Prof. Guus van Dongen writes about VUmc and the knowledge based economy

The Randstad region website presents a column by VU University medical center's professor Guus van Dongen, who build a case for a 'knowledge-based economy" and how our medical imaging center serves as an example. Please click here.

Can ethnic differences in children’s body composition be explained by differences in eating, physical activity, sedentary or sleeping?

In earlier research published in the journal Pediatric Obesity, we have found that -across Europe and in other affluent countries- children from non-native ethnicity are in general more likely to be overweight or obese, and to have unhealthy eating , physical activity and sleeping patterns than 'native' children. In further analyses just published in the journal PLOS One, with Juan Miguel Fernández-Alvira as first author, we explored if differences in eating, physical activity, sedentary and/or sleeping behaviors according to ethnic background can explain the ethnic differences in overweight and obesity. We conducted mediation analyses on the data of the ENERGY cross sectional study, a cross-European study among 10-12 year old schoolchildren and their parents across eight countries in Europe. For this study we used only data from the countries where ethnic differences in overweight and obesity were most prominent: Greece and the Netherlands. In these two country the ethnic differences were, however, in the opposite direction. As we published before in PLOS One, in Greece -the country with the highest prevalence of childhood overweight and obesity-, children from ethnic minorities are less likely to be overweight or obese than native Greek children. In the Netherlands -a country with relatively low prevalence of overweight and obesity-, ethnic minority children are more likely to be overweight or obese than native Dutch children. In the now published paper in the same journal, we show ethnic differences in children’s body composition were partially mediated by differences in breakfast skipping in the Netherlands and sugared drinks intake, sports participation and sleep duration in Greece.

Children's physical activity and sedentary time, home and neighborhood environments in urban and rural areas.

The environments children live in, their home as well as their school and neighborhood environments, are likely to influence what they do and do not do. A library of research now suggests that such environments influence children's physical activities and sedentary behaviors. How -via what kind of causal pathways- such influences come about, is, however, certainly not well researched and thus not clear. In a study just published online in the scientific journal Health and Place, first authored by Prof. Jo Salmon, Deakin University, Melbourne, we studied associations of home and neighbourhood READI) study, i.e. a cohort of women (aged 18–45 years) and their children (5–12 years). 613 children and their mothers participated. Urban children had higher screen time (i.e. TV and computer time) than rural children. In rural areas access to physical activity equipment in the home was higher, and mothers set better examples for their children regarding PA, had better knowledge of the neighborhood, a stronger social network, and reported higher safety than urban mothers.  Among urban children, the importance of doing PA together as a family was positively associated with ST. Interventions targeting PA and ST may need to target different factors according to urban/rural location.
environments with children's physical activity (PA), and sedentary time (ST). We also investigated if such associations were different for children living in urban vs. rural locations. Data were from the the Resilience for Eating and Activity Despite Inequality (

Obesity rates among pre-schoolers from low income families are declining in many states in the US

A 'vital signs'  report published by the US Centers of Disease Control and Prevention, published August 9, shows that in 18 out of 43 states or territories in the US obesity rates among 2-4 year olds from low income families, have declined significantly between 2008 and 2011. No change was observed in 20 states, while 3 states showed increased obesity rates. The results are based on measured height and weight from 11.6 million low-income children. In USA today, US experts say that the changes are small, but encouraging, because this is the first time in a generation that trends appear to be moving in the right direction.

Evidence-based physical activity guidelines for cancer survivors

Physical activity during and after cancer treatment has beneficial effects on a number of physical and psychosocial outcomes. In a paper that was just published in the journal Cancer Treatment Reviews, with Dr. Laurien Buffart as first author, we discuss the existing physical activity guidelines for cancer survivors and describe future research directions to optimize prescriptions for physical activity among cancer survivors.

Physical activity guidelines for cancer survivors suggest that physical activity should be an integral and continuous part of care for all cancer survivors. However, the development of these guidelines has been limited by the research conducted. To be able to develop more specific guidelines, future studies should focus on identifying clinical, personal, physical, psychosocial, and intervention moderators explaining ‘for whom’ or ‘under what circumstances’ interventions work. Further, more insight into the working mechanisms of exercise interventions on health outcomes in cancer survivors is needed to improve the efficacy and efficiency of interventions. Finally, existing programs should embrace interests and preferences of patients to facilitate optimal uptake of interventions. In conclusion, current physical activity guidelines for cancer survivors are generic, and research is needed to develop more personalized physical activity guidelines. In an ongoing project called POLARIS (Predicting OptimaL cAncer RehabIlitation and Supportive care) we are using existing data from many countries in individual patient data meta analyses to inform better tailored and targeted recommendations for cancer survivors.

Which health behaviors are associated with socio-economic status differences in overweight in school children?

It is well known that the prevalence of overweight and obesity is considerably higher among youth from lower socio-economic families, but there is little information about which eating and physical activity behaviors may play a role in explaining these differences in overweight. In a paper just published in the International Journal of Behavioral Nutrition and Physical Activity, with Juan Fernandez Alvira as first author, we looked at which behavior mediate the association between parental education and children's body composition. Data were obtained from the cross sectional study of the "EuropeaN Energy balance Research to prevent excessive weight Gain among Youth" (ENERGY) project and we explored the possible mediating effect of sugared drinks intake, breakfast consumption, active transportation to school, sports participation, TV viewing, computer use and sleep duration.
The association between parental education and children's b
ody composition was partially mediated by breakfast consumption, sports participation, TV viewing and computer use.

Interventions in low SES neighborhoods to promote health behavior: implementation issues

Although many interventions aiming to improve social and physical environments in low socio-economic status neighborhoods have been and are being implemented, what enhances and what promotes implementation of such interventions has rarely been studied. In a paper just published in the European Journal of Public Health, with Dr. Jeroen Lakerveld as first author, we assessed 18 implemented interventions in three underprivileged neighborhoods. Health promotion experts and representatives from the neighborhoods scored each of the interventions on 'RE-AIM', i.e. on reach, efficacy, adoption, implementation and maintenance of the interventions.
Effectiveness and implementation success were higher when the target group was involved in the planning of the intervention. Interventions were better maintained in the absence of competition with other projects. If the intervention was informed by a thorough inventory of  the current situation the effectiveness, adoption and implementation were better.  Involvement of the target group during implementation resulted in higher reach, effectiveness and adoption. Finally, the reach was higher when the intervention was supported by manpower.