Saturday, August 5, 2017

Objectively measured sedentary time among five ethnic groups in Amsterdam

Sedentary behaviour is increasingly recognised as a health risk behaviour, partly independent of moderate to vigorous physical activity. An increasing number of studies focus on sedentary behaviour, but  studies on sedentary behaviour among ethnic minority groups are scarce. In a a study just published in Plos ONE -with Dr. Anne Loyen as first authors- we compared levels and socio-demographic and lifestyle-related correlates of objectively measured sedentary time in five ethnic groups in Amsterdam, the Netherlands.
Data were collected as part of the HELIUS study, a cohort study conducted in Amsterdam. The sample consisted of adults from a Dutch, Moroccan, African Surinamese, South-Asian Surinamese and Turkish ethnic origin. Data were collected by questionnaire, physical examination, and a combined heart rate and accelerometry monitor (Actiheart). Sedentary time was defined as waking time spent on activities of <1 .5="" a="" href="" target="_blank">metabolic equivalents
. All analyses were adjusted for gender and age.Sedentary time ranged from 569 minutes/day (9.5 hours/day) for participants with a Moroccan and Turkish origin to 621 minutes/day (10.3 hours/day) in African Surinamese participants. There were no statistically significant differences in the levels or correlates of sedentary time between the ethnic groups. Meeting the physical activity recommendations (150 minutes/week) was consistently inversely associated with sedentary time across all ethnic groups, while age was positively associated with sedentary time in most groups.

Wednesday, July 26, 2017

Effects of a high intensity exercise program after stem cell transplantation

In a paper just published in Plos ONE, we report on a single blind, multicenter randomized controlled trial in which we evaluate the effects of a supervised high intensity exercise program on physical fitness and fatigue in patients with multiple myeloma or lymphoma recently treated with autologous stem cell transplantation, with Saskia Persoon as first author.
A hundred and nine patients joined our study and were randomly assigned to the 18-week exercise intervention or a usual care control group. The primary outcomes included physical fitness (VO2peak and Wpeak determined using a cardiopulmonary exercise test; grip strength and the 30s chair stand test) and fatigue (Multidimensional Fatigue Inventory) and were assessed prior to randomization and after the patients in de intervention group had completed their exercise program.
Patients in the exercise intervention group a
ttended 86% of the prescribed exercise sessions. Of the patients in the control group, 47% reported to have attended more than 10 physiotherapy sessions in the same period of time. Such physiotherapy sessions most likely include supervised exercise. Thus, because the intervention group exercised less than planned, and the control group did more, the difference in exercise participation between the two groups was smaller than anticipated before the study was started.
Median improvements in physical fitness ranged between 16 and 25% in the intervention group and between 12 and 19% in the control group. Fatigue decreased in both groups. There were no statistical significant differences between the intervention and control group.

Sunday, July 16, 2017

Video analyses to study health information provided by midwives

To quantify to what extent evidence-based health behaviour topics relevant for pregnancy are discussed with clients during midwife-led prenatal booking visits and to assess the association of client characteristics with the extent of information provided, we conducted a study among midwives. This study was recently published in the journal Midwifery, with Dr. Ruth Baron as first author. 173 video recordings of prenatal booking visits with primary care midwives and clients in the Netherlands were analysed.
Thirteen topics regarding toxic substances, nutrition, maternal weight, supplements, and health promoting activities were categorized as either ‘never mentioned’, ‘briefly mentioned’, ‘basically explained’ or ‘extensively explained’. Rates on the extent of information provided were calculated for each topic and relationships between client characteristics and the extent of information provided were assessed.
Our findings showed that women who did not take folic acid supplementation, who smoked, or had a partner who smoked, were more likely to be provided with only basic about these topics. Furthermore, the majority of clients were provided with no information on recommended weight gain (91.9%), fish promotion (90.8%), caffeine limitation (89.6%), vitamin D supplementation (87.3%), physical activity promotion (81.5%) and antenatal class attendance (75.7%) and only brief mention of alcohol (91.3%), smoking (81.5%), folic acid (58.4) and weight at the start of pregnancy (52.0%). The importance of a nutritious diet was generally either never mentioned (38.2%) or briefly mentioned (45.1%). Nulliparous women were typically given more information on most topics than multiparous women.
In conclusion, the majority of women were provided with little or no information about pregnancy-relevant health behaviours examined in this study. Midwives may be able to improve prenatal health promotion by providing more extensive health behaviour information to their clients during booking visits.

Monday, July 10, 2017

Correlates of irregular family meal patterns among children

The importance of family meals to the consumption of healthful food choices has been demonstrated and discussed in recent reviews. However, little information is available on barriers that interfere with regular family meal patterns during childhood. In a paper just published in the journal Food and Nutrition Research, we describe family meal patterns among 11-year-old children across Europe and identify correlates of irregular family breakfast and dinner consumption. We used data from 13,305 children from nine European countries who participated in the Pro Children Study in 2003.
The proportions of children who regularly ate family breakfast and dinner were 62% and 90%, respectively. Children who ate less vegetables were less likely to engage in family breakfasts as well as dinners, irregular family breakfasts was associated with more television viewing, and social differences in family breakfast consumption was observed.

Counselor competence for telephone Motivation Interviewing addressing lifestyle change

In a paper just published in the journal Evaluation and Program Planning we explored counselor competence in telephone Motivation Interviewing (MI) to change lifestyle behaviors in a primary care population with the
Motivational Interviewing Treatment Integrity (MITI) rating system. Counselor behavior was evaluated by trained raters. The MI fidelity was examined by comparing the MI fidelity scores direction, empathy, spirit, % open questions, % complex reflections, reflections-to-questions ratio, % MI-adherent responses with the matching beginner proficiency MITI threshold.
The inter-rater agreements for the MI fidelity summary scores were good (spirit, reflections-to-questions ratio), fair (empathy, % open questions, % MI-adherent responses) or poor (direction, % complex reflection). The MI fidelity scores for direction, empathy, spirit and the percentage of complex reflections exceeded the MITI threshold, but lower scores were found for the percentage of open questions, the reflections-to-questions ratio and the percentage of MI-adherent responses.
In conclusion, evidence that MI was implemented was revealed. However, the inter-rater agreements scores and some fidelity scores leave room for improvement ,indicating that raters and counselors may need more ongoing training and feedback to achieve and maintain adequate competence.

Sunday, June 18, 2017

Patterns of objectively measured sedentary time in 10- to 12-year-olds

In a study just published in BMC pediatrics we examined the frequency of sedentary 'bouts' of different durations and the total time spent in sedentary on a weekday, a weekend day, during school hours, during after-school hours and during evenings among 10- to 12-year-old Belgian children. The study was part of the “EuropeaN Energy balance Research to prevent excessive weight Gain among Youth” (ENERGY)-project. We looked at total sitting time as well as different bouts of sitting, because uninterrupted sitting may be more harmful.
Accelerometer data were used to assess sedentary time and sedentary bouts. Differences in total sedentary time, sedentary bouts of 2–5, 5–10, 10–20, 20–30 and ≥30 min and total time accumulated in those bouts were examined on a weekday, a weekend day, during school hours, during after-school hours and in the evening period.
More than 60% of the participants’ waking time was spent sedentary. Children typically engaged in short sedentary bouts of 2–5 and 5–10 min, which was almost 50% of their total daily sedentary time. Although the differences were very small, children engaged in significantly fewer sedentary bouts of nearly all durations during after-school hours compared to during school hours and in the evening period. Children also engaged in significantly fewer sedentary bouts of 5–10, 10–20, and 20–30 min per hour on a weekend day than on a weekday.
Although primary school children spend more than 60% of their waking time sitting, they generally do interrupt their sitting time frequently. Children’s sedentary bouts were slightly longer on weekdays, particularly during school hours and in the evening period.

Tuesday, May 30, 2017

Who sits too much in Europe? A hierarchy of sociodemographic correlates of sedentary behavior

Too much sitting (extended sedentary time) is recognized as a public health concern in Europe and beyond. People who sit too much too long have lower cardio metabolic health and increased risk of premature death. Identifying population subgroups that sit too much may help to develop targeted interventions to reduce sedentary time. In a paper just published in Preventive Medicine, with Dr. Jeroen Lakerveld as first author (Jeroen is leader of the so-called Upstream Team, a research network focusing on environmental determinants of physical activity, dietary behaviours and chronic disease risk), we explored the relative importance of socio-demographic correlates of sedentary time in adults across Europe. We used data from 26,617 adults from 28 EU member states who participated in the 2013 Special Eurobarometer study on sport and physical activity. Their self-reported sedentary time was dichotomized into sitting less or >7.5h/day. A Chi-squared Automatic Interaction Detection (CHAID) algorithm was used to create a 'tree' that hierarchically partitions the data on the basis of the independent variables (i.e., socio-demographic factors) into homogeneous (sub)groups with regard to sedentary time. This allows for the tentative identification of population segments at risk for too much sitting. Eighteen and a half percent of respondents reported sitting >7.5h/day. Occupation was the primary discriminator. The subgroup most likely to engage in extensive sitting were higher educated, had white-collar jobs, reported no difficulties with paying bills, and used the internet frequently.