Effectiveness of workplace interventions in Europe promoting healthy eating: a systematic review

The worksite is a promising setting for health promotion. A review recently published online in the European Journal of Public Health by professor Lea Maes et al. summarizes the evidence of effect of intervention studies in European countries promoting a healthy diet solely and in combination with increasing physical activity at the workplace. The review included studies published from 1 January 1990 to 1 October 2010; worksite-based interventions promoting a healthy diet solely or in combination with physical activity aiming at primary prevention and measuring anthropometrical or behavioural change among adults (≥18 years old) were included.

Seventeen studies solely focusing on promotion of a healthy diet were identified. Eight of these studies investigated health education intervention, one studie explored the effects of changes in the worksite environment, and eight used a combination of both (i.e. multi-component interventions). None of the interventions was rated as very 'strong'. The reviewed studies showed moderately strong evidence for effects on dietary change.

In conclusion only moderate evidence was found for positive effects of nutrition interventions implemented at the workplace. Effects of workplace health promotion interventions may be improved if stronger adherence to established quality criteria for such interventions is realized.

FUSE (the centre for translational research in public health) strategy meeting

Last Tuesday I attended - as an external member of the FUSE strategy board- a strategy meeting to explore and inform the centre's policy, strategy and tactics for the years to come. The meeting was led by the centre's director, Professor Martin White, and was held after the centre's third anniversary, and two yeard before its firts term ends. FUSE is an inter-university centre for translational research in public health. It is a collaboration between  five universities in the north-east of England - Durham, Newcastle, Northumbria, Sunderland and Teesside - and works in partnership with the public and in collaboration with the National Health Service, local and regional government and other public, private and voluntary organisations in North East England. FUSE focusses on the translation from research into public health policy and practice, it aims to do practice-based research to improve evidence-based practice, and its main goal is to develop a scalable model for such translation. Such translation of research into policy and practice, and translation of policy and practice issues in research is of of great importance in the field of public health. A lot of research is being conducted but the results certainly do not always find their way into true practice, and much of policy and practice in public health is not evidence-based. In the Netherlands this translation issue is being tackled by so-called academic collaborative centre's. The EMGO Institute for Health and Care Research leads and participates in anumber of such centre's, for example for public health, for youth health care, for occupational health, and mental health.

Impact Factor of the International Journal of Behavioral Nutrition and Physical Activity

This week the new impact factor (IF) of the International Journal of Behavioral Nutrition and Physical Activity was announced: 3.17.  This is a significant increase from last year's 2.63. This means that on average the papers published in IJBNPA are now cited 3.2 times. This is an impressive IF for such a young journal. The journal was established as part of the International Society of Behavioral Nutrition and Physical Activity (ISBNPA) about 10 years ago. The society and the journal have grown into a leading society and journal in the field. Given the fact that nutrition and physical activity are important in the prevention and management of the most important chronic diseases, including diabetes, cardiovascular disease and some cancers, the ISBNPA and IJBNPA scientific platforms are timely and important.

ISBNPA 2011

Just a bit more than an hour ago the 10th annual meeting of the International Society of Behavioral Nutrition and Physical Activity, held in Melbourne Australia, ended. The conference was three days of energizing and inspiring presentations and discussions of cuting edge research on nutrition, physical activity and sedentary behaviors. The focus of the society is on the associations of these  behaviors with a variety of health outcomes, the determinants of engagement is these behaviors and ways to motivate, enable and facilitate people across the life course to engage in healthful eating and physical activity.

The conference ended today with a very funny as well as very serious debate on where the in most countries relatively tiny budget available for promotion of healthful eating and physical activity should be invested: in the young only, or not (and thus also in the old(er)). Three experts argued for each side, and in different forms, including a rap act, a home movie on one of the experts young and old dog's, preaching and plain old argumentation. Professors Jim Sallis, Louis Barr and Dr. Karen Campbell argued in favour of the proposition by binging forward that health behaviors track from childhood into adulthood, that epigenetic influences at a very young age may make people more liable for chronic disease across their life span and many arguments more. The opposition consisted of Profs. Tony Worsely, Adrian Bauman and Abby King, and they argued that the largest burden of chronic disease is in midlife and the elderly, that lifestyle behavior changes in adults and elderly have a much faster return on investment, that adults and the elderly provide role models for the young and meny arguments more. It was very lively debate, and at the end the team arguing against the propostion were declared the winners, based on the strength of theur argumentation as well as the show they performed to bring their arguments across.

The debate waa follwoed by the announcement of the prices for the best presentations from young investigators, farewell words of the outgoing president of the society (Prof Knut Inge Klepp), some words of thanks from the chair of the local organising committee and the incoming president (Prof. David Crawford), and a great performance by the chair of the local organising committee for next year's conference (in Austin, Texas), Prof. Deanna Hoelscher.

A joint EMGO+ - C-PAN pre-ISBNPA meeting

Two days before the actual kick-off of the tenth annual meeting of the International Society for Behavioral Nutrition and Physical Activity (ISBNPA) in Melbourne, we organised a pre-conference meeting to celebrate and confirm the very fruitful collaboration between the behavioral nutrition & physical activity research groups of EMGO+ (VU University and VU Medical Center) and of the Center for Physical Activity and Nutrition Research (C-PAN) (Deakin University).

After introductions and words of welcome from the two directors of EMGO+  and C-PAN, i.e. myself and Prof. David Crawford, researchers from both institutes presented overviews of different research lines, e.g. on pricing and labeling strategies to influence nutrition behaviors, on studies on disparities in behavioral nutrition and physical activity according to socio-economic status, on determinants and intervantions on sedentary behaviors, on genetic and environmental determinants of nutrition and physical activity behaviors, et cetara. Thereafter, three guests, (associate) Profs. Annie Anderson, Frank van Lenthe and Stuart Biddle, provided overviews on where they think the field of behavioral nutrition and physical activity is especially in need of further research. At the end of the day, researchers from broke out in small group sessions to develop innovative research ideas for joint projects.

The success of the collaboration between the two centers so far is illustrated by the fact that we have an intensive exchange program, with 9 researchers having visited C-PAn from EMGO+ or vice versa for a few weeks up to a couple of months, and by five joint externally funded research projects, sponsored by for example the European Commission and the World Cancer Research fund, as well as more than 10 joint international publications (the link provides some examples) and more than others 10 under review.

For whom and under what circumstances do school-based interventions to promote energy balance behaviors work?

The aim of a review recently published on-line by Mine Yildirim et al. in the International Journal of Pediatric Obesity was to systematically review the results and quality of studies investigating the so-called moderators of schoolbased interventions aimed at energy balance-related behaviors (diet, phsyical activity and sedentary behaviors). Such moderators tell us for whom and under what circumstances these interventions are effective or not. In total 61 original studies were included in our review. Gender, ethnicity, age, baseline values the different behaviors, weight status and socioeconomic status were the most frequently studied potential moderators of intervention effects. Gender was found to be a consistent moderator of intervention effects, i.e. school-based interventions appear to work differently for boys and gilrs, and our review evidence suggests that such interventions generally work better among girls.  For the other potential moderators, there were just not enough studies of good enough quality to draw further conclusions. Consequently, our review revealed that there is still lack of insight into what interventions work for whom and that future studies should do better jobs to explore if and how intervention effects differ among different target group segments.

Keep cycling!

The objective of the study recently published by Dr. Elling Bere et al. in the International Journal of Pediatric Obesity was to assess the longitudinal association between cycling to school and weight status in two cities where cycling to school is common - Kristiansand (Norway) and Rotterdam (The Netherlands). Data from the ENDORSE (Rotterdam) and YOUTH IN BALANCE (Kristiansand) studies were used. Both studies were longitudinal studies with two years between the two measurements and both studies were among students in early adolesence (13.2 and 13.4 years at the start of the study). We categorized the students according to their mode of commuting to school at the two measurements: NO cycling at both measurements, STARTED cycling to school, STOPPED cycling and CONTINUED cycling. Measured weight and height were obtained at both time points, and weight status (overweight vs. not overweight) was calculated using international classification criteria for BMI from the International Obesity Task Force. The two datasets were analyzed separately and together. The results showed that those who stopped cycling had a three times greater odds of being overweight at the end of the study while those continued cycling had more than half the odds of being overweight, as compared to the other three groups together. The same trend was observed in both study samples. This study thus indicates that kids should continue to cycle to school; it is not only a fun, fit and environmentally friendly means of transportation, it may also help to avoid becoming overweight.