions suggested those who stopped working were more likely to have ≥5% change in weight. Estimated directions of continuous outcomes for women who stopped working relative to continued workers showed less weight gain and more WC gain. Men who retired gained less weight and had smaller WC gain compared to reference. The findings imply that the short-run impact of exiting the labor force may not exacerbate weight gain., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Aim: Prehabilitation for colorectal cancer has focused on exercise-based interventions that are typically designed by clinicians; however, no research has yet been patient-oriented. The aim of this feasibility study was to test a web-based multimodal prehabilitation intervention (known as PREP prehab) consisting of four components (physical activity, diet, smoking cessation, psychological support) co-designed with five patient partners., Method: A longitudinal, two-armed (website without or with coaching support) feasibility study of 33 patients scheduled for colorectal surgery 2 weeks or more from consent (January-September 2021) in the province of British Columbia, Canada. Descriptive statistics analysed a health-related quality of life questionnaire (EQ5D-5L) at baseline (n = 25) and 3 months postsurgery (n = 21), and a follow-up patient satisfaction survey to determine the acceptability, practicality, demand for and potential efficacy in improving overall health., Results: Patients had a mean age of 52 years (SD 14 years), 52% were female and they had a mean body mass index of 25 kg m -2 (SD 3.8 kg m -2 ). Only six patients received a Subjective Global Assessment for being at risk for malnutrition, with three classified as 'severely/moderately' malnourished. The majority (86%) of patients intended to use the prehabilitation website, and nearly three-quarters (71%) visited the website while waiting for surgery. The majority (76%) reported that information, tools and resources provided appropriate support, and 76% indicated they would recommend the PREP prehab programme. About three-quarters (76%) reported setting goals for lifestyle modification: 86% set healthy eating goals, 81% aimed to stay active and 57% sought to reduce stress once a week or more. No patients contacted the team to obtain health coaching, despite broad interest (71%) in receiving active support and 14% reporting they received 'active support'., Conclusion: This web-based multimodal prehabilitation programme was acceptable, practical and well-received by all colorectal surgery patients who viewed the patient-oriented multimodal website. The feasibility of providing active health coaching support requires further investigation., (© 2024 The Authors. Colorectal Disease published by John Wiley & Sons Ltd on behalf of Association of Coloproctology of Great Britain and Ireland.)

Background: Cardiovascular diseases (CVD) are the second leading cause of death in Canada with many modifiable risk factors. Pharmacists at a Canadian university delivered a novel CVD risk management program, which included goal-setting and medication management. Aim: This study aimed to describe what CVD prevention goals are composed of in a workplace CVD risk reduction program, and how might these goals change over time. Methods: A longitudinal, descriptive qualitative study using a retrospective chart review of clinical care plans for 15 patients enrolled in a CVD prevention program. Data across 6 visits were extracted from charts (n = 5413 words) recorded from May 2019-November 2020 and analyzed using quantitative content analysis and descriptive statistics. Results: Behavioural goals were most popular among patients and were more likely to change over the 12-month follow-up period, compared to health measure goals. Behavioural goals included goals around diet, physical activity (PA), smoking, medication, sleep and alcohol; health measure goals centered on weight measures, blood pressure (BP) and blood lipid levels. The most common behavioural goals set by patients were for diet (n = 11) and PA (n = 9). Over time, goals around PA, medication, alcohol and weight were adapted while others were added (e.g. diet) and some only continued. Patients experienced a number of barriers to their goal(s) which informed how they adapted their goal(s). These included environmental limitations (including COVID-19) and work-related time constraints. Conclusions: This study found CVD goal-setting in the pharmacist-led workplace wellness program was complex and evolved over time, with goals added and/or adapted. More detailed qualitative research could provide further insights into the patient-provider goal-setting experience in workplace CVD prevention.

Background/objectives: Evidence supports therapeutic carbohydrate restriction (TCR) for managing appropriate patients with chronic illness, but little is known about TCR prescribing among dietitians. This study evaluated dietitians' knowledge, information use and needs for TCR in Canada., Methods: Registered dietitians (RDs) were recruited (n = 274) from January to December 2020 to collect semi-structured data using an online needs assessment survey (French and English). Descriptive and inferential statistics were used to describe and assess which nine RD practice characteristics predicted TCR prescription in clinical practice., Results: Respondents were located in all provinces and territories in Canada, with few international responses in the sample (3.5%). We found statistically significant differences between RDs who have prescribed TCR or not in four practice characteristics studied: level of knowledge (p < 0.001), reviewing literature (p = 0.02), clinician referrals (p < 0.001) or personal experience (p < 0.001). Multivariable models showed that the odds of prescribing TCR was associated with intermediate/expert knowledge (OR 5.92 [95% CI: 2.26-17.77]), clinician's referral (OR 3.22 [1.73-6.14]) and personal experience, whether a former user (OR 2.24 [1.09-4.72]) or a current user of TCR (OR 9.09 [2.70-42.09]), compared to no knowledge, no referral or no experience., Conclusion: There is a strong link between the use, or lack, of TCR in clinical practice among RDs and their knowledge level, personal experience and clinician referrals/support. Scope exists to develop novel educational tools and resources on scientific evidence for TCR, and increase multidisciplinary teams, so as to better support RDs in Canada to safely implement TCR in appropriate patients with chronic illness., (© 2022. The Author(s), under exclusive licence to Springer Nature Limited.)

Study Objectives: To examine the association between multiple measures of socioeconomic status (SES) and objectively measured obstructive sleep apnea (OSA) in a Canadian pediatric population., Methods: This was a cross-sectional study of 188 children (4-17 years, mean age 9.3 ± 3.5 years) prospectively recruited from two hospital sleep clinics in Canada, using multivariable-adjusted linear and logistic regression of five measures of SES including parental education, income, social class, geographic location, and perceived SES based on the MacArthur Scale of Subjective Social Status, assessed in relation to four polysomnographic OSA variables including apnea-hypopnea index, apnea index, mean oxygen saturation level, and oxygen desaturation index., Results: Overall, low household-level SES appeared to be associated with both frequency (apnea index ≥ 1 events/h) and severity (apnea-hypopnea index ≥ 5 events/h) of OSA in children, with maternal education showing the most consistent and significant associations. Specifically, children with mothers reporting less than high school education had nearly three times the odds of having OSA after controlling factors including body mass index (odds ratio 2.96 [95% confidence interval, 1.05-8.37]), compared to university-educated participants. Consistent associations were also observed for geographic location with less frequency and severity of OSA among nonurban children. Perceived SES was minimally inversely associated with our outcomes., Conclusions: This cross-sectional, multicenter study demonstrated that SES factors are linked to the occurrence and severity of OSA in children. Results indicated the need to incorporate the screening of SES in the diagnostic process of pediatric OSA to provide more targeted intervention and patient-centered care., Citation: Park JW, Hamoda MM, Almeida FR, et al. Socioeconomic inequalities in pediatric obstructive sleep apnea. J Clin Sleep Med . 2022;18(2):637-645., (© 2022 American Academy of Sleep Medicine.)

Background: Associations between social ties and hypertension are poorly understood in women and men. We investigated the association between marital status, living arrangement, social network size and social participation and hypertension by sex/gender., Methods: Cross-sectional analysis of 28 238 middle-age and old-age adults (45-85 years) was conducted using the baseline Canadian Longitudinal Study on Aging Comprehensive cohort data. Blood pressure (BP) was measured using the automated BpTRU device and hypertension was defined as BP more than 140/90 mmHg, or more than 130/80 mmHg in participants with diabetes, self-reported history or receiving antihypertensive therapy., Results: Being nonpartnered, having limited social participation (≤2 social activities per month) or a small social network size was associated with higher odds of having hypertension in women. Odds of hypertension were higher among widowed women [odds ratio 1.33 (95% confidence interval (CI): 1.16, 1.51)] compared with married women. The largest difference in adjusted mean SBP in women was between widowed [3.06 mmHg (95% CI: 2.01, 4.11)], vs. married women. For men, lone-living (vs. coliving) was linked to a lower odds of hypertension [odds ratio 0.85 (95% CI: 0.75, 0.96)] When considering two social ties simultaneously, the adverse associations between nonpartnership (mainly for singles and divorced) and BP were mitigated with increased social participation, especially among women., Conclusion: Social ties appear to be more strongly associated with hypertension in middle and older aged women than men. Women who are nonpartnered or who engage in few social activities and men who are coliving represent at risk groups for having hypertension. Healthcare professionals may need to consider these social factors in addressing risk for hypertension and cardiovascular disease prevention., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)

Objectives: Preventing cardiovascular diseases (CVD) is a public health and policy priority, including for employers. A novel CVD risk management programme that included medication management was delivered by pharmacists to employees of a Canadian university. This qualitative study describes the experiences and perceptions of participants who received individual health consultations in this programme., Methods: A qualitative study design using free-text responses was adopted. Data (5658 words) came from evaluation surveys completed by 119 programme participants were iteratively coded and thematically analysed., Key Findings: We identified four themes characterising participant experiences of pharmacist-led CVD prevention. Theme one was labelled self-efficacy because personalised health information and advice on CVD risk factor management empowered participants to make improvements for their health. Participants expressed a range of positive responses about the longer consultations, supportive communication and safe setting of their pharmacist-led encounters; hence, Theme two is labelled pharmacists' interpersonal skills. The wider context of the programme included a number of enabling factors (Theme three) that either supported or limited participant engagement in the programme. A number of changes to behaviour and health measures were identified and participant suggestions to expand and continue the programme further contributed to perceptions of positive programme impact (Theme four)., Conclusions: This study raises questions about how external resources and broader determinants might enable, or hinder, future programme success and sustainability. It also highlights the need for greater understanding and communication of the importance of primary prevention and the role of pharmacists in CVD risk reduction and workplace health promotion., (© 2020 Royal Pharmaceutical Society.)

Objectives: To quantify the link between four different types of social ties and objective measures of abdominal and general obesity, and to explore their inter-relationships in association with obesity using a gender-sensitive analysis., Methods: A cross-sectional analysis of 28,238 adults (45-85 years) from the baseline Canadian Longitudinal Study on Aging Comprehensive cohort (2012-15). Social ties (marital status, living arrangement, social network size, and social participation) and measured anthropometry (body mass index, waist circumference) were analyzed using linear and logistic regression models with interaction terms conditioned on known confounders., Results: We found that being single, widowed or divorced/separated was associated with worse anthropometric outcomes in women, including higher odds of both abdominal and general obesity, and that associations were enhanced when combined with limited social participation, lone-living and greater social network size. Few clear associations were observed in men. Limited social participation (no social activities at least once/month) among women was associated with larger waist circumference (+4.19 cm [95% CI: 1.86, 6.52]) and higher odds of both abdominal and general obesity. By contrast, associations appeared to be reversed in men: lone-living and smaller social networks were associated with lower odds of obesity, compared to co-living and larger social networks. We also found that more regular social participation can potentially mitigate the adverse associations between non-partnership (single, divorced) and obesity in women. Overall, the combined influence of two types of social tie deficits on excess weight measures was more pronounced in women than men., Conclusions: Results highlight the importance of considering how the role of social ties for obesity prevention may differ for women and men. Frequent social participation and number of social contacts may matter for assessing whether divorced, single or lone-living older women are at risk of obesity while living arrangement and social contacts may matter for obesity in men., Competing Interests: The authors have declared that no competing interests exist.