Gerda Feunekes - Academia.edu (original) (raw)

Papers by Gerda Feunekes

Recent recommendations in regard to the level of alcohol Intake have mainly been based on epidemi... more Recent recommendations in regard to the level of alcohol Intake have mainly been based on epidemiologic studies which relied on self-reported amounts of alcohol consumed. Therefore, it is important to be aware of the quality of self-reported measures of alcohol intake. Alcohol intake assessment methods were reviewed with respect to their capacity to rank individuals according to alcohol intake and their ability to explain the variation in the level of intake in population samples. In 33 methodological papers published after 1984, alcohol intake was assessed by five main methods: quantity frequency, extended quantity frequency, retrospective diary, prospective diary, and 24-hour recalls. The mean level of alcohol intake differed by 20 % between these methods. It was also found that when researchers asked specifically about intake of beer, wine, and liquor, this resulted in 20 % higher estimates of intake. These percentages were similar among populations with low and high mean alcohol...

Relative and biomarker-based validity of a food-frequency

Handbook of Eating and Drinking, 2020

Public health nutrition is concerned with the promotion and maintenance of good health through nu... more Public health nutrition is concerned with the promotion and maintenance of good health through nutrition and the prevention of nutrition-related illness in humans. Nutrition communication plays an important role in the dissemination of credible and practical dietary advice and promoting healthful dietary behaviors. The purpose of this chapter is to provide insight in the changes in public health nutrition communication, by addressing the history, key themes, concepts, and approaches of nutrition communication in the Netherlands. The chapter concludes with a broader view of the challenges of public health nutrition communication and presents potential future directions for this field.

Recent recommendations in regard to the level of alcohol Intake have mainly been based on epidemi... more Recent recommendations in regard to the level of alcohol Intake have mainly been based on epidemiologic studies which relied on self-reported amounts of alcohol consumed. Therefore, it is important to be aware of the quality of self-reported measures of alcohol intake. Alcohol intake assessment methods were reviewed with respect to their capacity to rank individuals according to alcohol intake and their ability to explain the variation in the level of intake in population samples. In 33 methodological papers published after 1984, alcohol intake was assessed by five main methods: quantity frequency, extended quantity frequency, retrospective diary, prospective diary, and 24-hour recalls. The mean level of alcohol intake differed by 20% between these methods. It was also found that when researchers asked specifically about intake of beer, wine, and liquor, this resulted in 20% higher estimates of intake. These percentages were similar among populations with low and high mean alcohol c...

Free Radical Biology and Medicine, 2013

Physiology & Behavior, 1995

The effect of the number of others present on the amount of food eaten was investigated in the Ne... more The effect of the number of others present on the amount of food eaten was investigated in the Netherlands by studying spontaneous meal size in 50 free-living young males and females. Subjects recorded food consumption, number of others present, hunger, taste of the food, food availability, and atmosphere at each eating or drinking moment for four (n = 30) or seven consecutive days (n = 20). The results of the study with four and the study with seven recording days were comparable. The mean Pearson within-person correlation coefficient between the number of others present and meal size was 0.24 (n = 50, p < 0.05). This correlation was significant for breakfast (0.40, p < 0.05) and snacks (0.18, p < 0.05), but not for lunch (r = 0.19, p > 0.05) and dinner (r = 0.15, p > 0.05). A path analysis showed no direct effect of the number of others on meal size, but revealed that social facilitation of spontaneous meal size was mediated by meal duration. Social influences Energy intake Meal size Humans Eating

Preventive Medicine, 1998

INTRODUCTION Background. Influences of the social environment Social influences on food intake re... more INTRODUCTION Background. Influences of the social environment Social influences on food intake refer to influences are important in determining eating behavior. Family that one or more subjects have on the eating behavior influences have been demonstrated by resemblances of others, either direct or indirect, either conscious or in intakes within families, but research on resemblance in intake between friends is lacking. We investi-subconscious. Even when eating alone, food choice is gated the resemblance in fat and food intake within influenced by social factors because attitudes and habsocial networks that included family members and its develop through the interaction with other people. peers. Although the impact of social influences is regarded as Methods. Fat consumption was assessed with a food large [1-4], research quantifying this phenomenon is frequency questionnaire in 361 social networks conscarce. In our opinion, there are three main causes that sisting of 15-year-old adolescents (n ‫؍‬ 347), their mothcomplicate the quantification of social influences on ers (n ‫؍‬ 309), their fathers (n ‫؍‬ 270), their friends food intake. (n ‫؍‬ 240), 79 friends of mothers, and 29 friends of fa-(i) The influences that people have on the eating bethers. Ten family interviews and four focus group interhavior of others are not limited to one type, but include views were carried out in a subsample. a range of influences, for instance, modeling of eating Results. Within the nuclear family, the intake of 76 behavior of others, persuasion to consume or avoid to 94% of the foods was significantly associated, which eating certain foods, changing the availability of foods resulted in moderate Pearson correlations for fat and for others, and attempting to change someone's eating fatty acid intake (% of energy intake) between parents attitudes. These social influences are embedded in ev-(0.30-0.34), between mother and child (0.19-0.38), and eryday eating behavior, in family food rules, and in the between father and child (0.16-0.26). No significant coreating culture as a whole. Extraction of social influences relations for fat intake were found between friends, in an experimental situation to get information on the but the consumption of specific foods was related. impact of social influences in real life is therefore virtu-Conclusions. We found clear resemblance in habitual ally impossible. fat and food intake between parents and their adoles-(ii) Social influences play a role in different time cent children and between spouses. Friends do not frames. Influences may be exerted during the eating or seem to have a lot of influence on the fat intake of drinking occasion, such as persuasion, encouragement, adolescents and adults in this population. ᭧1998 American and social facilitation of food intake. Alternatively, they Health Foundation and Academic Press may be spread over a prolonged period, such as the Key Words: eating behavior; fat intake; social influeffect of cohabitation. ence; adolescents; families; peer influence. (iii) People are not necessarily aware of the social influences that are exerted on their eating behavior. If they are aware of this, they might not be eager to admit that their behavior is influenced by others. This makes 1 This research project was funded by the Ministry of Agriculture, it difficult to assess social influences by simply asking Nature Management, and Fisheries. 2 To whom reprint requests should be addressed. them to rate the perceived influences of others.

Nutrition Research, 1997

In order to establish the generalizability or cultural specificity of the factors that influence ... more In order to establish the generalizability or cultural specificity of the factors that influence the ad libitum eating patterns of free-living humans, the eating behaviors of 26 French, 140 American, and 50 Dutch university students were measured with a diet diary technique. Marked cultural differences were present in the amounts, composition, diurnal rhythm, and pattern of intake. In comparison to the French and the Americans, the Dutch ate considerably more overall and ingested a large number of small meals separated by relatively short intervals. They ate with more other people present, for a longer duration at a slower rate, with larger deprivation ratios and smaller satiety ratios, and had more food remaining in their stomachs at the beginning of the meal. Even with these differences the univariate or multivariate correlations between meal size or the Mtermeal interval with the time of day, the number of people present, the subjective state of hunger, the stomach contents, and the premeal interval were quite similar between nationalities. These relationships varied in magnitude especially when hunger self-ratings, the time of day, or the aftermeal interval were involved, but, the directions of the relationships were in all cases the same. These results suggest that, although cultural effects permeate the eating pattern, many of the social, psychological and physical variables that influence intake are similar across cultures.

Journal of Health Communication, 2009

Introduction: This study aimed to perform a quantitative and qualitative process evaluation of th... more Introduction: This study aimed to perform a quantitative and qualitative process evaluation of the introduction of the Choices logo, a front-of-pack nutrition logo on products with a favorable product composition, adopted by many food producers, retail and food service organizations, conditionally endorsed by the Dutch government, validated by scientists, and in the process of international dissemination. Methods: An online questionnaire was sent to adult consumers four months after the introduction of the logo (n=1032) and one year later (n=1127). Additionally, seven consumer focus groups (n=41) were conducted to provide more insight into the questionnaire responses. Results: Quantitative analyses showed that exposure to the logo had significantly increased. Elderly and obese reported to be more in need of a logo than younger and normal-weight respondents. Women perceived the logo more attractive and credible than men did. Further qualitative analyses indicated that the logo's credibility would improve if it became known that governmental and scientific authorities support it. Elderly indicated to need a logo due to health concerns. Consumers interested in health reported that they used the logo. Conclusions: Further research focusing on specific target groups, forming healthful diets and health outcomes is needed to investigate the effectiveness of the Choices logo.

European Journal of Clinical Nutrition, 1997

Objectives: To assess family resemblance in fat intake in a representative sample of Dutch famili... more Objectives: To assess family resemblance in fat intake in a representative sample of Dutch families. Design and subjects: Households (n 1077) with children between 1 and 30 y old were selected from the data set of the Dutch National Food Consumption Survey 1992. Two-day diet records were available for all household members. Results: Pearson correlation coef®cients for fat and fatty acid intakes (En%) ranged from r 0.51 to r 0.61 between parents, and from r 0.52 to r 0.72 between siblings. The mean associations in fat and fatty acid intake (En%) between mothers or fathers and children ranged from r 0.37 to r 0.50, and they were surprisingly similar for children from 1±3 y of age up to children above 21 y of age. Associations were consistently high for foods eaten at home, and weak for foods eaten outside of the home. Similar within-family associations were found in a set of 1052 households of the Dutch National Food Consumption Survey of 1987. Reported adherence to a therapeutic diet by one of the parents did not erase within-family intake correlations, suggesting that family resemblance is a dynamic phenomenon. Conclusion: Dutch parents and children living together resemble each other in short term intake of fats and fatty acids. Sponsorship: This study was supported by the Ministry of Agriculture, Nature Management and Fisheries.

BMC Public Health, 2013

As the global population grows there is a clear challenge to address the needs of consumers, with... more As the global population grows there is a clear challenge to address the needs of consumers, without depleting natural resources and whilst helping to improve nutrition and hygiene to reduce the growth of noncommunicable diseases. For fast-moving consumer goods companies, like Unilever, this challenge provides a clear opportunity to reshape its business to a model that decouples growth from a negative impact on natural resources and health. However, this change in the business model also requires a change in consumer behaviour. In acknowledgement of this challenge Unilever organised a symposium entitled 'Behaviour Change for Better Health: Nutrition, Hygiene and Sustainability'. The intention was to discuss how consumers can be motivated to live a more healthy and sustainable lifestlye in today's environment. This article summarises the main conclusions of the presentations given at the symposium. Three main topics were discussed. In the fi rst session, key experts discussed how demographic changesparticularly in developing and emerging countries-imply the need for consumer behaviour change. The second session focused on the use of behaviour change theory to design, implement and evaluate interventions, and the potential role of (new or reformulated) products as agents of change. In the fi nal session, key issues were discussed regarding the use of collaborations to increase the impact and reach, and to decrease the costs, of interventions. The symposium highlighted a number of key scientifi c challenges for Unilever and other parties that have set nutrition, hygiene and sustainability as key priorities. The key challenges include: adapting behaviour change approaches to cultures in developing and emerging economies; designing evidence-based behaviour change interventions, in which products can play a key role as agents of change; and scaling up behaviour change activities in cost-eff ective ways, which requires a new mindset involving public-private partnerships.

American Journal of Epidemiology, 1999

Recent recommendations in regard to the level of alcohol Intake have mainly been based on epidemi... more Recent recommendations in regard to the level of alcohol Intake have mainly been based on epidemiologic studies which relied on self-reported amounts of alcohol consumed. Therefore, it is important to be aware of the quality of self-reported measures of alcohol intake. Alcohol intake assessment methods were reviewed with respect to their capacity to rank individuals according to alcohol intake and their ability to explain the variation in the level of intake in population samples. In 33 methodological papers published after 1984, alcohol intake was assessed by five main methods: quantity frequency, extended quantity frequency, retrospective diary, prospective diary, and 24-hour recalls. The mean level of alcohol intake differed by 20% between these methods. It was also found that when researchers asked specifically about intake of beer, wine, and liquor, this resulted in 20% higher estimates of intake. These percentages were similar among populations with low and high mean alcohol consumption (4 vs. 10 drinks per week). It was found that ranking of individuals according to intake was satisfactory, with weighted correlation coefficients between methods ranging from 0.63 to 0.73. The authors conclude that, when there is sufficient evidence that alcohol intake is underestimated in a population, methods that enquire about both the frequency and amount consumed, for beer, wine, and liquor, separately, will yield the most realistic levels of intake.

Appetite, 2008

In two studies, the impact of eight front-of-pack nutrition labelling formats that differed in co... more In two studies, the impact of eight front-of-pack nutrition labelling formats that differed in complexity was investigated across four European countries. In total 1630 men and women (18-55 yrs) were recruited from Internet panels in the United Kingdom, Germany, Italy and the Netherlands for study 1 and 776 in Italy and the United Kingdom for study 2. Participants evaluated several products (healthier and less healthy variants of the same product category) with a front-of-pack nutrition labelling format. The first study evaluated different labelling formats on consumer friendliness (comprehension, liking and credibility) and the second study measured the effect of the different labelling formats on decision-making (usage intention and process time). The results indicated minor differences in consumer friendliness and usage intention between simpler (such as Healthier Choice Tick, Smileys and Stars) and more complex frontof-pack nutrition labelling formats (such as Multiple Traffic Light, Wheel of Health and GDA scores). Endorsement by national and international health organisations strongly increased the labelling formats' credibility. Participants needed significantly less time to evaluate simpler front-of-pack labelling compared to the more complex labelling format. Thus simpler front-of-pack labelling formats seem more appropriate in a shopping environment where quick decisions are made.

BMC Public Health

Background: Initiating and maintaining a healthy lifestyle-including healthy eating and sufficien... more Background: Initiating and maintaining a healthy lifestyle-including healthy eating and sufficient physical activity-is key for cardiometabolic health. A health-promoting environment can facilitate a healthy lifestyle, and may be especially helpful to reach individuals with a lower socioeconomic status (SES). In the Supreme Nudge project, we will study the effects of pricing and nudging strategies in the supermarketone of the most important point-of-choice settings for food choicesand of a context-specific mobile physical activity promotion app. This paper describes the stepwise and theory-based design of Supreme Nudge, which aims to develop, implement and evaluate environmental changes for a sustained impact on lifestyle behaviours and cardiometabolic health in low SES adults. Methods: Supreme Nudge uses a multidisciplinary and mixed methods approach, integrating participatory action research, qualitative interviews, experimental pilot studies, and a randomized controlled trial in a real-life (supermarket) setting. First, we will identify the needs, characteristics and preferences of the target group as well as of the participating supermarket chain. Second, we will conduct a series of pilot studies to test novel, promising and feasible intervention components. Third, a final selection of intervention components will be implemented in a full-scale randomised controlled supermarket trial. Approximately 1000 low SES adults will be recruited across 8-12 supermarkets and randomised at supermarket level to receive 1) no intervention (control); 2) environmental nudges such as food product placement or promotion; 3) nudges and a tailored physical activity app that provides time-and context specific feedback; 4) pricing interventions, nudges, and the physical activity app. The effects on dietary behaviours and physical activity will be evaluated at 3, 6 and 12 months, and on cardiometabolic health at 6 and 12 months. Finally, we will evaluate the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) of the intervention, and we will use insights from System Innovation and Transition Management theories to define the best strategies for implementation and upscaling beyond the study period. Discussion: The Supreme Nudge project is likely to generate thorough evidence relevant for policy and practice on the effects of a mixed method and multidisciplinary intervention targeting dietary behaviours and physical activity.

European Journal of Clinical Nutrition, 1995

The impact of the social environment on food and fat intake was investigated in several samples i... more The impact of the social environment on food and fat intake was investigated in several samples including family members, close friends, and meal time companions in the Netherlands. Firstly, a food frequency questionnaire to assess the intake of fat, fatty acids and cholesterol was developed. Biomarker-based validity (n = 99), relative validity against a dietary history (n = 191), and

Bibliotheca nutritio et dieta, 1992

Recent recommendations in regard to the level of alcohol Intake have mainly been based on epidemi... more Recent recommendations in regard to the level of alcohol Intake have mainly been based on epidemiologic studies which relied on self-reported amounts of alcohol consumed. Therefore, it is important to be aware of the quality of self-reported measures of alcohol intake. Alcohol intake assessment methods were reviewed with respect to their capacity to rank individuals according to alcohol intake and their ability to explain the variation in the level of intake in population samples. In 33 methodological papers published after 1984, alcohol intake was assessed by five main methods: quantity frequency, extended quantity frequency, retrospective diary, prospective diary, and 24-hour recalls. The mean level of alcohol intake differed by 20 % between these methods. It was also found that when researchers asked specifically about intake of beer, wine, and liquor, this resulted in 20 % higher estimates of intake. These percentages were similar among populations with low and high mean alcohol...

Relative and biomarker-based validity of a food-frequency

Handbook of Eating and Drinking, 2020

Public health nutrition is concerned with the promotion and maintenance of good health through nu... more Public health nutrition is concerned with the promotion and maintenance of good health through nutrition and the prevention of nutrition-related illness in humans. Nutrition communication plays an important role in the dissemination of credible and practical dietary advice and promoting healthful dietary behaviors. The purpose of this chapter is to provide insight in the changes in public health nutrition communication, by addressing the history, key themes, concepts, and approaches of nutrition communication in the Netherlands. The chapter concludes with a broader view of the challenges of public health nutrition communication and presents potential future directions for this field.

Recent recommendations in regard to the level of alcohol Intake have mainly been based on epidemi... more Recent recommendations in regard to the level of alcohol Intake have mainly been based on epidemiologic studies which relied on self-reported amounts of alcohol consumed. Therefore, it is important to be aware of the quality of self-reported measures of alcohol intake. Alcohol intake assessment methods were reviewed with respect to their capacity to rank individuals according to alcohol intake and their ability to explain the variation in the level of intake in population samples. In 33 methodological papers published after 1984, alcohol intake was assessed by five main methods: quantity frequency, extended quantity frequency, retrospective diary, prospective diary, and 24-hour recalls. The mean level of alcohol intake differed by 20% between these methods. It was also found that when researchers asked specifically about intake of beer, wine, and liquor, this resulted in 20% higher estimates of intake. These percentages were similar among populations with low and high mean alcohol c...

Free Radical Biology and Medicine, 2013

Physiology & Behavior, 1995

The effect of the number of others present on the amount of food eaten was investigated in the Ne... more The effect of the number of others present on the amount of food eaten was investigated in the Netherlands by studying spontaneous meal size in 50 free-living young males and females. Subjects recorded food consumption, number of others present, hunger, taste of the food, food availability, and atmosphere at each eating or drinking moment for four (n = 30) or seven consecutive days (n = 20). The results of the study with four and the study with seven recording days were comparable. The mean Pearson within-person correlation coefficient between the number of others present and meal size was 0.24 (n = 50, p < 0.05). This correlation was significant for breakfast (0.40, p < 0.05) and snacks (0.18, p < 0.05), but not for lunch (r = 0.19, p > 0.05) and dinner (r = 0.15, p > 0.05). A path analysis showed no direct effect of the number of others on meal size, but revealed that social facilitation of spontaneous meal size was mediated by meal duration. Social influences Energy intake Meal size Humans Eating

Preventive Medicine, 1998

INTRODUCTION Background. Influences of the social environment Social influences on food intake re... more INTRODUCTION Background. Influences of the social environment Social influences on food intake refer to influences are important in determining eating behavior. Family that one or more subjects have on the eating behavior influences have been demonstrated by resemblances of others, either direct or indirect, either conscious or in intakes within families, but research on resemblance in intake between friends is lacking. We investi-subconscious. Even when eating alone, food choice is gated the resemblance in fat and food intake within influenced by social factors because attitudes and habsocial networks that included family members and its develop through the interaction with other people. peers. Although the impact of social influences is regarded as Methods. Fat consumption was assessed with a food large [1-4], research quantifying this phenomenon is frequency questionnaire in 361 social networks conscarce. In our opinion, there are three main causes that sisting of 15-year-old adolescents (n ‫؍‬ 347), their mothcomplicate the quantification of social influences on ers (n ‫؍‬ 309), their fathers (n ‫؍‬ 270), their friends food intake. (n ‫؍‬ 240), 79 friends of mothers, and 29 friends of fa-(i) The influences that people have on the eating bethers. Ten family interviews and four focus group interhavior of others are not limited to one type, but include views were carried out in a subsample. a range of influences, for instance, modeling of eating Results. Within the nuclear family, the intake of 76 behavior of others, persuasion to consume or avoid to 94% of the foods was significantly associated, which eating certain foods, changing the availability of foods resulted in moderate Pearson correlations for fat and for others, and attempting to change someone's eating fatty acid intake (% of energy intake) between parents attitudes. These social influences are embedded in ev-(0.30-0.34), between mother and child (0.19-0.38), and eryday eating behavior, in family food rules, and in the between father and child (0.16-0.26). No significant coreating culture as a whole. Extraction of social influences relations for fat intake were found between friends, in an experimental situation to get information on the but the consumption of specific foods was related. impact of social influences in real life is therefore virtu-Conclusions. We found clear resemblance in habitual ally impossible. fat and food intake between parents and their adoles-(ii) Social influences play a role in different time cent children and between spouses. Friends do not frames. Influences may be exerted during the eating or seem to have a lot of influence on the fat intake of drinking occasion, such as persuasion, encouragement, adolescents and adults in this population. ᭧1998 American and social facilitation of food intake. Alternatively, they Health Foundation and Academic Press may be spread over a prolonged period, such as the Key Words: eating behavior; fat intake; social influeffect of cohabitation. ence; adolescents; families; peer influence. (iii) People are not necessarily aware of the social influences that are exerted on their eating behavior. If they are aware of this, they might not be eager to admit that their behavior is influenced by others. This makes 1 This research project was funded by the Ministry of Agriculture, it difficult to assess social influences by simply asking Nature Management, and Fisheries. 2 To whom reprint requests should be addressed. them to rate the perceived influences of others.

Nutrition Research, 1997

In order to establish the generalizability or cultural specificity of the factors that influence ... more In order to establish the generalizability or cultural specificity of the factors that influence the ad libitum eating patterns of free-living humans, the eating behaviors of 26 French, 140 American, and 50 Dutch university students were measured with a diet diary technique. Marked cultural differences were present in the amounts, composition, diurnal rhythm, and pattern of intake. In comparison to the French and the Americans, the Dutch ate considerably more overall and ingested a large number of small meals separated by relatively short intervals. They ate with more other people present, for a longer duration at a slower rate, with larger deprivation ratios and smaller satiety ratios, and had more food remaining in their stomachs at the beginning of the meal. Even with these differences the univariate or multivariate correlations between meal size or the Mtermeal interval with the time of day, the number of people present, the subjective state of hunger, the stomach contents, and the premeal interval were quite similar between nationalities. These relationships varied in magnitude especially when hunger self-ratings, the time of day, or the aftermeal interval were involved, but, the directions of the relationships were in all cases the same. These results suggest that, although cultural effects permeate the eating pattern, many of the social, psychological and physical variables that influence intake are similar across cultures.

Journal of Health Communication, 2009

Introduction: This study aimed to perform a quantitative and qualitative process evaluation of th... more Introduction: This study aimed to perform a quantitative and qualitative process evaluation of the introduction of the Choices logo, a front-of-pack nutrition logo on products with a favorable product composition, adopted by many food producers, retail and food service organizations, conditionally endorsed by the Dutch government, validated by scientists, and in the process of international dissemination. Methods: An online questionnaire was sent to adult consumers four months after the introduction of the logo (n=1032) and one year later (n=1127). Additionally, seven consumer focus groups (n=41) were conducted to provide more insight into the questionnaire responses. Results: Quantitative analyses showed that exposure to the logo had significantly increased. Elderly and obese reported to be more in need of a logo than younger and normal-weight respondents. Women perceived the logo more attractive and credible than men did. Further qualitative analyses indicated that the logo's credibility would improve if it became known that governmental and scientific authorities support it. Elderly indicated to need a logo due to health concerns. Consumers interested in health reported that they used the logo. Conclusions: Further research focusing on specific target groups, forming healthful diets and health outcomes is needed to investigate the effectiveness of the Choices logo.

European Journal of Clinical Nutrition, 1997

Objectives: To assess family resemblance in fat intake in a representative sample of Dutch famili... more Objectives: To assess family resemblance in fat intake in a representative sample of Dutch families. Design and subjects: Households (n 1077) with children between 1 and 30 y old were selected from the data set of the Dutch National Food Consumption Survey 1992. Two-day diet records were available for all household members. Results: Pearson correlation coef®cients for fat and fatty acid intakes (En%) ranged from r 0.51 to r 0.61 between parents, and from r 0.52 to r 0.72 between siblings. The mean associations in fat and fatty acid intake (En%) between mothers or fathers and children ranged from r 0.37 to r 0.50, and they were surprisingly similar for children from 1±3 y of age up to children above 21 y of age. Associations were consistently high for foods eaten at home, and weak for foods eaten outside of the home. Similar within-family associations were found in a set of 1052 households of the Dutch National Food Consumption Survey of 1987. Reported adherence to a therapeutic diet by one of the parents did not erase within-family intake correlations, suggesting that family resemblance is a dynamic phenomenon. Conclusion: Dutch parents and children living together resemble each other in short term intake of fats and fatty acids. Sponsorship: This study was supported by the Ministry of Agriculture, Nature Management and Fisheries.

BMC Public Health, 2013

As the global population grows there is a clear challenge to address the needs of consumers, with... more As the global population grows there is a clear challenge to address the needs of consumers, without depleting natural resources and whilst helping to improve nutrition and hygiene to reduce the growth of noncommunicable diseases. For fast-moving consumer goods companies, like Unilever, this challenge provides a clear opportunity to reshape its business to a model that decouples growth from a negative impact on natural resources and health. However, this change in the business model also requires a change in consumer behaviour. In acknowledgement of this challenge Unilever organised a symposium entitled 'Behaviour Change for Better Health: Nutrition, Hygiene and Sustainability'. The intention was to discuss how consumers can be motivated to live a more healthy and sustainable lifestlye in today's environment. This article summarises the main conclusions of the presentations given at the symposium. Three main topics were discussed. In the fi rst session, key experts discussed how demographic changesparticularly in developing and emerging countries-imply the need for consumer behaviour change. The second session focused on the use of behaviour change theory to design, implement and evaluate interventions, and the potential role of (new or reformulated) products as agents of change. In the fi nal session, key issues were discussed regarding the use of collaborations to increase the impact and reach, and to decrease the costs, of interventions. The symposium highlighted a number of key scientifi c challenges for Unilever and other parties that have set nutrition, hygiene and sustainability as key priorities. The key challenges include: adapting behaviour change approaches to cultures in developing and emerging economies; designing evidence-based behaviour change interventions, in which products can play a key role as agents of change; and scaling up behaviour change activities in cost-eff ective ways, which requires a new mindset involving public-private partnerships.

American Journal of Epidemiology, 1999

Recent recommendations in regard to the level of alcohol Intake have mainly been based on epidemi... more Recent recommendations in regard to the level of alcohol Intake have mainly been based on epidemiologic studies which relied on self-reported amounts of alcohol consumed. Therefore, it is important to be aware of the quality of self-reported measures of alcohol intake. Alcohol intake assessment methods were reviewed with respect to their capacity to rank individuals according to alcohol intake and their ability to explain the variation in the level of intake in population samples. In 33 methodological papers published after 1984, alcohol intake was assessed by five main methods: quantity frequency, extended quantity frequency, retrospective diary, prospective diary, and 24-hour recalls. The mean level of alcohol intake differed by 20% between these methods. It was also found that when researchers asked specifically about intake of beer, wine, and liquor, this resulted in 20% higher estimates of intake. These percentages were similar among populations with low and high mean alcohol consumption (4 vs. 10 drinks per week). It was found that ranking of individuals according to intake was satisfactory, with weighted correlation coefficients between methods ranging from 0.63 to 0.73. The authors conclude that, when there is sufficient evidence that alcohol intake is underestimated in a population, methods that enquire about both the frequency and amount consumed, for beer, wine, and liquor, separately, will yield the most realistic levels of intake.

Appetite, 2008

In two studies, the impact of eight front-of-pack nutrition labelling formats that differed in co... more In two studies, the impact of eight front-of-pack nutrition labelling formats that differed in complexity was investigated across four European countries. In total 1630 men and women (18-55 yrs) were recruited from Internet panels in the United Kingdom, Germany, Italy and the Netherlands for study 1 and 776 in Italy and the United Kingdom for study 2. Participants evaluated several products (healthier and less healthy variants of the same product category) with a front-of-pack nutrition labelling format. The first study evaluated different labelling formats on consumer friendliness (comprehension, liking and credibility) and the second study measured the effect of the different labelling formats on decision-making (usage intention and process time). The results indicated minor differences in consumer friendliness and usage intention between simpler (such as Healthier Choice Tick, Smileys and Stars) and more complex frontof-pack nutrition labelling formats (such as Multiple Traffic Light, Wheel of Health and GDA scores). Endorsement by national and international health organisations strongly increased the labelling formats' credibility. Participants needed significantly less time to evaluate simpler front-of-pack labelling compared to the more complex labelling format. Thus simpler front-of-pack labelling formats seem more appropriate in a shopping environment where quick decisions are made.

BMC Public Health

Background: Initiating and maintaining a healthy lifestyle-including healthy eating and sufficien... more Background: Initiating and maintaining a healthy lifestyle-including healthy eating and sufficient physical activity-is key for cardiometabolic health. A health-promoting environment can facilitate a healthy lifestyle, and may be especially helpful to reach individuals with a lower socioeconomic status (SES). In the Supreme Nudge project, we will study the effects of pricing and nudging strategies in the supermarketone of the most important point-of-choice settings for food choicesand of a context-specific mobile physical activity promotion app. This paper describes the stepwise and theory-based design of Supreme Nudge, which aims to develop, implement and evaluate environmental changes for a sustained impact on lifestyle behaviours and cardiometabolic health in low SES adults. Methods: Supreme Nudge uses a multidisciplinary and mixed methods approach, integrating participatory action research, qualitative interviews, experimental pilot studies, and a randomized controlled trial in a real-life (supermarket) setting. First, we will identify the needs, characteristics and preferences of the target group as well as of the participating supermarket chain. Second, we will conduct a series of pilot studies to test novel, promising and feasible intervention components. Third, a final selection of intervention components will be implemented in a full-scale randomised controlled supermarket trial. Approximately 1000 low SES adults will be recruited across 8-12 supermarkets and randomised at supermarket level to receive 1) no intervention (control); 2) environmental nudges such as food product placement or promotion; 3) nudges and a tailored physical activity app that provides time-and context specific feedback; 4) pricing interventions, nudges, and the physical activity app. The effects on dietary behaviours and physical activity will be evaluated at 3, 6 and 12 months, and on cardiometabolic health at 6 and 12 months. Finally, we will evaluate the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) of the intervention, and we will use insights from System Innovation and Transition Management theories to define the best strategies for implementation and upscaling beyond the study period. Discussion: The Supreme Nudge project is likely to generate thorough evidence relevant for policy and practice on the effects of a mixed method and multidisciplinary intervention targeting dietary behaviours and physical activity.

European Journal of Clinical Nutrition, 1995

The impact of the social environment on food and fat intake was investigated in several samples i... more The impact of the social environment on food and fat intake was investigated in several samples including family members, close friends, and meal time companions in the Netherlands. Firstly, a food frequency questionnaire to assess the intake of fat, fatty acids and cholesterol was developed. Biomarker-based validity (n = 99), relative validity against a dietary history (n = 191), and

Bibliotheca nutritio et dieta, 1992