Towards evidence-based, quality-controlled health promotion: the Dutch recognition system for health promotion interventions

Registration or recognition systems for best-practice health promotion interventions may contribute to better quality assurance and control in health promotion practice. In the Netherlands, such a system has been developed and is being implemented aiming to provide policy makers and professionals with more information on the quality and effectiveness of available health promotion interventions and to promote use of good-practice and evidence-based interventions by health promotion organizations. The quality assessments are supervised by the Netherlands Organization for Public Health and the Environment and the Netherlands Youth Institute and conducted by two committees, one for interventions aimed at youth and one for adults. These committees consist of experts in the fields of research, policy and practice. Four levels of recognition are distinguished inspired by the UK Medical Research Council's evaluation framework for complex interventions to improve health: (i) theoretically sound, (ii) probable effectiveness, (iii) established effectiveness, and (iv) established cost effectiveness. Specific criteria have been set for each level of recognition, except for Level 4 which will be included from 2011. The rationale, organization and criteria of this Dutch recognition system and the first experiences with the system are now described in a 'Point of View' article in Health Education Research.

Move more, sit less! A Think Tank meeting to encourage individuals and communities to increase physical activity and decrease sedentary behaviors

This week I participaed in an international 'Think Tank' meeting in NewCastle, UK. On Sunday the Great North Run will take place there, and attached to that 1/2 marathin event, in which some 50,000 people will participate, a Think Tank symposium was organised to brainstorm on how to promote healthy eating & physical activity, and discourage sedentray behaviours across the life course. I participated as a discussant in the meeting on physical activity and sedentary behaviours. In that meeting short introductions on the evidence regarding physical activity and sedentary behaviours for different target groups (i.e. pre-schoolers, school-age children, elderly etc) were provided by, for example, professors Fiona Bull, John Reilly, Gareth Stratton, Tom McKenzie, Wendy Brown, Jo Salmon and Simon Marschall. These introductions were followed by round table discussions.
Key Issues for the Think Tank were:

1. We are now realising that sedentary behaviour is often excessive and we need to seek ways to reduce too much sitting
2. Often physical activity has been seen as something for children and young adults. More emphasis needs to be placed on all ages across the lifespan
3. We need a dual approach to increasing physical activity and decreasing sedentary behaviour
4. We need to know more about successful ways to change behaviour.

The Think Tank aim was to:

• Tackle the important issues of physical activity and sedentary behaviour across the lifespan (pre-school children, young people and older adults), consider how guidelines and policies can work to encourage behaviour change, and evaluate the role of new technologies in behaviour change
• Synthesise state-of-the-art evidence
• State clear conclusions about what is known, not known, and what needs to be known in the future
• Arrive at practical suggestions for behaviour change in the context being addressed.

The chair of the Think Tank, professor Stuart Biddle of Loughborough University, wit some support staff will now try to synthesize the conclusions from the intensive discussions in a recommendations document.

Front-of-pack nutrition label appears to stimulate 'healthier' product development

In addition to helping consumers make healthier food choices, front-of-pack nutrition labels, such as the 'choices' label or 'trafiic light' logos that are in fashion today, could encourage companies to reformulate existing food products and/or develop new ones with a product composition more in line with dietary recommendations. In the International Journal of Behavioral Nutrition and Physical Activity the largest study to date on this topic was published recently. The study by Ellis Vyth and colleagues investigated the effect of a nutrition logo on the development of healthier products by food manufacturers in the Netherlands.

A total of 47 food manufacturers joining the Choices Foundation in the Netherlands indicated whether their Choices products were newly developed, reformulated or already complied with the Choices criteria and provided nutrient composition data for their products.

Most products carrying the logo as a result of reformulation and new product development were soups and snacks. Sodium (salt) reduction was the most common change found in processed meats, sandwiches, soups and sandwich fillings. Dietary fiber was significantly increased in most newly developed Choices product groups; for example, in fruit juices, processed meats, dairy products, sandwiches and soups. Saturated fatty acids and added sugar were significantly decreased both in reformulated and newly developed dairy products. Caloric content was significantly decreased only in reformulated dairy products, sandwich fillings and in some newly developed snacks.

The results indicate that the Choices logo has motivated food manufacturers to reformulate existing products and develop new products with a healthier product composition, especially where sodium and dietary fiber are concerned.

A new edition of 'Obesity Epidemiology'

Yesterday I received my firts copy of the new edition of''Obesity Epidemiology', published by Oxford University Press, that I edited with professors David Crawford, Bob Jeffery and Kylie Ball. The full title of the book is 'Obesity epidemiology: From aetiology to public health'. The 26 chapters in the book, with authors from Australia, North America, Europe and East Asia describes the epidemiology of obesity, the drivers of the obesity epidemic, and prevention approaches.