Sitting Time and Metabolic Health in Dutch and Hungarian schoolchildren

Sitting time, or 'sedentary behavior' may have negative health consequences, independent of physical activity; thus, even when one is sufficiently physically active, prolonged or extensive sedentary time may contribute to higher risk for metabolic syndrome, diabetes, overweight and obesity. However, these associations need to be researched in more detail and in more rigorous studies.
The association between objectively assessed sedentary time and metabolic risk factors in childhood has hardly been studied at all. Therefore, we examined the independent relationship between objectively assessed and self-rated sedentary time and indicators of metabolic health in Dutch and Hungarian 10–12 year olds. The research paper reporting on this study, led by Dr. Mai Chin A Paw, was just published in the journal Plos ONE.
Sedentary time was measured using accelerometers and the children self-reported their TV and computer time. Weight, height and waist circumference of the kids were measured and fasting plasma glucose, C-peptide, total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, and triglycerides were determined in capillary blood and summed into a metabolic risk score.
Children spent on average 7.6 hours of their daily waking time in sedentary behavior and self-reported 116664 min/day watching TV and 85657 min/day using the computer. Comparing the quartile of kids with highest with the quartile of kids with the lowest objectively assessed sedentary time, we found that the most sedentary kids had higher body weights (BMI) bigger waists and higher C-Peptide levels. The difference in the total, overall metabolic risk score was only borderline significant. When we compared the kid who watched most TV with those who watched least we found that among the TV kids, BMI was significantly higher.
In summary: although BMI and WC were higher in the most sedentary versus the least sedentary children; we found no further consistent evidence that the most sedentary children were at increased metabolic risk.

Delfien van Dyck defended her thesis in Ghent

Yesterday Delfien van Dyck received her doctorate at Ghent University after successfully defending her thesis ' The physical environment and its association with physical activity and sedentary behaviors in adults and adolescents'. I had the honor to be part of the examination committee. Dr. van Dyck has written an exceptionally good thesis in the field of behavioral nutrition and physical activity. Her thesis comprises 16 scientific papers, most of these published in the best journals in the field. Before her defense she gave a very lively, clear and scientifically sound public lecture about her work, and after that she did a very good job in discussing her work with the examination committee.
The day after the thesis defense, Dr. van Dyck and her primary supervisor, Prof. Ilse de Bourdeaudhuij organized a symposium on behavioral nutrition and physical activity issues with four presentations. Profs. David Crawford (Deakin University, Australia), Neville Owen (Barker IDI, Australia), Jim Sallis (University of California, USA) and myself presented some of our work and discussed this with an audience of scientists, policy makers and people active in health promotion practice. The discussion focussed strongly on what the main drivers of healthy nutrition and physical activity behaviors are, the opportunities for health behavior in the environments where people live, or the individual motivations and abilities that people have for living healthily.

The ENERGY symposium at the European Conference on Obesity

This Wednesday we had the final symposium of the ENERGY project on overweight, obesity and its determinants in school children across Europe. Just two weeks after the publication of the first main results paper published in Plos ONE and the substantial media attention for the project, we presented an overview of the project at a pre-conference symposium in Lyon, i.e. before the European Conference on Obesity. Dr. Amika Singh, the project's coordinator at EMGO+/VU University medical Center in Amsterdam, introduced the project, I presented the results of the cross sectional ENERGY study, and Dr. Elling Bere from the University of Agder, Norway, presented the design and results of the intervention study. Three eminent 'discussants', i.e. Profs Wolfgang Ahrens from Bremen University, Germany, and David Crawford from Deakin University, Australia, and Michel Chauliac, the Director of Nutrition Programmes at the Ministry of Health of France commented upon and discussed our results.

New edition of the Dutch handbook on health promotion published

Last week the new edition of 'Gezondheidsvoorlichting & Gedragsverandering; een planmatige aanpak' (health education and behavior change: a planned approach), i.e. the Dutch handbook ofn health education, was published. The book, edited by myself in collaboration with Prof. Lilian Lechner and Dr. Patricia van Assema, covers all steps of planned promotion of population health, from the epidemiological analyses, to behavior determinant analysis, to intervention mapping, intervention dissemination, and evaluation, and provides practical examples of health education interventions.

First results of the ENERGY study: Greece tops the European league for overweight children

A survey of children in seven European countries, as part of the ENERGY project, found Greece topped the league, with twenty percent of all 10-12-year-olds obese, and a further 30% overweight, according to our paper published today in the scientific journal PLoS-ONE.
Obesity is hitting record levels among Europe’s children, with nearly one in ten obese and a further 20% overweight, averaged across all seven countries. Lowest levels were found in Norway where only 4% are obese, and a further 15% overweight.
Explaining these differences is not easy. We found children in Greece have the lowest levels of sports activities, children in Hungary and Greece watch the most television, children in Belgium sleep the most, and children in the Netherlands consume the most sugared drinks.
The team of researchers from 15 institutions across Europe found that girls tended to be slimmer than boys, but girls also tended to participate in sports less than boys. Boys watched more television and drank more soft drinks. The team also found that children of better educated parents tended to be slimmer, except in Greece or Spain. Clearly there are differences in the cultural traditions, family customs and dietary habits across different European communities that may determine such differences. The research tells us that children have one thing in common – they are all exposed to multiple causes of obesity which lead them to gain excess weight. Tackling just one cause on its own will not work.
The research is supported by a €2.9m grant from the European Commission, and will include pilot testing new interventions designed to reduce sedentary behaviour in children aged 10-12 years.

Please see the links below for publicity in the Dutch, Belgian and Norwegian media regarding this study, and click here for a TV item with an interview about our study.

The Netherlands:
http://www.volkskrant.nl/vk/nl/2672/Wetenschap-Gezondheid/article/detail/3246827/2012/04/26/Bijna-een-kwart-van-de-Nederlandse-kinderen-is-te-dik.dhtml#.T5kWld7Ys9g.facebook
http://www.nu.nl/algemeen/2796613/bijna-kwart-nederlandse-kinderen-dik.html
http://nos.nl/artikel/366803-kinderen-nl-drinken-veel-frisdrank.html

http://www.rtl.nl/(/actueel/rtlnieuws/binnenland/)/components/actueel/rtlnieuws/2012/04_april/26/binnenland/Bijna-kwart-Nederlandse-kinderen-te-dik.xml

http://www.rtl.nl/(/actueel/rtlnieuws/)/components/actueel/rtlnieuws/2012/04_april/26/gezondheid/bijna-kwart-nederlandse-kinderen-te-dik.xml

http://www.telegraaf.nl/vrouw/12001587/__Kwart_kinderen_te_dik__.html

http://www.gezondheidsnet.nl/alles-over-afvallen/nieuws/7908/22-procent-van-de-nederlandse-kinderen-te-dik

http://www.refdag.nl/nieuws/binnenland/bijna_kwart_nederlandse_kinderen_te_dik_1_639744

http://www.metronieuws.nl/nieuws/bijna-25-van-de-nederlandse-kinderen-te-dik/SrZldz!YK6ic9F7ryXY2/

http://www.elsevier.nl/web/Nieuws/Wetenschap/337118/Bijna-een-kwart-Nederlandse-kinderen-veel-te-zwaar.htm?rss=true

http://www.nd.nl/artikelen/2012/april/26/kwart-nederlandse-kinderen-te-dik

http://www.hartvannederland.nl/nederland/2012/bijna-kwart-kinderen-te-dik/

http://www.spitsnieuws.nl/archives/raar/2012/04/kwart-kindertjes-te-dik

http://www.hyves.nl/topic/19117181/Helft_Nederlandse_kinderen_te_dik/?fromSidebar=topic

http://www.brabantsdagblad.nl/algemeen/gezondheid/10930863/Bijna-kwart-Nederlandse-kinderen-te-dik.ece

http://www.rnw.nl/nederlands/bulletin/bijna-kwart-nederlandse-kinderen-te-dik

http://smanked.com/?p=243721

http://4nieuws.nl/show.php?key=323161&titel=Bijna%20een%20kwart%20van%20de%20Nederlandse%20kinderen%20is%20te%20dik

http://snoodnet.nl/wordpress/?p=15115

http://www.112regio.nl/2012/04/26/bijna-kwart-kinderen-te-dik/

http://www.limburger.nl/article/20120426/ANPNIEUWS01/304269931/1008

http://drimble.nl/weblogs/gezondheid/9107623/bijna-kwart-nederlandse-kinderen-te-dik.html

http://www.rsscockpit.com/article.do?action=show&id=2160679109

http://www.hetnieuws.in/nieuws/388826/amsterdam

http://www.q-music.nl/page/nieuws_bekijken/1962085/bijna-een-kwart-van-de-nederlandse-kinderen-is-te-dik

http://www.topnieuwtjes.nl/bijna-kwart-nederlandse-kinderen-te-dik/

http://www.richliving.nl/bijna-kwart-nederlandse-kinderen-te-dik/

http://www.pyroplace.nl/2012/bijna-kwart-nederlandse-kinderen-te-dik/

http://www.blikopnieuws.nl/bericht/143713/22_van_de_Nederlandse_kinderen_te_dik.html

http://intranet/organisatie/nieuws/grootschalig-onderzoek-overgewic/

http://www.vumc.nl/zorg/nieuws/6915279/

http://www.dvhn.nl/nieuws/nederland/article9003311.ece/Bijna-kwart-Nederlandse-kinderen-te-dik

http://vrouwenpower.nl/forum/threads/50452-Bijna-kwart-Nederlandse-kinderen-te-dik

http://4nieuws.nl/show.php?key=323248&titel=Bijna%20kwart%20Nederlandse%20kinderen%20te%20dik

http://amsterdam.nieuws.nl/3668204

http://www.nieuws-nederland.com/bijna-kwart-nederlandse-kinderen-te-dik/

http://drimble.nl/binnenlands-nieuws/9108995/bijna-25-van-de-nederlandse-kinderen-te-dik.html

http://drimble.nl/binnenlands-nieuws/9108995/bijna-25-van-de-nederlandse-kinderen-te-dik.html

http://247nu.nl/index.php/nieuws/nieuwsitem/nieuws/binnenland/Bijna%20kwart%20Nederlandse%20kinderen%20te%20dik

http://www.rss24.nl/newsitem/119955-bijna-een-kwart-van-de-nederlandse-kinderen-is-te-dik.html

http://www.transport-online.nl/site/algemeen-nieuws/index.php?news=13388

http://www.gelderlander.nl/algemeen/gezondheid/10930864/Bijna-kwart-Nederlandse-kinderen-te-dik.ece

http://www.gezondheidsnet.nl/voeding/nieuws/7908/een-vijfde-nederlandse-kinderen-te-dik
Belgium
http://www.hln.be/hln/nl/33/Fit-Gezond/article/detail/1429688/2012/04/26/Een-op-vijf-Belgische-kinderen-is-te-dik.dhtml
http://www.standaard.be/artikel/detail.aspx?artikelid=DMF20120426_107&word=overgewicht
http://www.demorgen.be/dm/nl/993/Gezondheid/article/detail/1429688/2012/04/26/Een-op-vijf-Belgische-kinderen-is-te-dik.dhtml
Norway:
http://www.aftenposten.no/meninger/kronikker/Vi-lever-i-et-fedmefremmende-samfunn-6816382.html
http://www.aftenposten.no/helse/Norske-barn-er-sunnest-i-Europa-6816293.html

Lack of effects of computer-tailored health education interventions

Computer-tailored health education that enables individualized, personal relevant information and feedback regarding healthful behavioral changes, has been regarded as a promising way to promote healthier life styles to contribute to better population health. Many studies, and systematic reviews of these studies, strongly indicate that computer-tailored health education is more effective than generic -one-size-fits-all health education. We have just conducted a new systematic review of computer-tailored interventions for promoting healthy diets and physical activity that will appear shortly in the journal Annals of Behavioral Medicine, and I will notify its publication here as zoos as it is out. However, I have been involved in a umber of studies recently that fail to show effects of computer-tailored interventions. There are a few reasons for lack of effects in these more recent studies, I believe. One reason is that these newer studies provide tailored feedback via web-based systems, while earlier studies used printed feedback letters or other printed materials as the means to provide participants with tailored feedback. In web-based interventions the actual exposure to the intervention content is often low and incomplete, because participants may be more easily distracted and may be less willing to read the information from the screen. Please see a recent review by Dr. Wendy Brouwer et al for an exploration of what may help to improve exposure to web-based interventions. Another reason for the lack of effects found in some recent studies is that in these more recent studies biomarkers or other objective measures of effects were used. In earlier research the assessment of effects were often based on self-reports, that may be biased for example because of social desirability bias. A recent study by Dr. Kroeze et al showed that effects of a computer-tailored nutrition education intervention aiming to help respondents to reduce their saturated fat intake levels based on self-reported fat intakes, could not be confirmed in further research using blood lipids as an objective indicator of effects.
This week a study by Karen Broekhuizen was pre-published in BMC Research Notes. In this study a computer-tailored loire style health education intervention was tested that aimed to help people with familiar hypercholesterolemia to adopt healthier lifestyles and to adhere to their statin treatment. This study used objective biomarkers to test this web-based computer-tailored intervention. The results indeed showed very low exposure to the web-based tailored feedback as well as lack of changes in lipids (low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), total cholesterol (TC) and triglycerides), systolic blood pressure, glucose, body mass index (BMI) and waist circumference. Exposure to web-based tailored health education interventions obviously need to be improved in order to make present-day tailored e-health promotion interventions more effective.

The ENERGY project towards its final

The EuropeaN Energy balance Research to prevent excessive weight Gain among Youth (ENERGY) project uses the Intervention Mapping protocol to systematically use both existing scientific information and secondary analyses of evaluation data of existing schemes, as well as perform additional research to identify the most important intrinsic and extrinsic factors that determine energy-balance health behaviours, and translate this information into an evidence-based intervention scheme for 10-12 year old children in the transition age to adolescence. ENERGY is now in its final stages.  The entire project has used systematic reviews, secondary data analyses, a cross European cross-sectional school-based study and intervention study. The last few days we had our before-last ENERGY consortium meeting here in Amsterdam, where the consortium discussed the projects progress and made preparations for the ENERGY final symposium in Lyon on May 9, 9.00-12.00 AM, right before the upcoming European Congress on Obesity. At the final symposium we will present the results of the cross sectional and intervention studies. The results of the cross sectional study will soon be published in PLOS One, and I will report on that publication as soon as it is out. The results of the intervention study are now being analyzed and will be presented for the first time in Lyon.