No strong evidence that effectiveness of Dutch behavioral nutrition and physical activity interventions differ according to socio-economic status

Reducing health inequalities is a policy priority in many countries. Socio-economic status (SES) differences in obesity and its underlying health behaviors, i.e. diet, physical activity and sedentary behaviors, are among such important health inequalities in many affluent as well as developing countries. Although such inequalities have been well-documented, we are still largely in the dark when it comes to how we can reduce such inequalities. One way to shed some more light on this issue is to  investigate differential effectiveness of interventions aimed at obesity
prevention, the promotion of physical activity or a healthy diet by SES, i.e. to study is such interventions work for different SES groups.
In a paper just published in the American Journal of Preventive Medicine, first authored by Tessa Magnee and led by Frank van Lenthe, 26 Dutch studies conducted since 1990 were re-analysed for this purpose.  Seven of these lifestyle interventions were rated more effective and four less effective in groups with high SES; for 15 studies no differential effects could be demonstrated. If we looked at the specific settings and strategies of these interventions the following pattern appeared: the one study conducted in the healthcare setting showed comparable effects in both socioeconomic groups. The only mass media campaign provided modest evidence for higher effectiveness among those with high SES. Individually tailored and workplace interventions were either more effective in higher-SES groups or no differential effects were demonstrated. School-based studies showed mixed results. Two of six community studies provided evidence for better effectiveness in lower-SES groups; none were more effective in higher-SES groups. One high-intensity community-based study provided best evidence for higher effectiveness in low-SES groups.
We concluded that for the majority of interventions aimed at obesity prevention, no strong systematic differences in effects could be established. Interventions may widen as well as reduce socioeconomic inequalities in these outcomes. 

A joint programming initiative to study determinants of diet and physical activity across Europe: DEDIPAC

Yesterday and today 30+ scientists from 7 countries in Europe met as the main writing team to prepare a proposal for the first pilot of the Joint Programming Initiative (JPI) 'A healthy diet for a healthy life'. This JPI's vision is to ensure that all consumers across Europe have the motivation, ability and opportunity to eat a healthy diet and be physically active.
The JPI has three main pillars:
1. Determinants of diet and physical activity
2. Diet and food production
3. Diet-related chronic disease

The Knowledge Hub on the DEterminants of DIet and Physical Activity. In the framework of DEDIPAC, a network of selected research groups and scientists from 12 JPI Member States will carry out a programme of joint trans- und multidisciplinary activities for a better understanding on how individual, social and environmental determinants influence food and physical activity choices. A few weeks ago, I was elected coordinator of this DEDIPAC knowledge hub. DEDIPAC has three thematic areas:

Thematic Area A: Data Assessment and Harmonization, led by Prof. Pieter van t Veer, Wageningen University and Research Center
Thematic Area B: Analysis of Determinants, led by Prof. Nanna Lien, University of Oslo
Thematic Area C: Interventions and Policies, led by Prof. Ilse de Bourdeaudhuij, University of Ghent
In the last two days these thematic areas were specified in work packages, tasks and deliverables to be strived for in the next few years to build a better research and monitoring infrastructure for such determinant research across Europe.

Physical activity and the risk of developing lung cancer among smokers: A meta-analysis

In order to investigate the relationship between physical activity and lung cancer among smokers and whether this relationship differed according to physical activity intensity, smoking status, and gender, we conducted a meta analysis. The paper reporting on this study was just published in the Journal of Science and Medicine in Sport. Dr. Laurien Buffart is the first author of this publication.
Pooled analysis of the results of 7 cohort studies showed that physical activity was associated with a somewhat reduced risk of lung cancer in smokers. We did not find clear dose–response relationship regarding exercise or smoking intensity, i.e. high levels of physical activity did not show a higher risk reduction than moderate physical activity levels, and the association between physical activity and risk reduction did not differ between heavy and light smokers.
Results of this meta-analysis thus indicate that leisure time physical activity is associated with reduced risk of developing lung cancer among smokers. But, of course, non smoking is much more important and effective in preventing lung cancer .

An Amsterdam University Medical alliance

Today the two university medical centers in the Amsterdam region, VU University Medical Center, and the Amsterdam Medical center of the University of Amsterdam signed an alliance agreement. NRC Handelsblad -one of the Dutch national newspapers- covered this important development in today's paper and their website. The two centers will join forces to face the grand challenges for health care and biomedical research and education. Regarding scientific research, the two centers will develop joined translational research focus areas, organized in joined research institutes, based on their existing excellence in oncology, neurosciences, cardiovascular disease, infectious diseases and immunology, gastro-intestinal and metabolic disease, and public health and movement sciences. With this concentration in expertise, we will be able to further improve our international positions in these important research areas and contribute even more significantly to improving health care, prevention and rehabilitation.

Longer sleep means slimmer kids?

More and more research indicates that sufficient sleep helps to prevent overweight and obesity. Lack of sleep may lead to hormonal disturbances related to increased likelihood to gain unnecessary weight and become overweight, and lack of sleep may also be associated with lower physical activity and exercise levels or my lead to overeating. In our ENERGY study data we have now also explored the association between sleep habits and weight status in 10-12 year old schoolchildren across 7 countries in Europe. Few studies have differentiated between weekday and weekend day sleep duration in their association with indicators of weight status in children. Therefore, we examined the association of week and weekend day sleep duration with indicators of body composition, i.e. measured body mass index (BMI) and waist circumference (WC). The paper presenting the results of these analyses is now published in the journal PLOS One. In our analyses we adjusted for other behaviors that have been found te be associated with overweight/obesity (dietary, physical; activity and sedentary behaviors). Our results confirmed earlier findings that kids who sleep have lower BMIs and WCs. The association with weekday sleep were stronger than for weekend sleep.

B.Slim: Healthy eating and physical activity with the DOiT program; the Wellantcollege in Amsterdam example

The DOiT (Dutch Obesity intervention in Teenagers) is an evidence-based program to encourage teenagers to adopt and maintain healthier eating and physical activity to contribute to prevention of overweight and obesity. The program was developed and evaluated by a team led by Dr. Amika Singh. The program has been adopted by the municipality health service in the Amsterdam region, and is implemented in secondary schools here.  The further dessemination an implementation is evaluated by Femke van Nassau. A video about this implementation -with one school as an example- was shot by the Amsterdam municipality health service and broadcasted on YouTube.

Breakfast skipping, watching TV while eating breakfast, and underweight, overweight and obesity in school children across Europe

In a paper just published in e-pub in the journal Public Health Nutrition we describe a study looking at the relationships between skipping breakfast, watching TV while having breakfast, and weight status in 10-12 y old schoolchildren in eight countries across Europe. This paper is another product from the cross-European ENERGY study.

We found that, as compared to children who eat breakfast every day without watching TV (and  adjusting for sex, ethnicity and parental level of education) children who skip breakfast at least once a week were 1.2 times more likely to be overweight and 1.8 times more likely to be obese; children who watch TV while having breakfast were half as likely to be underweight and 1.4 times more likely to be obese than kids who do not watch TV while having breakfast. Our results are thus in line with earlier studies that also indicated that breakfast skippers are significantly more likely to be overweight and obese. Our study further indicates that watching TV while having breakfast is associated  with higher risk for obesity, but also with lower risk for underweight in schoolchildren.