Heather J A Foulds

• PhD
• Professor (Associate) at University of Saskatchewan

Background Chronic musculoskeletal (MSK) pain disproportionately affects Indigenous Peoples, and rural/remote communities face significant barriers in accessing care. La Loche, a Dene/Métis community in northern Saskatchewan, has limited access to specialized chronic pain management services and specialized health providers. Aims The aim of this n...

Introduction Social support within Indigenous worldviews is recognized as a component of health and has been associated with physical activity and sedentary behaviour. Physical Activity (PA) is a modifiable behaviour that can help reduce risks of disease and benefit many dimensions of health. The purpose of this study was to compare the physical ac...

Historical factors including colonization and ongoing socioeconomic inequities impact Indigenous Peoples’ ability to mitigate chronic disease risks such as achieving recommended physical activity (PA) levels. Reliably assessing, reflecting, and promoting PA participation among Indigenous Peoples may be impacted by a lack of culturally appropriate a...

Indigenous Elder advisors in Pelican Narrows, a Cree community in Northern Saskatchewan, have indicated that Western pain scales may not be responsive tools for pain assessments within their community. This study employed a mixed methods research design that involved two phases. Phase one was the development of a pain scale in collaboration with an...

This final chapter of the Canadian Women’s Heart Health Alliance “ATLAS on the Epidemiology, Diagnosis, and Management of Cardiovascular Disease in Women” presents ATLAS highlights from the perspective of current status, challenges, and opportunities in cardiovascular care for women. We conclude with 12 specific recommendations for actionable next...

Aim To critically explore the value and challenges of combining a traditional methodology (constructivist grounded theory) with a newer approach (Patient-Oriented Research) in nursing research. Overview of the Issue Researchers need to examine novel approaches to research which incorporate the thoughts and ideas of patients and stakeholders in ord...

Despite significant progress in medical research and public health efforts, gaps in knowledge of women’s heart health remain across epidemiology, presentation, management, outcomes, education, research, and publications. Historically, heart disease was viewed primarily as a condition in men and male individuals, leading to limited understanding of...

Women vs men have major differences in terms of risk-factor profiles, social and environmental factors, clinical presentation, diagnosis, and treatment of cardiovascular disease. Women are more likely than men to experience health issues that are complex and multifactorial, often relating to disparities in access to care, risk-factor prevalence, se...

Background: Indigenous Peoples: First Nations, Métis and Inuit, have experienced significant disruptions of physical, mental, emotional and spiritual health and well-being through centuries of ongoing colonization and assimilation. Consequently, breakdown of cultural connections, increasingly sedentary lifestyles and high levels of screen time con...

This chapter summarizes the sex- and gender-specific diagnosis and treatment of acute/unstable presentations and non-acute/stable presentations of cardiovascular disease in women. Guidelines, scientific statements, systematic reviews/meta-analyses, and primary research studies related to diagnosis and treatment of coronary artery disease (CAD), cer...

Background: Indigenous youth in settler nations are susceptible to poor mental health due to complex inter-generational systemic inequities. The purpose of this study is to assess the impact of a culturally-responsive, land-based, active living initiative on the mental health of Indigenous youth. Methods: This study is part of Smart Indigenous Yout...

Consideration of sex, hormonal status, and pregnancy history must all be included in the CV risk assessment, and diagnosis and treatment of women with CVD. Menstruation onset and characteristics, hypertensive or diabetic pregnancy complications, and menopausal timing and treatments are all contributory to CV health and/or disease. An awareness of i...

Fibromyalgia is a serious condition, encompassing a wide range of symptoms. Chronic widespread nonarticular pain is the main symptom and other common, but not universal, symptoms include fatigue (~90% of individuals), sleep disturbances, mood disorders such as anxiety and depression (~75% of individuals), and cognitive dysfunction. Physical activit...

Colonization impacts Indigenous Peoples’ way of life, culture, language, community structure and social networks. Links between social determinants of health and physical activity (PA) among Indigenous Peoples in Saskatchewan, with 16% Indigenous residents, are unclear. This cross-sectional study, guided by Indigenous Community Advisors, compared m...

Background: Aerobic exercise is recommended for reducing blood pressure; however, recent studies indicate that stretching may also be effective. The authors compared 8 weeks of stretching versus walking exercise in men and women with high-normal blood pressure or stage 1 hypertension (ie, 130/85-159/99 mm Hg). Methods: Forty men and women (61.6...

This Atlas chapter summarizes the epidemiology of cardiovascular disease (CVD) in women in Canada, discusses sex and gender disparities, and examines the intersectionality between sex and other factors that play a prominent role in CVD outcomes in women, including gender, Indigenous identity, ethnic variation, disability, and socioeconomic status....

Background: Sleep is an important component of health. Sleep disturbance increase in women as they enter the menopause. Physical activity has been associated with improved sleep among older populations. The purpose of this study is to determine if physical activity and/or physical fitness are associated with sleep quantity and quality in middle-ag...

Background: North American indigenous populations experience higher rates of obesity and chronic disease compared with nonindigenous populations. Improvements in musculoskeletal fitness can mitigate negative health outcomes, but is not well understood among indigenous populations. This review examines musculoskeletal fitness measures among North A...

Cultural connectedness has been associated with increased self-esteem and mental health among Indigenous Peoples. Physical activity is an important contributor to health, although the importance of culture as a determinant of physical activity for Indigenous Peoples in Canada is unclear. The purpose of this study is to evaluate differences in cultu...

Indigenous athletes living in remote or rural areas, interested in pursuing sport at elite levels, often relocate from their home communities to urban “mainstream” centres. The purpose of this qualitative case study was to explore the psychological well-being and multicultural adjustment experiences of two relocating First Nations athletes. Convers...

Flexibility exercise training for adults with fibromyalgia This review summarizes the effects of flexibility exercise for adults with fibromyalgia. What problems do fibromyalgia cause? People with fibromyalgia have persistent, widespread body pain. They may also have fatigue, anxiety, depression, and sleep difficulties. What is flexibility exercise...

Objective: This study examined trajectories of trunk fat mass (FM) accrual during emerging adulthood of individuals categorized, at 36 years of age, as having higher compared with lower scores of (1) metabolic risk and (2) blood pressure risk. Methods: Fifty-five individuals from the Saskatchewan Pediatric Bone Mineral Accrual Study (1991-2017)...

Background: The prevalence of overweight and obesity doubles between adolescence and young adulthood. However, the exact age, and appropriate metric to use, to identify when overweight develops is still debated. Aim: To examine the age of onset of overweight by sex and four metrics: body mass index (BMI), fat mass (%FM), waist circumference (WC) an...

Objective: Indigenous populations experience greater proportions of cardiovascular disease, diabetes, and obesity, though lower rates of hypertension. This investigation evaluated blood pressure relationships with vascular measures, anthropometry, cultural identity, and smoking status among Canadian Indigenous and European adults. Methods: In 20...

Limited understanding of Indigenous adults’ cardiovascular structure and function exists despite high rates of cardiovascular disease. This investigation characterised cardiovascular structure and function among young Indigenous adults and compared to age- and sex-matched European descendants. Echocardiographic assessments included apical two- and...

Indigenous populations experience health disparities including increased obesity, diabetes and cardiovascular disease rates. Cardiorespiratory fitness is beneficial for maintaining positive health outcomes. The objective of this systematic review is to evaluate cardiorespiratory fitness among Indigenous populations including comparisons across gend...

Objectives: Emerging adulthood, a potential critical period, is an understudied period of fat mass accrual. The aim of this study was to describe patterns of fat mass accrual, and weight status, from adolescence, through emerging adulthood, into young adulthood. Methods: One-hundred-eighteen participants (59 male) were measured repeatedly for 20...

Exercise hypertension is a common occurrence among individuals with aortic coarctation. Although exercise is known to be beneficial among the general population, the risks and benefits of exercise among those with aortic coarctation are less clear. This systematic review evaluates the benefits and risks of exercise for persons with aortic coarctati...

Background Exercise training is commonly recommended for individuals with fibromyalgia. This review is one of a series of reviews about exercise training for people with fibromyalgia that will replace the “Exercise for treating fibromyalgia syndrome” review first published in 2002. Objectives • To evaluate the benefits and harms of aerobic exercise trai...

Background: Exercise training is commonly recommended for individuals with fibromyalgia. This review is one of a series of reviews about exercise training for people with fibromyalgia that will replace the "Exercise for treating fibromyalgia syndrome" review first published in 2002. Objectives: • To evaluate the benefits and harms of aerobic exe...

Background: Cardiovascular disease disproportionately affects North American Indigenous populations. Ethnic differences in cardiac responses to exercise are known, though Indigenous populations response is unknown. To evaluate cardiac responses to aerobic exercise among Canadian Indigenous and European adults. Methods: Indigenous (N = 12, 4 fema...

Screen time (computer, television, video game and smartphone/tablet activity) is associated with increased obesity and other health risks. This systematic review evaluates screen time among North American Indigenous populations and compares it with that of North American Europeans. Electronic databases (e.g. MEDLINE and EMBASE) were searched, and c...

Poster presentation (published abstract)

Indigenous populations currently experience greater cardiovascular disease burdens. However, subclinical vascular structure and function among these populations is not well known. This investigation evaluated vascular structure and function among Canadian Indigenous populations. Blood pressure, body composition, pulse-wave velocity (PWV), barorecep...

Objective: To evaluate sex differences in left ventricular (LV) function after an ultramarathon, and the association of vascular and training indices with the magnitude of exercise-induced cardiac fatigue. Design: Descriptive field study. Setting: Fat Dog 100 Ultramarathon Trail Race, Canada. Participants: Thirty-four (13 women) recreational runner...

Unlabelled: Indigenous populations currently experience greater rates of cardiovascular disease. Although ethnic differences in cardiovascular responses to exercise have previously been identified, these responses among indigenous populations are unknown. Purpose: This investigation aimed to evaluate the vascular responses to aerobic exercise of...

The health benefits of exercise are well established. However, the relationship between exercise volume and intensity and health benefits remains unclear, particularly the benefits of low-volume and intensity exercise. The primary purpose of this investigation was, therefore, to examine the dose-response relationship between exercise volume and int...

Hypertension is becoming increasingly prevalent among western societies. However, different ethnic groups appear to be affected unequally. This systematic review sought to evaluate blood pressure and hypertension among North American Indigenous populations. Electronic databases (e.g. MEDLINE and EMBASE) were searched and citations cross-referenced....

Abstract Altered autonomic function has been identified following ultra-endurance event participation among elite world-class athletes. Despite dramatic increases in recreational athlete participation in these ultra-endurance events, the physiological effects on these athletes are less known. This investigation sought to characterise changes in sur...

Physical activity is beneficial for many chronic conditions. However, activity levels of Native Americans are not well known. This systematic review investigated if Native American populations achieve the recommended physical activity levels, compared current and past activity levels, and assessed the ability of exercise training programmes to impr...

Cardiometabolic risk is a growing concern in Western society in which rates of cardiovascular disease, diabetes, and obesity are on the rise. Aboriginal populations currently experience unequal burdens of these chronic conditions. However, limited information regarding the experience of cardiometabolic risk among Métis populations is available. Thi...

Background: This systematic review sought to evaluate critically the health benefits of physical activity among persons with atrial fibrillation (AF). AF is increasing in Western society. While health benefits of physical activity are well established, benefits of physical activity among individuals with AF are not clearly identified. Methods: L...

Canadians currently experience elevated rates of chronic conditions compared with past populations, and ethnic differences in the experience of select chronic conditions have previously been identified. This investigation examined the prevalence of select chronic conditions among an ethnically diverse convenience sample of British Columbian adults....

We aimed to investigate the effects of a single session of prolonged strenuous exercise (PSE) on arterial stiffness by measuring pulse wave velocity (PWV) before and after competition in an ultramarathon. A total of 20 routine ultramarathon competitors (UM) completed baseline and postrace evaluation of central PWV (cPWV), upper-limb PWV (uPWV), and...

There is a growing interest in training for and competing in race distances that exceed the marathon; however, little is known regarding the vascular effects of participation in such prolonged events, which last multiple consecutive hours. There exists some evidence that cardiovascular function may be impaired following extreme prolonged exercise,...

Hypertension and obesity are major contributors to cardiovascular disease, and the relationship between these conditions is known to vary among ethnicities. However, this relationship has not previously been examined in aboriginal populations. The present investigation aimed to identify and compare this relationship among white (n = 3566), aborigin...

Aboriginal people have experienced elevated rates of obesity, diabetes, cardiovascular disease, and other chronic conditions that are disproportionate to the general Canadian population. We sampled British Columbian Aboriginal populations to determine the current health status of this population. A total of 882 Aboriginal adults ≥16 years of age fr...

The relationship between diabetes and obesity, major contributors to cardiovascular disease, varies with ethnicity; however, only limited information is available regarding Aboriginal and South Asian populations. Objective: This investigation aimed to identify and compare the relationship between diabetes and dysglycemia, and obesity across several...

Though historically rare, Aboriginal individuals continue to experience greater levels of cardiovascular disease than the general Canadian population. Increasing evidence indicates rising sedentary behaviors from the traditional healthy and active lifestyles of this population. This investigation aimed to examine the health benefits of a community-...

We aimed to compare the Finapres system, which is designed for accurate intra-arterial amplitude measurement, to the Caretaker system, which is designed for temporal accuracy of intra-arterial measurement, in regard to measurement of pulse transit time (PTT) at baseline and following an endurance exercise session. Pulse transit time was evaluated b...

This systematic review examines critically “best practices” in the training of qualified exercise professionals. Particular attention is given to the core competencies and educational requirements needed for working with clinical populations. Relevant information was obtained by a systematic search of 6 electronic databases, cross-referencing, and...

Recommendations for physical activity during pregnancy have progressed significantly in the last 30 years and continue to evolve as an increasing body of scientific evidence becomes available. In addition, there is an increasing number of women who wish to either maintain physical fitness levels during the prenatal period or initiate exercise for a...

Overweight and obesity among Aboriginal populations has been a growing challenge within Canada. This investigation aimed to identify the prevalence of overweight and obesity within British Columbian adult Aboriginal populations including both on and off reserve individuals through direct measurement. Further, this study stratified the variations in...

Running an ultramarathon has been shown to have a transient negative effect on right ventricular (RV) and left ventricular (LV) function. Additionally, recent findings suggested that ultraendurance athletes may be more at risk of developing a RV cardiomyopathy. The standard echocardiographic assessment of RV function is problematic; however, the in...

PURPOSES 1) To determine whether international physical activity guidelines are adequate to change health status in inactive adults. 2) To examine directly the dose‐response relationship between exercise volume and indicators of health status. METHOD Participants (N=65; age=44±12 yr) were assigned randomly to one of five 13 week exercise training...