EMGO seminar on obesity, physical activity and tailored health education

On Wednesday, January 16 we held a seminar at the EMGO Institute (http://www.emgo.nl/) featuring three distinguished scientists in the field of behavioural nutrition and physical activity research. First, Deanna Hoelscher presented data from the School Physical Activity and Nutrition (SPAN) study. This study to monitor trends and determinants of childhood overweight and obesity in Texas, shows that the rising trends in obesity prevalence that were observed in the last decades appear to have topped off or even reversed in some parts of the state of Texas. Dr. Hoelscher, who is the director of the Michael and Susan Dell Centre for Advancement of Healthy Living (http://www.sph.uth.tmc.edu/DellHealthyLiving/) and Associate Professor at the University of Texas at Houston, argued that a comprehensive approach of health education and policy change may have initiated this promising development.
Dr. Ron Iannotti from the prevention research branch of the National Institute of Child Health and Human Development (http://www.nichd.nih.gov/) presented research from the Health Behaviour in School Children study, showing that physical activity and sedentary behaviour are associated with a range of physical and mental health indicators as well as with other health behaviours among school children. His results further indicate that physical activity and sedentary behaviour are not two sides of the same coin. His research compared the US to different regions in Europe and his results indicate that patterns between physical activity, sedentary behaviour and health may differ between regions.
Finally, Dr. Kim Gans, Associate Professor at Brown University (http://www.brown.edu/) department of Community Health, presented some interesting results from two studies on tailored nutrition education. Both studies indicated that tailored nutrition education is more effective than generic nutrition education. However, her studies also indicate that multiple tailored feedback is not always more effective than single tailored feedback and that enrichment of tailored feedback with interactive motivational elements may not be superior to tailored feedback only.
The EMGO Institute was honoured to be able to host these three scientists and grateful for their contribution to the EMGO seminar program.

The Overveen ISBNPA Executive Committee Meeting

On 14-15 January 2008 the executive committee of the International Society of Behavioral Nutrition and Physical Activity (ISBNPA; http://www.isbnpa.org/) met in Overveen, near Amsterdam, the Netherlands. This was the first time we held such a midterm, in between annual society meetings (see http://www.isbnpa.org/meeting.cfm), to discuss strategic priorities and ‘SMART’ goals for further fostering the society.

ISBNPA as formally established in 2002 at the first annual meeting in Seattle, USA. Since then we held a scientific meeting every year; we went to Quebec City, Washington DC, Amsterdam, Boston and Oslo, and we will meet in Banff, Canada in May of this year. In our almost 7-year history our society we have grown steadily to a 500+ membership, we have established an open-access journal that is on its way to a good impact factor (see http://www.ijbnpa.org/), and produce monthly news letters to inform our members about issues important to research related to nutrition behavior and physical activity.

ISBNPA’s Vision Statement is:
ISBNPA will be the international leader in advancing and fostering excellence in research on nutrition behavior and physical activity.

And our Mission Statement:
We stimulate, promote and advocate innovative research and policy in the area of behavioral nutrition and physical activity toward the betterment of human health worldwide.

These statements were developed in Seattle in 2002 and have been re-confirmed at the Overveen meeting. The midterm executive committee (see http://www.isbnpa.org/committee.cfm for a list of the officers serving on the executive committee as well as other ISBNPA committees) meeting started informally at my home with dinner and drinks at our kitchen table. The more formal meeting was held at Hotel Roozendaal, and in the course of two days we discussed all aspects of our society, i.e. the annual meeting, membership issues, the journal, the website, finance, nominations for future officers, et cetera, based on SWOT (strength, weaknesses, opportunities, threats, see http://en.wikipedia.org/wiki/Swot_analysis) analyses and SMART (specific, measurable, attainable, realistic, timely, see http://en.wikipedia.org/wiki/SMART_(project_management)) strategic goals prepared by the members of the EC in advance of the meeting.

During the meeting we have decided to build a better foundation for our society by means of, amongst other things:

• Development of a annual meeting preparation handbook to facilitate the organization of our annual meetings


• Promote a further growth in the number of members, especially from countries that are now underrepresented by:

1. Establishing a scholarship program to support colleagues from developing countries to attend the annual meeting and present their research


2. Establishing an ambassador program, with ISBNPA ambassadors in underrepresented countries for promoting our society there


3. Providing free registration for people from underrepresented countries for our next annual meeting in Banff, under the condition that they become ISBNPA members

• Establishing a sounder financial basis by developing a structured sponsorship program
  Development of a new ISBNPA website that provides:

1. Better facilities to communicate with and between members


2. Better facilities to have an up-to-date administration of members and conference registration

• Further provide financial support for the ISBNPA journal (http://www.ijbnpa.org/) so that the journal can further grow into the leading journal on nutrition behavior and physical activity research

ISBNPA is now able to work on these issues because or growing membership and successful annual meeting proof that our society is here to stay, and has created the financial means to enable some further investments in our society.

A formal report on the decisions made during the Overveen meeting will be prepared for the Executive Committee and Business meetings at the Banff conference coming spring.

HOPE: Health Promotion through Obesity Prevention in Europe

Today we had our second work package leader and researcher meeting for the HOPE project (see http://www.hopeproject.eu/) at the EMGO Institute (http://www.emgo.nl/) in Amsterdam. HOPE is a European Commission funded FP7 project. In this project we aim to bring the scientific knowledge on overweight, obesity and their determinants together and use the expertise of researchers all over Europe to help to tackle the obesity epidemic. This project aims to integrate and further enrich the widely available and diverse knowledge on all these topics across Europe and use this information for designing various scenarios based on careful evidence-based epidemiological modelling. This will provide entry-points for policy making, and will help the European Commission and member states to set priorities for curbing the obesity epidemic.
The project also aims to build a network of researchers across Europe active in the further study to inform obesity prevention efforts.

The HOPE team consists of international experts in the field of the study and prevention of obesity, such as Philip James and Tim Lobstein of the International Obesity Task Force (www.iotf.org/), Frank van Lenthe and Anton Kunst of Erasmus University Medical Center in Rotterdam (http://www2.eur.nl/fgg/mgz/), Knut Inge Klepp of the University of Oslo (http://www.uio.no/), ILse de Bourdeaudhuij and Lea Maes of Ghent University (http://www.ugent.be/), Adriano Cattaneo of the institute of child health in Trieste (http://www.burlo.trieste.it/), Jean Michel Oppert of INSERM, France (http://www.inserm.fr/fr/), and Agneta Yngve of the Karolinska Institute, Sweden (http://ki.se/).

Today in Amsterdam we prepared a ‘network-ofnetworks meeting’ that will be held preceding the European Congress on Obesity (http://www.eco2008.org/), where we will present the HOPE project to our colleagues from across Europe and where we hope to learn from our colleagues to further inform and target our efforts within the HOPE project.

From ice to snow

After the two days of ice on the Dutch canals that provided proof that environmental factors do predict specific physical acivities, and the Christmas days, I took a few days off. We travelled to Norway where a very good friend and colleague let us stay in his mountain hut in the Hogfjell mountains near Honefoss. The days in Norway at this time of year are very short. It gets light at about 9.00 am and dark at about 3.30 pm. The hours inbetween we used for cross country skiing, the afternoons I was able to write a paper based on a presentation I gave at the fifth Heelsum conference early December 2007. The Heelsum conferences are bi-annual invitation meetings focussed on the possibilities of healthful nutrition promotion in primary care. Professor Gerrit Hiddink from Wageningen University is the main initiator of thse conferences. This time one of the aims was to explore how nutrition education by the general practitionar fits within the broader physical and social environmental determinants of health eating.
I also wrote a draft edotorial for a special issue I am guest editing together with Prof. Arja Aro from Denmark on risk perceptions and risk communication related to emerging infectious diseases. To control new infectious diseases the identification of the organisms, the infectivity, development of vaccines and therapies, contact tracing, isolation, and screening may all be important. Many of these issues are partly dependent on human behaviours. For example, the success of prevention of infectivity (e.g. engaging in precautionary behaviours such as wearing masks, hand hygiene, isolation etc.), vaccination, contact tracing and population screening are all more or less dependent on whether people at risk comply with behavioural recommendations. Especially in the early phases of a possible epidemic, compliance to precautionary behaviours among the populations at risk is often the only means of prevention of a further spread of the disease. However, very little research has been conducted to explore the determinants of behavioural responses to infectious disease outbreaks, and risk perceptions and communications are regarded as important factors for behavioral responses. The International Journal of Beavioral Medicine now prepares this special issue on this important topic.
For further reading, please see:

• http://www.cdc.gov/ncidod/EID/vol10no8/04-0283.htm
• http://www.cdc.gov/eid/content/13/2/290.htm

Physical environmental factors do predict specific physical activities; an N=2 study

In the last decade it has been posited that the so-called obesogenic environment is the main driving force behind the obesity epidemic. Experts claim that our environment characterised by an over-abundant availability of palatable energy-dense foods that can be eaten anywhere and anytime, as well as lack of opportunities to be physically active make people eat too much calories and burn too little calories, leading to unnecessary weight gain and eventually to overweight and obesity. However, the scientific evidence for the hypothesis that physical environmental factors predict eating and physical activity behaviours is not yet strong, probably due to a lack of well-designed studies. Over the past few years we have conducted a series of systematic reviews on the availbale studies on associations between environmental factors and different nutrition behaviours and physical activity. These reviews (of mostly cross-sectional studies, using weak measurement instruments and often failing to adjust for possible confounding factors) indicated that the evidence was not yet strong. Only for very few associations was convincing and consistent evidence found, and the evidence for social environmental determinants of health behaviours was much stronger than for physical environmental factors. Recent studies further indicate that individual factors such as motivation and abilities remain important predictors of health behaviours. (See a list of links to the pubmed abstracts of the scientific papers on these reviews later in this message). However, today I did an N=2 study that illustrated that physical environmental circumstances can determine specific forms of physical activity, if motivation and ablities are taken care of. For the first time this year the ice on a few canals in the Netherlands was strong enough to allow ice skating on natural ice. We have had a few days of frost now, and although the ice is hardly reliable yet, many Dutch grabed their skates and went for it (some did get wet). My wife and I found a nice stretch of great ice a bit north of Haarlem. The icy environment allowed us to act on our motivation and to use our abilities!

• http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=17300279&ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum


• http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=17169715&ordinalpos=13&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum


• http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=16861362&ordinalpos=5&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum


• http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=16861362&ordinalpos=5&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum


• http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=17010219&ordinalpos=4&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum


• http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=17716300&ordinalpos=3&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum


• http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=17197152&ordinalpos=11&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum

A drink before the Christmas break

On Thursday afternoon, December 20, the EMGO Institute met for an informal drink at the café attached to the VU University medical center. This was a great occasion to look back at a good year for the EMGO institute (http://www.emgo.nl/) . We had good scientific accomplishments with more than 20 PhD theses, Over 300 publications in Science Citation Index or Social Science Citation Index journals, and good acquisition of projects that will ensure scientific output for the years to come.
Our societal impact was also of good quality with policy and media attention for many of our projects, for example regarding e-health interventions, patient safety research, childhood obesity, and studies on environmental determinants of health lifestyles.
The year to come also looks good, with many interesting ongoing projects within our four research tracks, and some very interesting opportunities for additional research projects. One of these opportunities is research to test physical activity and training programs for cancer patients to build evidence based cancer rehabilitation programs, in collaboration with and supported by Alp-dhuzes (http://www.alpe-dhuzes.nl/templates/mercury.asp?page_id=1473). This is a yearly sponsored cycling event on the Alp D’Huez mountain to raise money for cancer research. I get back on this topic in the weeks to come.
Another important event in the coming year will be the preparation and probabale start of an interfaculty research institute together with partners from the faculty of Psychology and Education and the faculty of Earth and Life Sciences.
The next week I will celebrate Christmas with family and friends and then go to Norway for some days to do cross country skiing.
I wish you all a very merry Christmas and a great new year.

Prevention of unnecessary weight gain at the worksite

Yesterday Lydia Kwak defended her PhD thesis at a public meeting at Maastricht University. Her thesis describes the development, implementation and evaluation of an intervention program aiming to contribute to prevention of unnecessary weight gain among employees. Her PhD research was part of the NHS-NRG project, a comprehensive project funded by the Netherlands Heart Foundation on obesity prevention. This project consisted of two studies exploring behavioural, cognitive and environmental determinants of weight gain and energy-balance related behaviours, and three intervention studies; one aimed at adolescents (the Do-IT intervention), one for elderly people (the WAAG-study), and the one Lydia used for her PhD thesis which was called the In-Balance study.
Lydia Kwak used the Intervention Mapping protocol to develop the intervention that consisted of health education, self monitoring and environmental change components. The evaluation study used a controlled design and the results indicated that employees in intervention worksites had a lower fat mass at follow-up than employees of control worksites where the intervention program was not implemented. Her studies also showed the difficulties to convince worksites to participate in such an important study and to convince employees to participate in weight gain prevention activities. Prevention of weight gain should be key in attempts to curb the obesity epidemic, since treatment of obesity is hardly ever successful on the loner run.
Lydia Kwak’s thesis studies have been published in different international scientific journals. See for example:

• http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=17610944&ordinalpos=9&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum


• http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=17578384&ordinalpos=11&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum


• http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=17241761&ordinalpos=18&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum