Health Reports
Trends in physical fitness among Canadian adults, 2007 to 2017

by Caroline Y. Doyon, Rachel C. Colley, Janine Clarke, Ian Janssen, Brian W. Timmons, Grant R. Tomkinson, Mark S.Tremblay and Justin J. Lang

Release date: November 17, 2021

DOI: https://www.doi.org/10.25318/82-003-x202101100001-eng

Abstract

Background

The fitness levels of Canadian adults declined substantially between 1981 and the years 2007 to 2009, suggesting a reduction in population health. This paper updates the fitness trends of Canadians aged 20 to 69 years by extending the time period to 2017

Data and methods

The Canadian Health Measures Survey is a repeated cross-sectional survey that is conducted to produce nationally representative health estimates. Descriptive statistics are presented for fitness measures in 2016 and 2017 by age and sex, and trends in fitness were calculated spanning a period of 10 years (2007 to 2017). The associations between fitness measures and meeting the 2020 Canadian physical activity recommendations were also assessed.

Results

From 2007 to 2017, there were few statistically significant changes in the fitness levels of Canadian adults. When all ages were combined, there were declining trends in predicted cardiorespiratory fitness, from 39.5 to 36.7 mL•kg-1•min-1 among men and 34.0 to 32.2 mL•kg-1•min-1 among women. Trends indicated declining flexibility among men. In general, meeting the current Canadian moderate-to-vigorous physical activity recommendation was associated with better fitness, particularly in the categories of predicted cardiorespiratory fitness and body composition.

Interpretation

The periodic assessment of fitness in Canadians provides valuable insight into population health. The present update provides evidence that fitness levels among adults have generally stabilized over the past 10 years. Taken with the reported declines in fitness that occurred from 1981 to the 2007-to-2009 period, this study shows that the fitness of Canadian adults remained low between 2007 to 2009 and 2016 to 2017. It is necessary to explore new ways to help improve the fitness levels of the Canadian population.

Keywords

anthropometry, body composition, cardiorespiratory fitness, flexibility, muscular strength, muscular power

Authors

Caroline Y. Doyon and Janine Clarke are with the Centre for Population Health Data, Statistics Canada. Rachel C. Colley is with the Health Analysis Division, Analytical Studies and Modelling Branch, Statistics Canada. Ian Janssen is with the School of Kinesiology and Health Studies and Department of Public Health Sciences, Queen’s University. Brian W. Timmons is with the Child Health and Exercise Medicine Program, Department of Pediatrics, McMaster University. Grant R. Tomkinson is with the Department of Education, Health and Behavior Studies, University of North Dakota, Grand Forks, North Dakota, United States and Alliance for Research in Exercise, Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia. Mark S. Tremblay is with the Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Institute, Ottawa, Ontario. Justin J. Lang (justin.lang@canada.ca ) is with Centre for Surveillance and Applied Research, Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada and the School of Mathematics and Statistics, Department of Health Sciences, Carleton University.

 

What is already known on this subject?

  • Physical fitness is associated with health among adults.
  • The fitness levels of Canadian adults declined between 1981 and the 2007-to-2009 period.

What does this study add?

  • Few meaningful changes in the fitness levels of Canadian adults occurred between 2007 and 2017. The only exceptions were significant declines in predicted cardiorespiratory fitness among men and women aged 20 to 69 years. There were also significant declines in the flexibility of men for some age groups.
  • Predicted cardiorespiratory fitness was higher in those who met the current Canadian moderate-to-vigorous physical activity recommendation. Measures of body mass index and waist circumference were generally lower in those who met the Canadian physical activity recommendation.

Introduction

Health-related physical fitness refers to an integrated series of characteristics, including cardiorespiratory fitness (CRF), musculoskeletal fitness (strength, power, endurance and flexibility) and adiposity, that collectively describe an individual’s ability to perform physical activity.Note 1 A large body of evidence has shown that aspects of physical fitness, especially CRF and adiposity, are associated with cardiometabolic health and are strong predictors of future morbidity and mortality.Note 2Note 3Note 4Note 5 Since the early 2000s, research has also identified important associations between musculoskeletal fitness and health outcomes. In addition to being used as a proxy for overall and upper limb strength,Note 6Note 7 several studies support the importance of handgrip strength as an indicator of current and future health.Note 8Note 9Note 10Note 11 Research also suggests that handgrip strength is a correlate of bone mineral density and a potential predictor of frailty and fall-related fractures among older adults.Note 12Note 13

Given the link between measures of physical fitness and health, temporal trends in these measures provide insight into overall population health. A recent systematic review identified meaningful declines in CRF among 2,525,827 adults from eight high-income and upper-middle-income countries since the 1980s, which have progressively increased in magnitude in more recent years.Note 14 A similar systematic review reported negligible to small declines in handgrip strength among 2,592,714 adults from 142 high-income and upper-middle-income countries since 2000.Note 15 It is also well established that trends in overweight and obesity among adults have been increasing internationally since the 1980s,Note 16 although there is evidence that this trend has begun to stabilize in industrialized countries such as Canada.Note 17 Between 1981 and 2007 to 2009, the fitness of Canadian adults also declined substantially, while body mass index (BMI), waist circumference and skinfold measurements increased.Note 18Note 19 Updating previous fitness surveillance data could help identify whether more recent trends in the physical fitness of Canadian adults track with reported international trends in physical fitness and adiposity.

The overarching objective of the present study was to provide an update to the Shields et al.Note 18 and Craig et al.Note 19 nationally representative fitness estimates and trends by extending the time period from the years 2007 to 2009 to the years 2016 to 2017. The specific objectives for this study included describing (1) the most recent (2016 to 2017) levels of physical fitness among Canadians aged 20 to 69 years, (2) the temporal trends in fitness among Canadian adults from the years 2007 to 2009 to the years 2016 to 2017, and (3) the relationship between fitness and meeting the Canadian moderate-to-vigorous physical activity (MVPA) recommendation published in 2020.Note 20

Methods

Data source

Data for this study are from cycles 1 (2007 to 2009), 2 (2009 to 2011) and 5 (2016 and 2017) of the Canadian Health Measures Survey (CHMS). Fitness measures were not obtained in cycles 3 and 4 because of the rotation of content within the survey. The CHMS is a repeated cross-sectional survey conducted by Statistics Canada that produces nationally representative data on the health of Canadians.Note 21 The survey is representative of approximately 96% of the Canadian population, excluding residents of Indigenous reserves or Crown lands, residents of institutions, residents of some remote regions, and full-time members of the Canadian Forces.Note 22 Combined response rates of 51.7% for cycle 1,Note 23 55.5% for cycle 2Note 24 and 48.5% for cycle 5Note 25 were observed. Informed written consent was obtained from participants prior to testing. Ethics approval was obtained from the Health Canada and Public Health Agency of Canada Research Ethics Board.Note 26

The CHMS took place in two parts that occurred within eight weeks. First, CHMS respondents participated in a household interview where a detailed health questionnaire was administered. Next, respondents were invited to a mobile examination centre, where fitness and physical measurements were obtained, and an accelerometer was attached to be worn for seven consecutive days to obtain movement behaviour data, including physical activity. The physical fitness assessments were conducted by a specialist certified by the Canadian Society for Exercise Physiology. All respondents were asked about their current health and any use of prescription medications prior to testing. They were also asked to complete the Physical Activity Readiness Questionnaire (PAR-Q) to further assess eligibility for fitness testing. Respondents were asked to adhere to pre-exercise recommendations related to food, alcohol, nicotine, exercise and blood donations. More details on respondent screening for the CHMS can be found elsewhere.Note 23Note 24Note 25

The present study was limited to respondents aged 20 to 69 years who completed at least one fitness measure during cycle 1, 2 or 5 of the CHMS (n = 9,137). For the analysis, respondents were combined into four groups: all ages, 20 to 39 years, 40 to 59 years and 60 to 69 years. Overall, 2,191 adults (24% of the total sample) aged 20 to 69 years did not complete the modified Canadian Aerobic Fitness Test (mCAFT) because of the stringent inclusion criteria. The reasons for exclusion were an affirmative answer to the PAR-Q (n = 933), a contraindication with medication (n = 605), an acute or chronic condition (n = 287), high blood pressure (n =165), a forgotten breathing aid (n = 68), an appointment as a home visit (n = 31), a pregnancy of more than 12 weeks (n = 61), an elevated heart rate (n = 19), or other reasons (n = 22). An additional 290 respondents were unable to complete one full stage of the mCAFT, resulting in an incomplete score. Those who were screened out from the mCAFT were similar across all three cycles of the CHMS (Appendix Table A).

Measures

Fitness measures

Standing height was recorded to the nearest 0.1 cm using a ProScale M235 digital stadiometer (Accurate Technology Inc., Fletcher, United States). Body weight was measured to the nearest 0.1 kg using a Mettler Toledo CW-90/90X terminal scale (Mettler Toledo Canada, Mississauga, Canada). BMI was calculated as weight in kilograms divided by height in metres squared (kg•m-2)

In cycle 1, waist circumference was measured at the midpoint between the iliac crest and the last rib, following the World Health Organization protocol.Note 27 In cycles 2 and 5, the waist circumference protocol changed to the U.S. National Institutes of Health protocol, which used a measurement on a horizontal line at the superior border of the iliac crest at the end of a normal exhalation.Note 28Note 29 A published equation was used to adjust the cycle 1 data to match the measurement protocol from cycles 2 and 5 (men R2 = 0.99; women R2 = 0.98).Note 30 All waist circumference measurements were taken using a Gulick II tape measure with a calibrated tension indicator device (Country Technology, Gays Mills, United States) and recorded to the nearest 0.1 cm.

The mCAFT was used as a submaximal test to predict a respondent’s CRF as V ˙ O 2max MathType@MTEF@5@5@+= feaagKart1ev2aaatCvAUfeBSjuyZL2yd9gzLbvyNv2CaerbuLwBLn hiov2DGi1BTfMBaeXatLxBI9gBaerbd9wDYLwzYbItLDharqqtubsr 4rNCHbGeaGqiVu0Je9sqqrpepC0xbbL8F4rqqrFfpeea0xe9Lq=Jc9 vqaqpepm0xbba9pwe9Q8fs0=yqaqpepae9pg0FirpepeKkFr0xfr=x fr=xb9adbaqaaeGaciGaaiaabeqaamaabaabaaGcbaaeaaaaaaaaa8 qaceWGwbWdayaacaWdbiaad+eapaWaaSbaaSqaa8qacaaIYaGaamyB aiaadggacaWG4baapaqabaaaaa@3BD8@ in mL•kg-1•min-1. Details on the mCAFT protocol are provided elsewhere.Note 19Note 31 In brief, during the mCAFT, respondents were asked to step up and down on two 20.3 cm steps following a set cadence from an audio track that increased with each consecutive three-minute stage. The last stage for women and the last two stages for men were performed using a single 40.6 cm step. The respondent’s starting stage was determined based on age and sex. Heart rate was recorded immediately after each stage, and the test was terminated once a participant’s heart rate reached 85% of their age-predicted maximum heart rate (220 – age). Heart rate was measured using a heart-rate monitor (Polar Electro Canada Inc., Lachine, Quebec, Canada). CRF ( V ˙ O 2max MathType@MTEF@5@5@+= feaagKart1ev2aaatCvAUfeBSjuyZL2yd9gzLbvyNv2CaerbuLwBLn hiov2DGi1BTfMBaeXatLxBI9gBaerbd9wDYLwzYbItLDharqqtubsr 4rNCHbGeaGqiVu0Je9sqqrpepC0xbbL8F4rqqrFfpeea0xe9Lq=Jc9 vqaqpepm0xbba9pwe9Q8fs0=yqaqpepae9pg0FirpepeKkFr0xfr=x fr=xb9adbaqaaeGaciGaaiaabeqaamaabaabaaGcbaaeaaaaaaaaa8 qaceWGwbWdayaacaWdbiaad+eapaWaaSbaaSqaa8qacaaIYaGaamyB aiaadggacaWG4baapaqabaaaaa@3BD8@  in mL•kg-1•min-1) was predicted using estimated oxygen cost during the final stage, body weight in kilograms and age in years.Note 32

Flexibility was assessed using the sit-and-reach test.Note 28 Respondents were first asked to follow a standardized warm-up. Respondents were then asked to sit on a mat with their legs fully extended and the soles of their feet flat against the flexometer (Fit Systems Inc., Calgary, Canada). They stretched as far forward as possible in a steady motion without bending their knees while stretching their arms toward their toes. The results of two trials were recorded to the nearest 0.1 cm, with the better of two kept for analyses.

Muscular strength was assessed as isometric handgrip strength using a Smedley III analog hand dynamometer (Takei Scientific Instruments, Tokyo, Japan).Note 28 Both hands were measured twice, while alternating attempts between each hand. Results were recorded to the nearest kilogram. The best result for each hand was selected and combined to obtain the total handgrip strength score in kilograms. Relative handgrip strength was calculated by dividing the total handgrip strength score by body weight (kg/kg).

Jumping performance (i.e., muscular power) was tested for the first time in cycle 5, using a Leonardo Mechanography® Ground Reaction Force Plate (Novotec Medical GmbH, Pforzheim, Germany). Details on the jumping mechanography procedures and an overview of the predicted variables are available elsewhere.Note 33 In brief, respondents completed a single two-leg jump test, which consisted of a single countermovement jump with arm swing performed in a fluid movement with both feet leaving and landing on the plate simultaneously to achieve maximal jumping height. The respondents repeated the test until three valid trials were completed, with a maximum of five attempts. The trial with the best performance was used in the analysis. The Leonardo Mechanography Ground Reaction Force Plate Research Edition® software (v.4.2.b06.10f) uses force and time data to predict jumping height (m), absolute peak power (kW) and relative peak power (kW per kg of body weight).Note 33 The force plate signal was sampled at a frequency of 400 or 800 Hz. The validity of each trial was initially assessed by the software or manually assessed by a trained kinesiologist. Subsequently, the validity of all trials was confirmed by an external reviewer specialized in jumping mechanography.

Measurement of physical activity

Participants with at least one valid fitness measure and valid accelerometer-measured physical activity (n = 7,136) were included in a subsample analysis to compare the fitness levels of respondents who meet the MVPA recommendation from the new 2020 Canadian 24-hour movement guidelines (150 minutes of MVPA per week, with no bout length requirement) with those who do not meet it.Note 20

Following the visit to the mobile examination centre, eligible respondents were provided with an Actical activity monitor (Phillips Respironics, Oregon, United States). They were instructed to wear the activity monitor on an elasticized belt over their right hip during waking hours for seven consecutive days. Respondents were unable to see their results during the data collection period. The Actical measures and records time-stamped acceleration in all directions, providing an estimate of movement intensity as a count value per minute. A valid day was defined as an accumulation of 10 or more hours of a respondent wearing their activity monitor, and a valid respondent was defined as someone who accumulated a minimum of four valid days.Note 34 To determine daily wear time, non-wear time in minutes was subtracted from 1,440 minutes (24 hours). Non-wear time was defined as at least 60 consecutive minutes of 0 counts, with allowance for one to two minutes of counts between 0 and 100. Average daily and weekly minutes of MVPA were derived in two ways: first, for minutes accumulated in bouts of at least 10 minutes, and second, for all minutes of MVPA (i.e., all accelerometer epochs identified as MVPA). Respondents were classified as having met or not having met the 2020 Canadian 24-hour movement guideline physical activity recommendation of 150 minutes per week of non-bouted MVPA.Note 20 Further details on data reduction procedures and accelerometer data analysis have been published elsewhere.Note 35

Analytical techniques

Age- and sex-specific descriptive statistics for fitness measures were calculated for the most recent cycle of the CHMS (2016 and 2017). Age was divided into three groups, representing young (20 to 39 years), middle-aged (40 to 59 years) and older (60 to 69 years) adults. Pairwise contrasts were used to assess age and sex differences across cycles (i.e., temporal trends) and to examine differences in fitness for those meeting and not meeting the Canadian physical activity guidelines for all three cycles, combined.Note 20 Significance was set at p < 0.05 when comparing the results of those who met the guidelines and those who did not, and it was set at p < 0.01 for all other analyses to account for multiple comparisons. The standardized effect size anchored to cycle 1 (2007 to 2009) was also plotted to help visualize the trends in fitness. The jumping mechanography data were available only for cycle 5, and thus were not included in the fitness trends analysis. All analyses were weighted using survey weights produced by Statistics Canada to account for non-response bias. Bootstrap weights using the balance repeated replication method were used to calculate the 95% confidence intervals (CIs) to account for the complexity of the CHMS sampling design.Note 23Note 24Note 25 Analyses were conducted with SAS version 9.4 (SAS Institute, Cary, United States) and SUDAAN version 11.0.1 (RTI International, Research Triangle Park, United States).

Results

Age and sex differences in physical fitness measures, 2016 and 2017

Descriptive statistics for cycle 5 fitness variables are included in Table 1. All measures of fitness declined with age, except for measures of adiposity, which increased with age. Compared with women, men in all age groups had higher levels of predicted CRF, absolute and relative handgrip strength, jumping height, jumping power, and waist circumference. Women in all age groups had better sit-and-reach flexibility than men. There were no differences between men and women for BMI, except for the group of respondents aged 20 to 39, where men had higher values than women.


Table 1
Age and sex differences for fitness measures, household population aged 20 to 69 years, Canada, 2016 to 2017
Table summary
This table displays the results of Age and sex differences for fitness measures. The information is grouped by Physical fitness measures and sex (appearing as row headers), 20 to 39 years, 40 to 59 years, 60 to 69 years, Number, Mean and 95% confidence interval (appearing as column headers).
Physical fitness measures and sex 20 to 39 years 40 to 59 years 60 to 69 years
Number Mean 95% confidence interval Number Mean 95% confidence interval Number Mean 95% confidence interval
from to from to from to
Predicted cardiorespiratory fitness (ml/kg/min)
Men 447 42.8Table 1 Note  42.2 43.4 404 34.2Table 1 Note †† 32.7 35.8 194 26.0Table 1 Note †† Table 1 Note  23.9 28.0
Women 415 37.9Note ** Table 1 Note  37.0 38.8 383 29.6Note ** Table 1 Note †† 28.2 31.0 197 23.8Table 1 Note †† Table 1 Note  23.1 24.6
Absolute handgrip strength (kg)
Men 525 93.3 88.6 98.0 497 89.3 85.0 93.6 317 78.7Table 1 Note †† Table 1 Note  74.4 83.1
Women 533 55.7Note ** 52.5 59.0 507 53.2Note ** 50.5 55.9 315 49.5Note ** Table 1 Note †† Table 1 Note  47.1 51.8
Relative handgrip strength (kg/kg)
Men 525 1.1Table 1 Note  1.1 1.2 497 1.1Table 1 Note †† 1.0 1.1 317 0.9Table 1 Note †† Table 1 Note  0.9 1.0
Women 533 0.8Note ** 0.8 0.9 507 0.7Note ** 0.7 0.8 315 0.7Note ** Table 1 Note †† Table 1 Note  0.7 0.7
Sit-and-reach flexibility (cm)
Men 512 24.0 22.6 25.4 484 22.3 20.9 23.6 297 18.8Table 1 Note †† Table 1 Note  17.0 20.7
Women 506 30.1Note ** 28.1 32.1 484 28.9Note ** 27.5 30.3 281 28.7Note ** 26.9 30.6
Predicted vertical jumping height (m)
Men 459 0.46Table 1 Note  0.44 0.48 439 0.37Table 1 Note †† 0.36 0.38 247 0.30Table 1 Note †† Table 1 Note  0.29 0.31
Women 442 0.31Note ** Table 1 Note  0.30 0.32 403 0.27Note ** Table 1 Note †† 0.26 0.28 220 0.22Note ** Table 1 Note †† Table 1 Note  0.21 0.23
Absolute jumping peak power (kW)
Men 459 3.96Table 1 Note  3.72 4.20 439 3.38Table 1 Note †† 3.24 3.53 247 2.72Table 1 Note †† Table 1 Note  2.58 2.85
Women 442 2.25Note ** 2.13 2.38 403 2.10Note ** 2.02 2.18 220 1.74Note ** Table 1 Note †† Table 1 Note  1.67 1.80
Relative jumping peak power
(W per kg of body weight)
Men 459 47.5Table 1 Note  45.9 49.2 439 40.1Table 1 Note †† 38.6 41.5 247 32.2Table 1 Note †† Table 1 Note  31.1 33.3
Women 442 34.2Note ** Table 1 Note  32.7 35.7 403 29.2Note ** Table 1 Note †† 28.2 30.2 220 24.2Note ** Table 1 Note †† Table 1 Note  23.0 25.3
Body mass index (kg/m2)
Men 533 26.4Table 1 Note  25.8 27.0 508 27.9Table 1 Note †† 27.2 28.6 330 29.0Table 1 Note †† 28.4 29.5
Women 514 25.7 24.1 27.2 514 28.2 26.8 29.6 326 29.1Table 1 Note †† 28.0 30.2
Waist circumference (cm)
Men 533 91.5Table 1 Note  89.0 93.9 507 97.7Table 1 Note †† 96.0 99.5 329 103.0Table 1 Note †† Table 1 Note  101.4 104.6
Women 517 84.2Note ** 80.3 88.1 515 91.8Note ** 88.0 95.6 328 95.7Note ** Table 1 Note †† 92.7 98.7

Temporal trend in fitness, 2007 to 2017

Fitness did not change substantially among Canadian adults over the 10-year period from 2007 to 2017 (Table 2 and Figure 1). For predicted CRF, there was a significant decline when comparing cycle 5 (2016 and 2017) with cycle 1 (2007 to 2009) for all age groups combined (20- to 69-year-olds) for both men and women. However, when examined separately by age group, the temporal trend of decreasing predicted CRF disappeared. Among men, there were significant declines in sit-and-reach flexibility for all ages combined and for 40- to 59-year-olds when comparing both cycles 2 (2009 to 2011) and 5 (2016 and 2017) with cycle 1 (2007 to 2009). There were no significant temporal changes in the measures of adiposity (BMI and waist circumference) among men and women.


Table 2
Trends in fitness measures by age and sex, household population aged 20 to 69 years, Canada, 2007 to 2017
Table summary
This table displays the results of Trends in fitness measures by age and sex Cycle 1 (2007 to 2009), Cycle 2 (2009 to 2011), Cycle 5 (2016 to 2017), Number , Mean and 95% confidence interval (appearing as column headers).
Cycle 1 (2007 to 2009) Cycle 2 (2009 to 2011) Cycle 5 (2016 to 2017)
Number Mean 95% confidence interval Number Mean 95% confidence interval Number Mean 95% confidence interval
from to from to from to
Predicted cardiorespiratory fitness (ml/kg/min)
All ages
Men 1,034 39.5 38.7 40.3 1,140 38.2 36.9 39.6 1,045 36.7Note * 36.0 37.5
Women 1,160 34.0 33.3 34.6 1,292 32.9 32.3 33.6 995 32.2Note * 31.4 32.9
20 to 39 years
Men 466 44.1 42.9 45.2 486 43.7 42.1 45.3 447 42.8 42.2 43.4
Women 534 38.4 37.4 39.4 586 38.8 38.0 39.7 415 37.9 37.0 38.8
40 to 59 years
Men 418 36.5 35.4 37.7 469 35.3 33.5 37.2 404 34.2 32.7 35.8
Women 480 31.1 30.4 31.9 485 30.1 29.2 31.0 383 29.6 28.2 31.0
60 to 69 years
Men 150 27.6 26.5 28.7 185 26.5 25.4 27.6 194 26.0 23.9 28.0
Women 146 24.1 23.5 24.6 221 24.0 23.2 24.8 197 23.8 23.1 24.6
Absolute handgrip strength (kg)
All ages
Men 1,434 92.7 90.5 95.0 1,497 88.7 85.8 91.6 1,339 89.0 85.1 93.0
Women 1,639 54.1 52.7 55.4 1,748 52.1 50.4 53.9 1,355 53.5 51.0 56.0
20 to 39 years
Men 517 96.8 93.9 99.8 552 92.2 89.0 95.4 525 93.3 88.6 98.0
Women 656 56.1 54.2 58.1 766 53.4 51.0 55.8 533 55.7 52.5 59.0
40 to 59 years
Men 581 92.5 90.3 94.8 609 88.4 84.4 92.4 497 89.3 85.0 93.6
Women 648 54.2 52.9 55.5 608 53.0 51.3 54.7 507 53.2 50.5 55.9
60 to 69 years
Men 336 81.2 78.8 83.5 336 80.5 77.4 83.5 317 78.7 74.4 83.1
Women 335 48.1 46.6 49.6 374 46.7 44.8 48.6 315 49.5 47.1 51.8
Relative handgrip strength (kg/kg)
All ages
Men 1,434 1.1 1.1 1.1 1,497 1.1 1.0 1.1 1,339 1.1 1.0 1.1
Women 1,639 0.8 0.8 0.8 1,748 0.8 0.7 0.8 1,355 0.8 0.7 0.8
20 to 39 years
Men 517 1.2 1.2 1.2 552 1.1 1.1 1.2 525 1.1 1.1 1.2
Women 656 0.8 0.8 0.9 766 0.8 0.8 0.8 533 0.8 0.8 0.9
40 to 59 years
Men 581 1.1 1.0 1.1 609 1.0 1.0 1.1 497 1.1 1.0 1.1
Women 648 0.8 0.8 0.8 608 0.8 0.7 0.8 507 0.7 0.7 0.8
60 to 69 years
Men 336 1.0 0.9 1.0 336 0.9 0.9 1.0 317 0.9 0.9 1.0
Women 335 0.7 0.6 0.7 374 0.7 0.6 0.7 315 0.7 0.7 0.7
Sit-and-reach flexibility (cm)
All ages
Men 1,394 24.2 23.5 24.8 1,462 21.8Note * 20.4 23.2 1,293 22.4Note * 21.5 23.3
Women 1,571 29.3 28.4 30.1 1,659 28.4 27.4 29.4 1,271 29.3 28.3 30.4
20 to 39 years
Men 515 25.4 24.1 26.7 551 22.4 19.6 25.3 512 24.0 22.6 25.4
Women 630 30.6 30.1 31.2 731 29.9 28.4 31.4 506 30.1 28.1 32.1
40 to 59 years
Men 560 25.1 24.0 26.2 591 23.0Note * 21.9 24.1 484 22.3Note * 20.9 23.6
Women 630 28.7 27.1 30.4 593 27.8 26.2 29.5 484 28.9 27.5 30.3
60 to 69 years
Men 319 17.4 16.1 18.7 320 17.0 16.1 18.0 297 18.8 17.0 20.7
Women 311 26.9 25.4 28.5 335 26.1 24.7 27.6 281 28.7 26.9 30.6
Body mass index (kg/m2)
All ages
Men 1,448 27.6 27.2 28.0 1,513 27.4 26.7 28.2 1,371 27.5 27.1 27.9
Women 1,624 26.8 26.0 27.6 1,732 27.1 26.4 27.8 1,354 27.4 26.5 28.3
20 to 39 years
Men 524 26.5 26.2 26.8 556 26.1 25.1 27.1 533 26.4 25.8 27.0
Women 633 25.9 24.7 27.0 737 25.6 24.7 26.6 514 25.7 24.1 27.2
40 to 59 years
Men 582 28.3 27.6 29.0 616 28.1 27.3 28.8 508 27.9 27.2 28.6
Women 654 27.0 26.3 27.8 612 28.0 27.0 28.9 514 28.2 26.8 29.6
60 to 69 years
Men 342 28.5 27.9 29.1 341 29.0 27.8 30.3 330 29.0 28.4 29.5
Women 337 28.7 27.8 29.5 383 28.2 26.9 29.6 326 29.1 28.0 30.2
Waist circumference (cm)
All ages
Men 1,446 96.9 95.6 98.2 1,513 96.0 93.9 98.1 1,369 96.1 94.7 97.5
Women 1,620 89.0 86.9 91.2 1,729 89.6 87.8 91.5 1,360 89.7 87.2 92.2
20 to 39 years
Men 524 92.2 91.1 93.3 555 90.3 87.5 93.1 533 91.5 89.0 93.9
Women 631 85.0 82.4 87.5 737 85.0 82.7 87.3 517 84.2 80.3 88.1
40 to 59 years
Men 581 99.5 97.3 101.6 618 98.3 96.2 100.4 507 97.7 96.0 99.5
Women 652 90.3 88.1 92.5 611 92.1 89.6 94.6 515 91.8 88.0 95.6
60 to 69 years
Men 341 102.8 100.8 104.8 340 103.9 100.3 107.4 329 103.0 101.4 104.6
Women 337 95.8 93.3 98.3 381 93.9 91.0 96.8 328 95.7 92.7 98.7

Figure 1 Temporal trends in physical fitness for 20- to 69-year-old Canadians between 2007 to 2009 and 2016 to 2017

Data Table for Figure 1 
Data table for figure 1
Table summary
This table displays the results of Data table for figure 1 2007 to 2009, 2009 to 2011 and 2016 to 2017 (appearing as column headers).
2007 to 2009 2009 to 2011 2016 to 2017
Predicted cardiorespiratory fitness
Men
20 to 39 0 –0.03 –0.11
40 to 59 0 –0.08 –0.16
60 to 69 0 –0.12 –0.17
Women
20 to 39 0 0.04 –0.05
40 to 59 0 –0.11 –0.16
60 to 69 0 –0.02 –0.05
Absolute handgrip strength
Men
20 to 39 0 –0.12 –0.09
40 to 59 0 –0.11 –0.08
60 to 69 0 –0.03 –0.09
Women
20 to 39 0 –0.09 –0.01
40 to 59 0 –0.06 –0.05
60 to 69 0 –0.09 0.09
Relative handgrip
Men
20 to 39 0 –0.13 –0.13
40 to 59 0 –0.08 –0.06
60 to 69 0 –0.08 –0.14
Women
20 to 39 0 –0.08 0
40 to 59 0 –0.10 –0.12
60 to 69 0 –0.01 0.03
Sit-and-reach flexibility
Men
20 to 39 0 –0.14 –0.06
40 to 59 0 –0.17 –0.23
60 to 69 0 –0.03 0.13
Women
20 to 39 0 –0.04 –0.03
40 to 59 0 –0.05 0.01
60 to 69 0 –0.06 0.14
Body mass index
Men
20 to 39 0 –0.06 –0.02
40 to 59 0 –0.03 –0.06
60 to 69 0 0.07 0.06
Women
20 to 39 0 –0.02 –0.01
40 to 59 0 0.08 0.1
60 to 69 0 –0.04 0.04
Waist circumference
Men
20 to 39 0 –0.08 –0.03
40 to 59 0 –0.05 –0.08
60 to 69 0 0.05 0.01
Women
20 to 39 0 0 –0.03
40 to 59 0 0.06 0.05
60 to 69 0 –0.08 0

Physical activity recommendations and fitness

Associations between fitness measures and meeting the 2020 Canadian MVPA recommendation are presented in Table 3.Note 20 Associations between fitness measures and the 2011 Canadian physical activity recommendation are presented in Supplemental Appendix Tables B-1 and B-2.Note 36 All three CHMS cycles were combined because there were no significant differences between them for the variables of interest. In the combined cycles, 42% of respondents met the 2020 recommendation of 150 minutes per week of MVPA with no bout length requirement. For all ages combined, meeting the recommendation was associated with better overall fitness for all measures except absolute handgrip strength and jumping peak power among men and women. For men aged 60 to 69, meeting the recommendation was associated with reduced absolute handgrip strength.


Table 3-1
Fitness measures by adherence to the 2020 Canadian physical activity recommendations for adults, household population aged 20 to 69 years, 2007 to 2017 - Part 1
Table summary
This table displays the results of Fitness measures by adherence to the 2020 Canadian physical activity recommendations for adults. The information is grouped by Physical fitness measures (appearing as row headers), All ages, 20 to 39 years, Men, Women, Number, Mean and 95% confidence interval (appearing as column headers).
Physical fitness measures All ages 20 to 39 years
Men Women Men Women
Number Mean 95% confidence interval Number Mean 95% confidence interval Number Mean 95% confidence interval Number Mean 95% confidence interval
from to from to from to from to
Predicted cardiorespiratory fitness (ml/kg/min)
Meet 1,241 40.1 39.2 41.1 1,115 35.3 34.7 35.9 569 44.6 43.6 45.6 498 39.4 38.7 40.0
Does not meet 1,286 35.7Note ** 34.9 36.5 1,714 31.4Note ** 30.9 31.9 453 41.4Note ** 40.4 42.5 682 37.2Note ** 36.6 37.8
Absolute handgrip strength (kg)
Meet 1,490 89.9 87.6 92.3 1,320 54.1 52.9 55.3 630 92.3 89.5 95.2 556 55.3 53.7 56.9
Does not meet 1,810 90.2 88.5 91.9 2,445 53.2 52.1 54.2 517 95.8 92.8 98.8 889 55.3 53.5 57.1
Relative handgrip strength (kg/kg)
Meet 1,490 1.1 1.1 1.1 1,320 0.8 0.8 0.8 630 1.2 1.1 1.2 556 0.8 0.8 0.9
Does not meet 1,810 1.1Note ** 1.0 1.1 2,443 0.8Note ** 0.7 0.8 517 1.2 1.1 1.2 889 0.8 0.8 0.9
Sit-and-reach flexibility (cm)
Meet 1,479 24.0 22.8 25.1 1,301 30.7 29.6 31.8 624 25.1 23.3 26.9 549 31.6 30.2 33.1
Does not meet 1,751 21.7Note ** 20.9 22.6 2,346 28.4Note ** 27.7 29.2 515 21.8Note * 19.7 23.9 853 29.8 28.5 31.1
Body mass index (kg/m2)
Meet 1,503 26.4 26.0 26.9 1,318 25.4 24.8 25.9 634 25.5 24.9 26.1 550 25.1 24.2 26.0
Does not meet 1,833 28.2Note ** 27.6 28.7 2,430 27.7Note ** 27.1 28.2 525 27.3Note * 26.0 28.6 856 26.0 25.0 26.9
Waist circumference (cm)
Meet 1,503 92.7 91.4 94.1 1,317 84.5 83.3 85.8 634 88.8 87.2 90.4 549 82.7 80.5 84.9
Does not meet 1,831 99.1Note ** 97.6 100.6 2,432 91.3Note ** 90.0 92.6 525 94.5Note ** 91.4 97.6 857 85.6 83.3 87.8
Predicted vertical jumping height (m)
Meet 415 0.4 0.4 0.4 310 0.3 0.3 0.3 172 0.5 0.4 0.5 116 0.3 0.3 0.4
Does not meet 437 0.4Note ** 0.4 0.4 495 0.3Note ** 0.3 0.3 144 0.5 0.4 0.5 180 0.3 0.3 0.3
Absolute jumping peak power (kW)
Meet 415 3.6 3.4 3.8 310 2.1 2.0 2.3 172 4.0 3.7 4.3 116 2.4 2.2 2.6
Does not meet 437 3.4 3.2 3.5 495 2.1 2.0 2.2 144 4.0 3.8 4.2 180 2.2 2.1 2.3
Relative jumping peak power (W per kg of body weight)
Meet 415 44.2 42.3 46.1 310 32.6 31.2 34.0 172 47.9 45.3 50.4 116 36.5 34.3 38.8
Does not meet 437 39.4Note ** 37.8 40.9 495 29.3Note ** 28.4 30.2 144 46.5 44.0 49.0 180 33.9Note * 32.1 35.6

Table 3-2
Fitness measures by adherence to the 2020 Canadian physical activity recommendations for adults, household population aged 20 to 69 years, 2007 to 2017 - Part 2
Table summary
This table displays the results of Fitness measures by adherence to the 2020 Canadian physical activity recommendations for adults. The information is grouped by Physical fitness measures (appearing as row headers), 40 to 59 years, 60 to 69 years, Men, Women, Number, Mean and 95% confidence interval (appearing as column headers).
Physical fitness measures 40 to 59 years 60 to 69 years
Men Women Men Women
Number Mean 95% confidence interval Number Mean 95% confidence interval Number Mean 95% confidence interval Number Mean 95% confidence interval
from to from to from to from to
Predicted cardiorespiratory fitness (ml/kg/min)
Meet 501 36.3 34.9 37.7 474 32.5 31.8 33.2 171 27.8 26.4 29.3 143 25.8 24.9 26.6
Does not meet 546 34.7 33.7 35.7 689 29.3Note ** 28.6 30.0 287 26.1Note * 25.0 27.1 343 23.4Note ** 22.8 24.0
Absolute handgrip strength (kg)
Meet 610 90.1 87.2 92.9 556 54.1 52.4 55.8 250 77.3 74.7 79.8 208 49.3 47.0 51.5
Does not meet 734 90.6 88.5 92.8 930 53.7 52.6 54.8 559 81.2Note ** 79.0 83.5 626 48.4 47.2 49.5
Relative handgrip strength (kg/kg)
Meet 610 1.1 1.0 1.1 556 0.8 0.8 0.9 250 1.0 0.9 1.0 208 0.7 0.7 0.8
Does not meet 734 1.1 1.0 1.1 929 0.7Note ** 0.7 0.8 559 1.0 0.9 1.0 625 0.7Note ** 0.7 0.7
Sit-and-reach flexibility (cm)
Meet 608 24.0 22.7 25.2 550 29.9 28.2 31.6 247 18.0 16.2 19.8 202 29.7 27.5 31.9
Does not meet 703 23.5 22.4 24.6 908 28.0Note * 27.0 29.0 533 18.1 17.2 19.0 585 27.0 25.7 28.3
Body mass index (kg/m2)
Meet 617 27.5 26.8 28.2 559 25.3 24.7 26.0 252 27.1 26.5 27.6 209 26.7 25.7 27.6
Does not meet 738 28.4 27.8 28.9 938 28.5Note ** 27.7 29.2 570 29.0Note ** 28.4 29.6 636 28.7Note ** 28.0 29.5
Waist circumference (cm)
Meet 617 96.5 94.4 98.6 559 85.4 83.3 87.5 252 97.5 95.6 99.3 209 88.7 86.4 91.0
Does not meet 738 99.9Note * 98.2 101.5 938 93.7Note ** 91.8 95.6 569 104.0Note ** 102.3 105.8 637 95.6Note ** 93.8 97.3
Predicted vertical jumping height (m)
Meet 165 0.4 0.4 0.4 137 0.3 0.3 0.3 78 0.3 0.3 0.3 57 0.2 0.2 0.3
Does not meet 174 0.4 0.4 0.4 193 0.3 0.3 0.3 119 0.3 0.3 0.3 122 0.2 0.2 0.2
Absolute jumping peak power (kW)
Meet 165 3.5 3.3 3.7 137 2.0 2.0 2.1 78 2.7 2.5 2.9 57 1.7 1.6 1.8
Does not meet 174 3.4 3.2 3.6 193 2.2 2.1 2.3 119 2.7 2.5 2.9 122 1.8 1.7 1.9
Relative jumping peak power (W per kg of body weight)
Meet 165 42.5 39.7 45.3 137 30.9 29.2 32.7 78 33.5 31.5 35.5 57 25.7 24.2 27.3
Does not meet Ù 39.1Note * 37.8 40.4 193 28.5Note * 27.2 29.8 119 32.1 30.5 33.8 122 23.8Note * 22.6 25.0

Discussion

The present study provides an update on fitness levels and trends among Canadian adults.Note 18Note 19 This study supports previously documented characteristics in adult physical fitness that indicate that measures of predicted CRF, handgrip strength and jumping power are generally higher in men than in women and decline with age, whereas flexibility is greater in women than in men and remains relatively stable with age for women, while it declines somewhat with age for men.Note 37 Overall, the fitness levels of Canadian adults have not changed substantially in the past 10 years (2007 to 2017), with only small declines in predicted CRF, and declines in flexibility for men only. These results are concerning given the documented declines in fitness that occurred from 1981 to the 2007-to-2009 period.Note 18Note 19 Furthermore, those who met the Canadian physical activity recommendationsNote 20 generally had better levels of fitness than those who did not meet the recommendations, regardless of age or sex.

Temporal trends in physical fitness

In their studies on the fitness trends among Canadian adults from 1981 to the years 2007 to 2009, Craig et al.Note 19 reported a 2.8% to 11.5% decline in predicted CRF, and Shields et al.Note 18 reported increases of 7.1% to 15.1% in BMI and 7.1% to 15.3% in waist circumference among men and women aged 20 to 69 years. These reductions in fitness among Canadian adults since 1981 were concerning because of the potential future health risks associated with low fitness levels.Note 18 The present study identified few substantial changes in fitness from 2007 to 2017, with observed changes in the adverse direction. Although the lack of further decline may be viewed as equating to a public health victory, it must be highlighted that the fitness levels of Canadian adults have not improved in the last decade and remain low compared with fitness levels from 1981. In comparison with health-related cut-points, the mean estimate for predicted CRF from 2016 and 2017 is considered “at risk” for men aged 40 to 69 and women aged 40 to 59.Note 38 In addition, all the mean BMI values from 2016 and 2017 are classified in the overweight category for men and women, and all except for men aged 20 to 39 are considered to have a high waist circumference. Thus, the poor fitness of Canadian adults remains troubling, considering the strong link between low fitness and poor health outcomes among adults.Note 5Note 11

A systematic review by Lamoureux et al.Note 14 reported an international decline in CRF among adults of 1.6% per decade from 1967 to 2016, with all eight included countries demonstrating a decline ranging from 0.6% (Republic of Korea) to 5.5% (Singapore) per decade. The review reported more pronounced declines among men and young adults. The current study identified similar declines that were greater in magnitude among men (7.1%) than women (5.3%) when looking at all age groups combined. However, when looking at specific age groups, this study identified general declines that did not reach statistical significance that may be the result of a reduced sample size. Nonetheless, making meaningful comparisons of the magnitude of the changes observed across individual trend studies remains difficult because of the heterogeneity in the type of test used to assess CRF (i.e., run or walk test, treadmill, or cycle ergometer) and how performance is reported (i.e., predicted or directly measured V ˙ O 2max MathType@MTEF@5@5@+= feaagKart1ev2aaatCvAUfeBSjuyZL2yd9gzLbvyNv2CaerbuLwBLn hiov2DGi1BTfMBaeXatLxBI9gBaerbd9wDYLwzYbItLDharqqtubsr 4rNCHbGeaGqiVu0Je9sqqrpepC0xbbL8F4rqqrFfpeea0xe9Lq=Jc9 vqaqpepm0xbba9pwe9Q8fs0=yqaqpepae9pg0FirpepeKkFr0xfr=x fr=xb9adbaqaaeGaciGaaiaabeqaamaabaabaaGcbaaeaaaaaaaaa8 qaceWGwbWdayaacaWdbiaad+eapaWaaSbaaSqaa8qacaaIYaGaamyB aiaadggacaWG4baapaqabaaaaa@3BD8@ in mL•kg-1•min-1, running time, or running distance). There is certainly a need to work toward an international standard for CRF testing given the strong link between CRF and health outcomes, and its potential utility for population and clinical health surveillance.Note 5

Worldwide, excess adiposity has been considered a pandemic, with a mean increase in BMI of 0.63 kg•m-2 (95% CI: 0.53 to 0.73) among men and 0.59 kg•m-2 (95% CI: 0.49 to 0.70) among women per decade from 1975 to 2014.Note 39 This is equivalent to an average increase in body weight of approximately 1.5 kg each decade. Despite these large temporal increases in BMI at the global level, there is evidence that, similar to the present findings, BMI levels have begun to plateau at high levels in many high-income countries.Note 17Note 40 Similar to BMI, this study has also identified a plateau at high levels in waist circumference among Canadian men and women. These findings are concerning given the strong association between high excess adiposity and an increased risk of all-cause mortality.Note 41

Physical activity recommendations and fitness

The present study found that meeting the physical activity recommendation was generally associated with lower absolute handgrip strength in older adult men. This finding may reflect that physically active older men are generally lighter than physically inactive older men, and that handgrip strength tends to be higher with greater body mass.Note 42 No differences were generally observed in the jumping measures between participants who met or did not meet the physical activity recommendations, with the exception of statistically significant associations between the 2020 recommendationNote 20 and relative jumping peak power. It is possible that these reflect the aerobic nature of the physical activity recommendations, which do not typically involve activities that would increase muscular strength and power. It is also possible, at least for the handgrip strength results, that heavier participants with higher absolute handgrip strength generally did not meet the physical activity recommendations; this is consistent when comparing these findings with relative handgrip strength (i.e., generally in the expected direction). An important area of the current physical activity recommendation that is often overlooked or assessed only via self-reporting in public health surveillance is the muscle strengthening portion (i.e., performing muscle strengthening activities using major muscle groups at least twice a week).Note 43 Future research should investigate the potential use of handgrip strength and jumping mechanography results to help evaluate the muscle strengthening portion of the physical activity recommendation.Note 20 Importantly, jumping mechanography is a new fitness measure in the CHMS that could provide more insight into different health outcomes for Canadians.

Strengths and limitations

An important strength of this study is the use of objective measures of physical fitness and physical activity. The measurement protocol for these measures, with the exception of waist circumference (which was adjusted for), has not changed substantially over the 10-year period, providing a strong basis for estimating temporal trends. It is important to note that the CHMS is a repeated cross-sectional survey that precludes the evaluation of causal relationships. As a result, when assessing the associations between physical activity and physical fitness, it is not possible to determine the direction of the association. Like any national survey, non-response bias may have had an impact on the generalizability of the results. However, the survey weights were calculated to help account for some of the non-response bias. There was also bias associated with the strict screening criteria that were implemented to avoid potential risk associated with the fitness tests. This likely skewed results toward values that would be healthier than those in the general population. For instance, Shields et al.Note 18 found that those who were screened out of data collection for the mCAFT during cycle 1 (2007 to 2009) of the CHMS had a substantially higher BMI than those who completed the test. This was also the case for subsequent cycles of the CHMS, as the inclusion criteria had not changed substantially (see Appendix Table C).

This study provides an update on the levels of and temporal trends in the fitness of Canadian adults by examining 10 years of data from 2007 to 2017. Few substantial changes in the fitness trends of Canadians were found. Exceptions included declining trends in predicted CRF when pooling all age groups for both men and women, and a general decline in flexibility among men. Fitness measures were also generally associated with meeting the Canadian physical activity recommendations, especially for predicted CRF, BMI and waist circumference. Continued monitoring of national fitness levels provides valuable insight into the general health of the Canadian population. Given the continued low levels of fitness relative to values observed in 1981, further action is needed to help Canadian adults improve their fitness..

Appendix


Appendix Table A
Percentage distribution of response outcomes for fitness tests by age, sex and cycle, household population aged 20 to 69 years, Canada
Table summary
This table displays the results of Percentage distribution of response outcomes for fitness tests by age Cycle 1, Cycle 2 and Cycle 5, calculated using number and percent units of measure (appearing as column headers).
Cycle 1 Cycle 2 Cycle 5
number percent number percent number percent
Cardiorespiratory fitness
Screened in—test done 2,194 73.0 2,432 74.8 2,040 73.6
Screened in—test not done 54 1.8 139 3.6 97 2.2
Screened out 854 25.1 714 21.7 623 24.2
Grip strength
Screened in—test done 3,073 99.2 3,245 98.5 2,694 98.6
Screened in—test not done 18 0.6 26 0.9 27 0.7
Screened out 11 0.2 14 0.6 39 0.8

Appendix Table B-1
Physical fitness measures by adherence to the 2011 Canadian Physical Activity Guidelines for adults and older adults, household population aged 20 to 69 years, 2007 to 2017 - Part 1
Table summary
This table displays the results of Physical fitness measures by adherence to the 2011 Canadian Physical Activity Guidelines for adults and older adults. The information is grouped by Physical fitness measures and sex (appearing as row headers), All ages, 20 to 39 years, Men, Women, Number, Mean and 95% confidence interval (appearing as column headers).
Physical fitness measures and sex All ages 20 to 39 years
Men Women Men Women
Number Mean 95% confidence interval Number Mean 95% confidence interval Number Mean 95% confidence interval Number Mean 95% confidence interval
from to from to from to from to
Cardiorespiratory fitness: predicted maximal aerobic power (ml/kg/min)
Meets CPAG 424 40.00 38.60 41.40 429 34.80 33.80 35.80 163 44.70 42.70 46.80 170 40.20 38.90 41.40
Does not meet CPAG 2,103 37.50Note ** 36.90 38.20 2,400 32.70Note ** 32.30 33.10 859 43.00 42.20 43.90 1,010 37.90Note ** 37.50 38.40
Absolute strength: handgrip strength (kg)
Meets CPAG 515 86.70 84.40 88.90 519 53.20 51.10 55.30 183 86.70 83.10 90.40 191 54.60 51.70 57.40
Does not meet CPAG 2,785 90.70Note ** 89.00 92.50 3,246 53.60 52.60 54.50 964 95.50Note ** 93.30 97.80 1,254 55.40 53.80 57.00
Relative strength: handgrip strength (grip in kg: body weight in kg)
Meets CPAG 515 1.10 1.10 1.10 519 0.80 0.80 0.80 183 1.10 1.10 1.20 191 0.80 0.80 0.90
Does not meet CPAG 2,785 1.10 1.10 1.10 3,244 0.80 0.80 0.80 964 1.20 1.10 1.20 1,254 0.80 0.80 0.90
Flexibility: sit-and-reach (cm)
Meets CPAG 511 23.70 21.20 26.20 510 30.40 28.60 32.20 182 24.80 20.10 29.40 188 32.20 30.00 34.30
Does not meet CPAG 2,719 22.60 22.10 23.20 3,137 29.10 28.50 29.70 957 23.50 22.30 24.70 1,214 30.40 29.50 31.30
Adiposity: body mass index (kg/m2)
Meets CPAG 518 25.80 25.30 26.40 521 25.40 24.60 26.20 185 24.70 23.80 25.50 190 25.10 23.60 26.50
Does not meet CPAG 2,818 27.60Note ** 27.20 28.10 3,227 27.00Note ** 26.50 27.50 974 26.60Note ** 25.90 27.40 1,216 25.60 24.90 26.40
Adiposity: waist circumference (cm)
Meets CPAG 518 90.90 89.30 92.50 521 84.80 82.50 87.00 185 86.50 84.10 88.80 190 82.20 78.70 85.80
Does not meet CPAG 2,817 97.20Note ** 96.00 98.30 3,245 94.40Note ** 91.80 97.00 974 92.30Note ** 90.50 94.20 1,233 97.10Note ** 90.50 103.70
Muscular power: predicted vertical jump heightAppendix Table B-1 Note †† (m)
Meets CPAG 157 0.38 0.35 0.42 135 0.28 0.25 0.30 50 0.42 0.32 0.52 45 0.33 0.29 0.36
Does not meet CPAG 695 0.40 0.39 0.41 670 0.28 0.27 0.29 266 0.46 0.44 0.49 251 0.32 0.30 0.33
Muscular power: jump peak powerAppendix Table B-1 Note †† (kW)
Meets CPAG 157 3.41 3.12 3.70 135 2.08 1.93 2.23 50 3.74 3.17 4.30 45 2.49 2.21 2.77
Does not meet CPAG 695 3.55 3.41 3.68 670 2.12 2.05 2.18 266 4.02 3.76 4.28 251 2.28 2.14 2.42
Muscular power: jump relative peak powerAppendix Table B-1 Note †† (W/kg of body weight)
Meets CPAG 157 41.57 38.81 44.33 135 30.51 28.39 32.63 50 46.08 40.23 51.94 45 36.14 33.43 38.85
Does not meet CPAG 695 41.99 40.72 43.27 670 30.73 29.84 31.61 266 47.70 45.67 49.74 251 35.00 33.37 36.62

Appendix Table B-2
Physical fitness measures by adherence to the 2011 Canadian Physical Activity Guidelines for adults and older adults, household population aged 20 to 69 years, 2007 to 2017 - Part 2
Table summary
This table displays the results of Physical fitness measures by adherence to the 2011 Canadian Physical Activity Guidelines for adults and older adults. The information is grouped by Physical fitness measures and sex (appearing as row headers), 40 to 59 years, 60 to 69 years, Men, Women, Number, Mean and 95% confidence interval (appearing as column headers).
Physical fitness measures and sex 40 to 59 years 60 to 69 years
Men Women Men Women
Number Mean 95% confidence interval Number Mean 95% confidence interval Number Mean 95% confidence interval Number Mean 95% confidence interval
from to from to from to from to
Cardiorespiratory fitness: predicted maximal aerobic power (ml/kg/min)
Meets CPAG 169 37.50 35.20 39.80 188 32.90 31.60 34.20 92 27.80 25.60 30.00 71 26.20 25.10 27.30
Does not meet CPAG 878 35.10Note * 34.30 35.80 975 30.10Note ** 29.50 30.60 366 26.40 25.40 27.40 415 23.70Note ** 23.30 24.20
Absolute strength: handgrip strength (kg)
Meets CPAG 199 90.70 87.60 93.80 220 53.60 50.30 57.00 133 76.80 73.00 80.60 108 48.90 45.20 52.60
Does not meet CPAG 1,145 90.30 88.20 92.50 1,266 53.90 53.00 54.80 676 80.70 78.60 82.80 726 48.60 47.50 49.60
Relative strength: handgrip strength (grip in kg: body weight in kg)
Meets CPAG 199 1.10 1.10 1.10 220 0.80 0.80 0.90 133 1.00 0.90 1.00 108 0.70 0.70 0.80
Does not meet CPAG 1,145 1.10 1.00 1.10 1,265 0.80 0.80 0.80 676 1.00 0.90 1.00 725 0.70Note * 0.70 0.70
Flexibility: sit-and-reach (cm)
Meets CPAG 199 24.80 22.70 26.90 217 28.70 25.70 31.80 130 17.20 14.40 20.00 105 30.50 27.80 33.20
Does not meet CPAG 1,112 23.50 22.70 24.30 1,241 28.60 27.70 29.50 650 18.20 17.40 19.10 682 27.30Note * 26.20 28.40
Adiposity: body mass index (kg/m2)
Meets CPAG 200 27.20 26.10 28.20 222 25.40 24.30 26.40 133 26.50 25.80 27.30 109 26.20 25.10 27.30
Does not meet CPAG 1,155 28.10 27.60 28.60 1,275 27.70Note ** 27.10 28.40 689 28.80Note ** 28.30 29.30 736 28.50Note ** 27.80 29.20
Adiposity: waist circumference (cm)
Meets CPAG 200 95.20 92.50 97.90 222 85.70 82.00 89.50 133 95.30 92.90 97.80 109 87.90 85.30 90.40
Does not meet CPAG 1,155 98.90Note * 97.60 100.20 1,275 91.70Note ** 90.10 93.30 687 103.40Note ** 101.80 104.90 737 94.70Note ** 93.10 96.30
Muscular power: predicted vertical jump heightAppendix Table B-2 Note †† (m)
Meets CPAG 62 0.39 0.37 0.42 60 0.27 0.23 0.31 45 0.31 0.28 0.33 30 0.24 0.21 0.26
Does not meet CPAG 277 0.37 0.36 0.39 270 0.27 0.26 0.28 152 0.30 0.29 0.32 149 0.22 0.21 0.23
Muscular power: jump peak powerAppendix Table B-2 Note †† (kW)
Meets CPAG 62 3.46 3.24 3.69 60 2.01 1.89 2.14 45 2.68 2.40 2.96 30 1.71 1.55 1.87
Does not meet CPAG 277 3.45 3.29 3.60 270 2.14 2.05 2.22 152 2.70 2.55 2.85 149 1.73 1.66 1.81
Muscular power: jump relative peak powerAppendix Table B-2 Note †† (W/kg of body weight)
Meets CPAG 62 41.54 38.90 44.18 60 29.32 26.91 31.73 45 33.11 30.15 36.07 45 33.11 30.15 36.07
Does not meet CPAG 277 40.46 38.87 42.05 270 29.54 28.37 30.71 152 32.52 31.11 33.92 152 32.52Note * 31.11 33.92

Appendix Table C
Adiposity in participants screened in and screened out of the modified Canadian Aerobic Fitness Test, household population aged 20 to 69 years, Canada, 2007 to 2017
Table summary
This table displays the results of Adiposity in participants screened in and screened out of the modified Canadian Aerobic Fitness Test. The information is grouped by Body composition measures and sex (appearing as row headers), Participants screened in the mCAFT, Participants screened out of the mCAFT, Number, Estimate and 95% confidence interval (appearing as column headers).
Body composition measures and sex Participants screened in the mCAFT Participants screened out of the mCAFT
Number Estimate 95% confidence interval Number Estimate 95% confidence interval
from to from to
Adiposity: body mass index (kg/m2)
All ages
Men 3,319 27.1 26.8 27.5 1,013 28.8Note ** 28.0 29.5
Women 3,606 26.4 25.8 27.0 1,104 29.5Note ** 28.7 30.2
20 to 39 years
Men 1,434 26.4 25.9 26.9 179 25.7 24.0 27.5
Women 1,626 25.5 24.7 26.3 258 27.1 25.3 28.9
40 to 59 years
Men 1,338 27.8 27.5 28.1 368 29.2Note ** 28.1 30.2
Women 1,389 27.0 26.3 27.7 391 30.0Note ** 28.8 31.1
60 to 69 years
Men 547 27.5 27.0 28.0 466 30.5Note ** 29.9 31.1
Women 591 27.4 26.6 28.2 455 30.5Note ** 29.7 31.4
Adiposity: waist circumference (cm)
All ages
Men 3,320 94.8 93.7 95.8 1,008 101.5Note ** 99.4 103.7
Women 3,609 87.5 86.0 89.1 1,100 95.8Note ** 94.1 97.4
20 to 39 years
Men 1,434 91.4 89.7 93.1 178 90.8 86.3 95.4
Women 1,628 84.1 82.1 86.2 257 88.3 84.0 92.6
40 to 59 years
Men 1,339 97.2 96.3 98.2 367 102.5Note ** 99.6 105.3
Women 1,389 89.7 87.7 91.6 389 96.7Note ** 94.4 99.1
60 to 69 years
Men 547 99.4 98.0 100.9 463 108.0Note ** 106.3 109.8
Women 592 91.8 89.9 93.7 454 99.8Note ** 97.7 101.9
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