Tuesday, October 18, 2016

Psychosocial variables moderate the relationship between leisure time physical activity and mortality among myocardial infarction survivors

Leisure time physical activity (LTPA) is inversely related to mortality risk among patients with a history of myocardial infarction (MI). In a paper just published in BMC Cardiovascular Disorders -with Dr. Rony Oosterom-Calo as first author- we explored if heart failure (HF) status and psychosocial variables moderate this association in a prospective cohort study among MI survivors.
LTPA was inversely associated with mortality. HF did not, but psychosocial variables did, moderate the association. Among the higher active patients, patients with a high level of depression had a lower mortality risk in comparison to those with a low level, and patients with a low level of social support had a lower mortality risk in comparison to those with a high level of social support.

Wednesday, September 28, 2016

Social capital, neighborhood income and overweight across Europe

People with lower socio-economic status -lower levels of education, income and/or job status- in general have poorer health and engage more in unhealthy life style behaviors such as unhealthy diets and lack of physical activity. They also tend to have higher body weight and are more likely to be overweight or obese. Neighbourhood income inequality may contribute to such differences in body weight. In a paper just published in the European Journal of Public Health -with Joreintje Mackenbach as first author- we explored whether neighbourhood social capital mediated the association of neighbourhood income inequality with individual body mass index (BMI). For this study data from the SPOTLIGHT project -a study in different urban regions across Europe to explore neighbourhood contextual determinants of overweight and obesity-were used. A total of 4126 adult participants from 48 neighbourhoods in France, Hungary, the Netherlands and the UK provided information on their levels of income, perceptions of neighbourhood social capital and BMI. Higher neighbourhood income inequality was associated with elevated levels of BMI a
nd lower levels of neighbourhood social networks and neighbourhood social cohesion. High levels of neighbourhood social networks were associated with lower BMI. Results stratified by country demonstrated that social networks fully explained the association between income inequality and BMI in France and the Netherlands. Social cohesion was only a significant mediating variable for Dutch participants. In conclusion our results suggest that in some European urban regions, neighbourhood social capital plays a large role in the association between neighbourhood income inequality and individual BMI.

Tuesday, September 13, 2016

Correlates of adherence to a physical exercise program after cancer treatment

In a paper just published in the International Journal of Behavioral Nutrition and Physical Activity we studied demographic, clinical, psychosocial, physical and environmental factors associated with participation in and adherence to a combined resistance and endurance exercise program among cancer survivors, shortly after completion of primary cancer treatment. Data from the randomized controlled Resistance and Endurance exercise After ChemoTherapy (REACT) study were used for this study.
Participants were randomly allocated to either a high intensity (HI) or low-to-moderate intensity (LMI) exercise program. Patients’ participation rate was defined as their decision to participate in the REACT study. Exercise adherence reflected participants’ attendance to the scheduled exercise sessions and their compliance to the prescribed exercises. High session attendance rates were defined as attending at least 80 % of the sessions. High compliance rates were defined as performing at least of 90 % of the prescribed exercise across all sessions. Correlates of exercise adherence were studied separately for HI and LMI exercise. Demographic, clinical, and physical factors were assessed using self-reported questionnaires. Relevant clinical information was extracted from medical records.

Cancer survivors who participated in the exercise program were more likely to have higher education, be non-smokers, have lower psychological distress, higher outcome expectations, and perceive more exercise barriers than non-participants. In HI exercise, higher self-efficacy was significantly associated with high session attendance and high compliance with endurance exercises, and lower psychological distress was significantly associated with high compliance with resistance exercises. In LMI exercise, being a non-smoker was significantly associated with high compliance with resistance exercises and higher BMI was significantly associated with high compliance with resistance and endurance exercises. Furthermore, breast cancer survivors were less likely to report high compliance with resistance and endurance exercises in LMI exercise compared to survivors of other types of cancer.

In conclusion, several demographic, clinical and psychosocial factors were associated with participation in and adherence to exercise among cancer survivors. Psychosocial factors were more strongly associated with adherence in HI than LMI exercise.

Tuesday, September 6, 2016

lack of association of health behaviors and psychosocial characteristics with preterm birth

Preterm birth is the leading pregnancy outcome associated with perinatal morbidity and mortality and remains difficult to prevent. There is evidence that some modifiable maternal health characteristics may influence the risk of preterm birth. The aim of our study just published in Maternal and Child Health Journal was to investigate the relationships of self-reported maternal health behaviour and psychological characteristics in nulliparous women with spontaneous preterm birth in prenatal primary care. We used data from the nationwide DELIVER multicentre cohort study, which was designed to examine perinatal primary care in the Netherlands. In our study, consisting of 2768 nulliparous women, we estimated the relationships of various self-reported health behaviours (smoking, alcohol consumption, folic acid supplementation, daily fruit, daily fresh vegetables, daily hot meal and daily breakfast consumption) and psychological characteristics (anxious/depressed mood and health control beliefs) with spontaneous preterm birth.
Of all variables investigated, low health control beliefs was the sole characteristic significantly associated with spontaneous preterm birth.

Saturday, August 27, 2016

Breakfast, lunch and dinner among school kids across Europe

In a study just published in Preventive Medicine, with Dr. Froydis Vik as first author, we aimed to assess (i) the prevalence of having regular family breakfast, lunch, dinner among 10–12 year olds in Europe, (ii) the association between family meals and child weight status, and (iii) potential differences in having family meals according to country of residence, gender, ethnicity and parental levels of education.
7716 children (mean age: 11.5 ± 0.7 years, 52% girls) in eight European countries (Belgium, Greece, Hungary, The Netherlands, Norway, Slovenia, Spain, Switzerland) participated in a cross-sectional school-based survey in 2010, as part of the ENERGY study. Data on family meals were self-reported by the parents and children's height and weight were objectively measured to determine overweight status.
The prevalence of regular family meals was 35%, 37% and 76% for breakfast, lunch and dinner respectively. Having regular family breakfast, but not lunch or dinner, was inversely associated with overweight. Children of higher educated parents were more likely to have regular family breakfast and less likely to have regular family lunch compared to children of lower educated parents.

Tuesday, July 19, 2016

SOS: systems of sedentary behaviour framework

Ecological models are currently in fashion to study and influence energy balance related behaviours, including sedentary behaviour. However, these ecological models are limited in their ability to capture the complexity of and interplay between determinants. The aim of the project described in a recent publication in the International Journal of Behavioural Nutrition and Physical Activity, with Seb Chasten as first author, was to develop a transdisciplinary dynamic framework, grounded in a system-based approach, for research on determinants of sedentary behaviour across the life span and intervention and policy planning and evaluation. This endeavour was part of the Determinants of Diet and Physical Activity (DEDIPAC) knowledge hub of the Healthy Diet for a Healthy Life joint programming initiative.

We conducted a comprehensive concept mapping approach to develop what we call the Systems Of Sedentary behaviours (SOS) framework, involving four main phases: (1) preparation, (2) generation of statements, (3) structuring (sorting and ranking), and (4) analysis and interpretation.

During the first phase, 550 factors regarding sedentary behaviour were listed across three age groups (i.e., youth, adults and older adults), which were reduced to a final list of 190 life course factors in phase 2 used during the consensus meeting. In total, 69 international delegates, seven invited experts and one concept mapping consultant attended this consensus meeting. The final framework obtained during that meeting consisted of six clusters of determinants: Physical Health and Wellbeing (71 % consensus), Social and Cultural Context (59 % consensus), Built and Natural Environment (65 % consensus), Psychology and Behaviour (80 % consensus), Politics and Economics (78 % consensus), and Institutional and Home Settings (78 % consensus). Conducting studies on Institutional Settings was ranked as the first research priority. The view that this framework captures a system-based map of determinants of sedentary behaviour was expressed by 89 % of the participants.

In summary, through an international transdisciplinary consensus process, the SOS framework was developed for the determinants of sedentary behaviour through the life course. Investigating the influence of Institutional and Home Settings was deemed to be the most important area of research to focus on at present and potentially the most modifiable. The SOS framework can be used as an important tool to prioritise future research and to develop policies to reduce sedentary time.

Sunday, July 3, 2016

Variation in population levels of physical activity in European adults

In a systematic literature review just published in the International Journal of Behavioural Nutrition & Physical Activity, with Anne Loyen as first authors- we aim to provide an overview of all existing cross-European studies that assess physical activity in European adults, describe the variation in population levels according to these studies, and discuss the impact of the assessment methods. The review is registered in the PROSPERO database under registration number CRD42014010334.
All but two of the studies used questionnaires to assess physical activity, with the majority of studies using the IPAQ-short questionnaire. The remaining studies used accelerometers. The percentage of participants who either were or were not meeting the physical activity recommendations was the most commonly reported outcome variable, with the percentage of participants meeting the recommendations ranging from 7 % to 96 % across studies and countries.
The included studies showed substantial variation in the assessment methods, reported outcome variables and, consequently, the presented physical activity levels. Because of this, absolute
population levels of physical activity in European adults are currently unknown. However, when ranking countries, Ireland, Italy, Malta, Portugal, and Spain generally appear to be among the less active countries. Objective data of adults across Europe is currently limited. These findings highlight the need for standardisation of the measurement methods, as well as cross-European monitoring of physical activity levels.

In the same journals we also published similar systematic reviews regarding sedentary time among adults across Europephysical activity among children and adolescents across Europe, and sedentary behaviour in children and adolescents across Europe. These reviews were all part of the DEDIPAC (determinants of diet and physical activity) joint action of the European joint programming initiative 'A Healthy Diet for a Healthy Life'.