Cycling in the Alps

The past week I have been cycling the Alps together with my wife and two friends, and my mother in law as the team director. With, among others, the Joux Plane, the Colombiere, The Iseran, the Telegraph, the Galibier, the Sarenne, Glandon and Madeleine on the program we burned between 2500 and 4500 kcal on our bikes. Rather difficult to keep a neutral energy balance on such days...

Biofuel, the food crises and the Dutch policy on healthful nutrition promotion

Today the Guardian summarizes a confidential, 'secret' report from the World Bank based on a careful analyses of the causes of the causes of the present food crisis, i.e. the growing shortages in and higher prices of food, that leads to undernutrition and hunger, especially in underdeveloped countries. The World Bank report contradicts claims made by the US government that greater demand for biofuels contributed only 3% to the raise in food prices. The World Bank report states that the demand for biofuel pushed food prices up by 75%. See http://www.guardian.co.uk/environment/2008/jul/03/biofuels.renewableenergy

In the Netherlands, the minister of health has published his food and nutrition policy plan, called "health nutrition; from start to finish" (http://www.minvws.nl/kamerstukken/vgp/2008/voedingsnota.asp). In this plan the minister asks food producers and consumers to take their responsiblity, but the national government itself is not willing to do much. Two task forces will be formed to explore how food producers can reduce the salt and saturated fatty acid content of regular foodstuffs; information on food stuffs should be improved to enable consumers to make healthier choices. Food and nutrition experts as well as the Netherlands consumers organisation have expressed their disappointment with the published policy plans; they do not expect that implementation of these plans will make too much of a difference, given the voluntary nature of the measures that are proposed.

The policy plan also ask for a chance in nutrition education in the Netherlands, from a food-oriented approach, to a more total nutrition and dietary pattern oriented approach. However, one of the key recommendations is that the Dutch people should eat fish 2-3 times per week. This is clearly a food-based advise, and an advice that may be heart-healthy, but not very sustainable, given the worl-wide depletion of fish stocks because of over-fishing http://en.wikepedia.org/wiki/overfishing.

VU Children’s city; a fantastic playground for hospitalized kids.

Last Friday I had the pleasure of visiting VU Kinderstad, or in English: The VU University Medical Center’s VU Children’s city (http://www.vumc.nl/afdelingen/VU-Kinderstad-VU-Huis/VUkinderstad2/). This ‘city’ is in fact a two story ‘playgroud’ on the two top floors of the VU University Hospital (http://www.english.vumc.nl/patientcare/).
Prof. John Roord (http://www.vumc.nl/afdelingen/voor-journalisten/zoeken-op-naam/zoeken--naam/855401/), the chair of the VUmc Children’s hospital and one of VUmc’s Division heads, organised a tour of the Kinderstad for the members of VUmc’s board and the other heads of Divisions.
VUmc Kinderstad is meant for children who have to stay in hospital for a longer period. Kinderstad offers them and their parents the opportunity to leave the hospital setting to enjoy a range of play and entertainment activities, from virtual racing in a Spijker sports car (http://www.spykercars.nl/?pag=1), enjoying video’s from and writing directly to the Ajax soccer team (http://www.ajax.nl/) players, surfing the internet, ‘flying’ in an almost real-life KLM airplane, making radio shows, as well as more basic every-day play activities.

The Internet and health education: unfulfilled promises?

The introduction and growth of the WWW has enabled swift and inexpensive distribution of nutrition education expertise and materials. Furthermore, the WWW has also been used for tailoring nutrition education to personal characteristics of the user. With the growing availability and opportunities of mobile Internet, web-based tailored nutrition education can be provided when and where it is most useful or appropriate. However, two important challenges for web-based nutrition education interventions are to realise sufficient exposure and to ensure sufficient source reliability and credibility. Only few studies have investigated the effects of web-based computer-tailored nutrition education, with some promising but mixed results.
Two recent studies by Willemieke Kroeze et al. shed further light on the potential of web-based tailored nutrition education. Her studies published in the Journal or Nutrition Education and Behavior (http://ees.elsevier.com/jneb/) and the Journal of Medical Internet Research (http://www.jmir.org/) suggest that an electronic, interactive web-based version of a nutrition education program that provides users with individually tailored feedback and advice to reduce saturated fat intake was as effective as the original print version of the program (http://www.ncbi.nlm.nih.gov/pubmed/18565463?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum). However, the print version was used and saved more often and was rated as somewhat more personally relevant (http://www.jmir.org/2008/2/e12/).

Eating and Physical activity: Planned or habitual behaviour?

Every morning I take my bike to work, where I eat my muesli breakfast while reading my email. No deliberations, cognitive efforts, or reasoned planning for me to engage in these behaviours; these are pure habits.
Behavioural nutrition and physical activity research and interventions have been strongly rooted in theoretical models that presume rational decision making and a certain level of planned health behaviour. In recent years health behaviour researchers more and more argue that such an approach is too limited. Behavioural nutrition and physical activity research more and more studies environmental factors in stead of cognitions as determinants of health behaviours. Such environmental cues, e.g. easy opportunities for healthful or unhealthy behaviours, may induce habitual responses. Habitual behaviour is characterised by three important feature: a history of repetition, automaticity (expressed by uncontrollability, lack of awareness, and efficiency), and expressing identity.

Many physical activities, sedentary behaviors and dietary behaviors are typically routine behaviors. They are repeatedly performed and we may engage in them without much cognitive effort, just like my commuting and breakfast habits. As a result, the concept of habit is important in studying these behaviors, in addition to measures of behavioral frequency, duration and intensity. Two recent studies, first authored by Drs Gert-Jan de Bruijn and Stef Kremers, I was involved in provide further limited but intriguing early evidence to support the concept of habit as being important in dealing with physical activity and diet in children and adults.
Please see:
http://www.ncbi.nlm.nih.gov/pubmed/18471932?ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
and
http://www.ncbi.nlm.nih.gov/pubmed/18364530?ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

The 7th ISBNPA conference is almost over.

In a few hours the closing ceremony of the 7th annual meeting of the International Society of Behavioral Nutrition and Physical Activity will take place. On this final day of the meeting we enjoyed a ‘battle of the giants’. Professors Tom Baranowski and Gaston Godin, two former presidents of the society and two of the founding fathers of the society held a keynote debate on objective or self-report measures of physical activity.

Measurement of physical activity and nutrition behaviors comes with many challenges. Most behavioural nutrition and physical activity research relied and still relies on self-report measures. Such measures are liable to many biases, and we just do not have truly valid self report measures. In recent years more ‘objective’ measures of nutrition and physical activity behaviours have been developed, such as biomarkers, observations, real time monitoring. But such measures may be strong interventions in itself.

Tom argued for using objective measures and moving away from self-report measures, preferably completely, since these measures have too low validity to be used in intervention or determinant studies, and he provided convincing evidence to support that. Gaston argued that we need self report measures, since the available objective measures are not by definition valid measures, and can often not be used in ‘real life’ population studies, again supported by convincing evidence.

The 7th ISBNPA conference was very interesting, with keynotes on the ethics of obesity prevention, the use of theory in development of physical activity interventions, the genetics of obesity and nutrition behaviours, symposiums on a great variety of behavioural nutrition and physical activity topics, and many more oral and poster presentations on cutting edge themes.

Next year’s conference will be in lovely Lisbon. For more information on this year’s (including the program and abstract book) and next year’s conference, see: http://www.isbnpa.org/.

ISBNPA 2008 has started.

Yesterday evening here in Banff, Alberta, Canada, the 7th annual conference of the International Society of Behavioral Nutrition and Physical Activity started with a word of welcome by Wendy Rodgers, the chair of the local organising committee, myself as president of the society, and a keynote address by Dr. Peter Katzmarzyk, professor at the Pennington Biomedical Research Center in Baton Rouge, USA.

After a full meeting of the executive committee of the society where we followed up on important issues such as renewing the society’s website, preparation for next year’s conference, the society’s financial status, et cetera, the conference actually started. Dr. Katmarzyk builds a case for research on the importance of the ‘physical activity transition’ as an important determinant of changes in mortality and morbidity trends. We are all familiar with the concept of the epidemiological transition, and most nutritionists have read Barry Popkin’s work on the nutrition transition, i.e. the changes in diet and nutrition that have driven associated changes in important burdens of disease, i.e. from infectious diseases and diseases related to under-nutrition, to diseases of affluence and over-nutrition, such as cardiovascular disease, diabetes and certain cancers. Dr. Katmarzyk argued that a physical activity transition has at least been of similar importance.