A second writing workshop to publish further results of the ENERGY project

The ENERGY project stands for the "EuropeaN Energy balance Research to prevent excessive weight Gain

among Youth : Theory and evidence-based development and validation of an intervention scheme to promote healthy nutrition and physical activity". ENERGY consists of a series of systematic reviews, secondary data analyses, a school-based and family involved cross sectional and intervention study among 7000 and 2500 children and one of their parents respectively. Seven countries across Europe are involved. The project description and study design papers regarding the cross sectional study in general and the accelerometer study (i.e. a study to monitor schoolchildren physical activity objectively) have been published, and a number of scientific papers have been submitted for publications. These concern papers on prevalence - and differences in prevalence between the seven countries - of overweight and obesity, as well as engagement in a range of behaviors (i.e. physical activity, sedentary behaviors, dietary behaviors) associated with risk for being or becoming overweight; differences in prevalence according to ethnic background of the children. Further papers that have been submitted focus on, for example, the reliability and validity of the measures used in the ENERGY study, the relation between weather circumstances and physical activity, the association between sedentary behavior and blood markers for metabolic health, et cetera.
These days another writing workshop is ongoing in a bed-and-breakfast facility in Amsterdam to write and prepare the next series of scientific papers from the project. Scientists from the UK, Norway, Spain, Belgium and the Netherlands meet here for 3 days to write and provide feedback on a series of papers regarding for example mediators of socio-economic differences in childhood overweight, the clustering of physical activity and sedentary behavior patterns, the contribution of TV watsching to total sedentary behavior and a range of other topics. All these papers use data from the cross sectional survey of ENERGY. Data for the ENERGY intervention study targetting sedentray behavior among school children in five of the partcipating countries are now being collected and will be available later this year.

A workshop in Stockholm on grading evidence regarding public health interventions

Last Wednesday, the Swedish National Institute of Public Health organised a meeting in Stockholm to explore the do's and don't's of grading evidence regarding public health interventions to help policy makers to identify the best and most effective interventions to promote population health. In public health and health promotion the cry for better evidence-based practice is strong and obvious. However, grading the evidence in public health is more complicated as compared to medical interventions. In public health, interventions are, for example, often group or population based rather than aimed at individuals, effects are often only to be observed in the long run, and interventions are mostly complex, multi-component and context dependent. These characteristics make it more difficult to study public health interventions in research designs that are regarded as the most internally valid, i.e. randomised controlled trials (RCT). In existing systems to grade evidence for medical interventions, such as the GRADE system, evidence not based on RCT designed studies can never be strong, thus favouring individual medical interventions above population-based public health interventions. Therefore, maybe new or other systems need to be developed, or the GRADE system may need to be adapted to better accomodate public health and health promotion interventions. At the workshop I presented the Dutch acknowledgement system for health promotion interventions, led by the the Centres for Healthy Living and Youth Health of the Netherlands National Institute for Public Health and the Environment and the Netherlands Youth Institute. This system was specifically designed  and 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.  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, taking into account the specific evaluation researhc challenges for public health and health promotion evaluation research. The way the Ducth system works and the first experiences and results were published in a paper in Health Education Research.

Nicole Ezendam successfully defends her PhD thesis

Today Nicole Ezendam received her doctorate degree after a successful public defence of her thesis entitled “Vet is niet Vet (Fat aint Phat): studies on the prevention of excessive weight gain among adolescents.” Her thesis encompasses three studies exploring determinants of unnecessary weight gain among adolescents and four studies on the development, effects and the process of the FATaintPHAT intervention. This is a computer-tailored program to motivate and enable adolescents to adopt more healthy dietary and physical activity habits.

Her research shows that the intervention appeared to help the participants to adopt healthier dietary habits, but failed to encourage them to become more physically active

The third Alpe D'Huzes cancer rehabilitation program annual meeting

Today the third annual meeting of the Alpe D'Huzes Cancer Rehabilitation (A-Care) program was held in Amsterdam. A-Care is a comprehensive program of eight PhD studies organised in two subprograms to further our knowledge on the effects of exercise in cancer rehabilitation and survival. The first subprogram focusses on clinical research to study the effects and mechanisms of effect of different exercise regimes in different groups of cancer patients. The second subprogram focusses on ways to implement and disseminate succesful exercise interventions. Dr. Laurien Buffart, the acting coordinator of A-CaRe 1 and a recent 'Bas Mulder award laureat, organised the day.

Prof. Rob Newton (see picture), and Drs. Lee Jones and Renate Winkels provided state of the art overviews of the roles of exercise and diet in cancer rehabilitation and survival, and Prof Wim van Harten and Dr. Mai Chinapaw provided overviews of ghe progress of the two subprograms.

Prof. Christianne de Groot is inaugurated as professor of obstetrics

Yesterday, Prof. Christianne de Groot gave her inaugural address as professor and head of department of obstetrics at the VU University Medical Center. She first presented the well known facts that perinatal mortality is higher in the Netherlands than in surrounding countries. She argued that for a better perinatal care true and close collaboration between extramural and intramural care, between midwifes and obstetricians, in a true women and child care center is of crucial importance. Such close collaborations are now being developed and researched within VUmc and the EMGO Institute for Health and Care Research.

The Journal of Nutrition Education and Behavior podcast on our study on computer-tailored nutrition education

In the upcomming issues of the Journal of Nutrition Education and Behavior, a paper by Dr. Kroeze et al is published on an evaluation of computer-tailored nutrition education on saturated fat intake among adults. This evaluation was not based on self-reported intakes, but on biomarkers, i.e. blood lipids. In more detail: a group of more than 400 adults receved either computer-tailored nutrition education about their fat intake levels or not, and cholesterol levels were measured in blood samples to assess if exposure to the nutrition education resulted in better blood lipid levels. However, despite clear favorable changes in self-reported fat intake levels, no effects on blood lipids were found. If you want to learn more about this study, and how these conflicting results should ne interpreted, please listen to a podcast interview with the firts author of our paper (look for 9/8/11).

Dr Anna Timperio gives a seminar on home and family determinants of overweight in children

Yesterday, Dr. Anna Timperio, of the Center for Physical Activity and Nutrition Research of Deakin University gave a seminar on her work on home and family environment determinants of physical activity, eating behaviors, sedentary activities and overweight in children. In her seminar she presented an overview of results of the CLAN and HEAPS studies, two longitudinal studies aiming to unravel why children become overweight or not. Her work shows that family environmental factors, such as example behavior of parents, doing physical acyivities together, and the availability of physical activity equipement in the home, appear to be more important than neighbourhood factors, for children's physical activity.