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.

Schoolchildren across Europe sit about 65% of their school hours.

In a study just published in the Journal of Science and Medicine in Sport, with Dr. Maartje van Stralen as first author, we investigated how much time children spent on sedentary and physical activities at school in five European countries. We also looked at differences between countries and differences between girls and boys, children from native and foreign ethnicity, normal and overweight children, and from lower or higher educated parents.
We used data from the ENERGY cross-European cross-sectional survey. Primary schoolchildren (n=1025) aged 10-12 years in Belgium, Greece, Hungary, the Netherlands, and Switzerland wore accelerometers -a device to objectively measure (lack of) activity- for at least six consecutive days. Only weekdays were used for this study to calculate the percentages of school-time spent in sedentary activities and moderate to vigorous intensity physical activities. Children were also measured for their height and weight.
We found that across the five countries, the children spent on average 65% of their time at school in sedentary activities and 5% on moderate to vigorous intensity activities. The differences between countries were small. Girls spent somewhat more time sitting than boys (67 vs. 63% of their school hours) and a little less time on moderate to vigorous intensity activities (4 vs. 5%). Children who were overweight were substantially  less active than normal weight children, but we found no differences according to parental education or ethnicity.

Joint programming initiative a healthy diet for a healthy life: DEDIPAC proposal getting close to completion

Led by the management team of the DEDIPAC (determinants of diet and physical activity) Knowledge Hub of the Joint Programming Initiative 'A Healthy Diet for a Healthy Life' , the DEDIPAC consortium is now in the final weeks of completing their proposal for strengthening research and building the research infrastructure for cross European research on determinants of diet and physical activity. The DEDIPAC MT had another live meeting last week at VU University Medical Center in Amsterdam to prepare the next draft of the DEDIPAC knowledge hub proposal, which is now circulated for final comments and adjustments among the consortium members.


DEDIPAC KH is a network of selected research groups and scientists from 12 JPI Member States that 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, and primarily to build a good network an infrastructure for such research.

DEDIPAC has three thematic areas: data assessment and harmonization. analyses of determinants, and interventions and policies. The proposal will be submitted in about two weeks time, and will be externally reviewed in July.

Eating while watching TV, and weight status in schoolchildren across Europe

In the ENERGY study data set, we have explored if and how eating while watching TV is associated with weight status among 10-12 year old children in 8 countries across Europe. The results have just been published in the International Journal of Behavioral Nutrition and Physical Activity, with Froydis Vik as first author. Many studies in recent years have reported on the association between so-called sedentary behavior and weight status, and it has been suggested that children who sit more, have higher likelihood to be overweight and obese, and metabolic ill health. However, a recent review of the literature published in Obesity Reviews as well as a further recent original study published in Plos ONE failed to show that such sedentary behaviors predict metabolic ill health. However, for one specific sedentary activity, i.e. TV watching, the associations with overweight and obesity appear to be stronger. It has been suggested that 'mindless'  eating while watching TV could be an underlying factor.
In an earlier study, published in Public Health Nutrition, we already looked at having breakfast while watching TV, breakfast skipping and overweigh/obesity. In the present study we looked at all three meals -breakfast, lunch, dinner, and indeed found that children who watched TV while eating their main meals, especially while having lunch or dinner, had somewhat (20-30%) higher odds to be overweight or obese. Our study also further provided supportive evidence that children who eat regular meal -i.e. who do not skip breakfast or dinner-s are less likely to be overweight or obese.