Jaap Seidell - Academia.edu (original) (raw)
Papers by Jaap Seidell
Research Square (Research Square), Mar 11, 2022
Background Childhood obesity is a complex disease resulting from the interaction of multiple fact... more Background Childhood obesity is a complex disease resulting from the interaction of multiple factors. The effective management of childhood obesity requires assessing the psychosocial and lifestyle factors that may play a role in the development and maintenance of obesity. This study centers on available scientific literature on psychosocial and lifestyle assessments for childhood obesity, and experiences and views of healthcare professionals with regard to assessing psychosocial and lifestyle factors within Dutch integrated care. Methods Two methods were used. First, a scoping review (in PubMed, Embase, PsycInfo, IBSS, Scopus and Web of Science) was performed by systematically searching for scientific literature on psychosocial and lifestyle assessments for childhood obesity. Data were analysed by extracting data in Microsoft Excel. Second, focus group discussions were held with healthcare professionals from a variety of disciplines and domains to explore their experiences and views about assessing psychosocial and lifestyle factors within Dutch integrated care. Data were analysed using template analysis, complemented with open coding in MAXQDA. Results The results provide an overview of relevant psychosocial and lifestyle factors that should be assessed and were classified as child, family, parental and lifestyle (e.g. nutrition, physical activity and sleep factors) and structured into psychological and social aspects. Insights into how to assess psychosocial and lifestyle factors were identified as well, including talking about psychosocial factors, lifestyle and weight; the professional-patient relationship; and attitudes of healthcare professionals. Conclusions This study provides an overview of psychosocial and lifestyle factors that should be identified within the context of childhood obesity care, as they may contribute to the development and maintenance of obesity. The results highlight the importance of both what is assessed and how it is assessed. The results of this study can be used to develop practical tools for facilitating healthcare professionals in conducting a psychosocial and lifestyle assessment.
IntroductionHealthcare professionals (HCPs) play an important role in childhood overweight and ob... more IntroductionHealthcare professionals (HCPs) play an important role in childhood overweight and obesity care, yet they often feel ill-equipped to manage this complex and sensitive health problem. As part of Dutch integrated care for childhood overweight and obesity, a training for coordinating professionals (CPs) was designed and carried out. This study evaluates the training based on the four levels of Kirkpatrick’s model of training evaluation: (1) reaction, (2) learning, (3) behaviour, and (4) results.MethodEleven CPs who completed the training participated in this mixed-methods study. First, completed questionnaires on the four levels were analysed with Qualtrics. Next, the transcripts of semi-structured interviews on levels 1, 3 and 4 were analysed in MAXQDA using thematic analysis. ResultsOn level 1, participants were satisfied with the training as it stimulated their professional and personal development, for instance awareness of prejudices about people with overweight and ob...
Maturitas, 1991
In 452 Pre-and post-menopausal women aged 41-75. participating in a breast cancer screening progr... more In 452 Pre-and post-menopausal women aged 41-75. participating in a breast cancer screening programme. we studied the associations between several factors and waist/hip ratio. Differences in waist/hiip ratio bet_
Public Health Nutrition
Objective:To investigate the content of lunchboxes of primary school children and to examine chil... more Objective:To investigate the content of lunchboxes of primary school children and to examine children’s support and preferences for alternative healthy school lunch concepts.Design:A cross-sectional study among Dutch children from seven primary schools. The content of the lunchboxes was assessed by photographs. Support and preferences for alternative lunch concepts were examined via a self-reported questionnaire. Linear regression analyses were used to investigate the associations between children’s support and preferences and sex, educational group and migration background.Setting:The Netherlands.Participants:Primary school children.Results:A total of 660 children were included (average 9·9 years old). Most lunchboxes contained sandwiches and a drink. Few lunchboxes contained fruit or vegetables. The alternative school lunch concepts elicited mixed support among children. The lunch concepts ‘Sandwiches prepared by the children themselves’ and a ‘hot lunch buffet’ had the highest me...
Appetite, 2016
The main purpose of this prospective intervention study was to determine whether eating styles af... more The main purpose of this prospective intervention study was to determine whether eating styles after an intensive, partly inpatient, one year combined lifestyle intervention are associated with weight change in the following year in severely obese children and adolescents. A total of 120 participants (8e19 years) with an average SDS-BMI of 3.41 (SD ¼ 0.38) was included. Measurements were conducted at baseline (T0), at the end of treatment (T12) and at the end of follow up two years after baseline (T24). The primary outcome measurement was the DSDS-BMI between T12 and
Nederlands tijdschrift voor geneeskunde, 2010
The Dutch College of General Practitioners (Dutch acronym: NHG) recently published a summary of t... more The Dutch College of General Practitioners (Dutch acronym: NHG) recently published a summary of their practice guidelines for the treatment of obesity in this journal. In the Netherlands, these guidelines form part of an integrated approach towards the prevention and management of obesity. The management section approaches obesity as a chronic disease that requires self-management by the patient with support from the healthcare system. The aim of treatment is improved quality of life and societal participation. Weight loss of 5-10% is an indicator of the success of the management strategy; this is accompanied by improvement in health and a substantial reduction of the risk of comorbidities. Management strategies currently require the general practitioner to play a central role, but care could possibly be organised more efficiently in the future.
TSG - Tijdschrift voor gezondheidswetenschappen
SamenvattingDit artikel bevat een samenvatting van en achtergrondinformatie over het in 2022 vers... more SamenvattingDit artikel bevat een samenvatting van en achtergrondinformatie over het in 2022 verschenen kinderdeel van de nieuwe overkoepelende multidisciplinaire richtlijn rond diagnostiek, ondersteuning en zorg voor mensen met overgewicht en obesitas. Deze richtlijn, waarvan het deel over volwassenen in 2023 verschijnt, is bestemd voor alle hulp- en zorgverleners die betrokken zijn bij de ondersteuning en zorg voor mensen met obesitas of overgewicht in combinatie met risicofactoren en/of comorbiditeit, en voor degenen die zorgdragen voor de organisatie en bekostiging van de benodigde ondersteuning en zorg.De kernboodschap van het kinderdeel van de nieuwe richtlijn is in lijn met het Landelijk model ketenaanpak voor kinderen met overgewicht en obesitas uit 2018 en ook met gerelateerde richtlijnen en zorgstandaarden: het behandelaanbod dient aan te sluiten bij de wensen, behoeften en mogelijkheden van kind en gezin. Voorafgaand aan de behandeling is het daarom belangrijk om niet all...
![Research paper thumbnail of [Lifestyle medicine: effective cure or just snake oil?]](https://attachments.academia-assets.com/103326482/thumbnails/1.jpg)
](Nederlands tijdschrift voor geneeskunde, 2019
Many chronic non-communicable diseases are at least partly caused by unhealthy lifestyles; an exa... more Many chronic non-communicable diseases are at least partly caused by unhealthy lifestyles; an example is type 2 diabetes mellitus (T2DM). Lifestyle interventions have been shown to substantially reduce the risk of T2DM in high-risk patients. The risk reduction diminishes over time, but a long-term (> ten years) reduction is still achieved. Better compliance with the intervention and higher quality of lifestyle counselling during a longer period of time are predictors of improved long-term risk reduction. In patients with established T2DM, lifestyle intervention can be of great benefit as well. This can result in remission in a substantial proportion of the patients (12-46%) over a one-year period. A Mediterranean diet, which is low in both refined, starch-rich foods and high-sugar drinks, seems to result in the best outcomes. However, again the compliance and quality of lifestyle counselling are of crucial importance. Lifestyle medicine deserves serious attention in clinical prac...
Nutrients, 2021
This study investigated ethnic differences in childhood body mass index (BMI) in children from Du... more This study investigated ethnic differences in childhood body mass index (BMI) in children from Dutch and Turkish descent and the role of infant feeding factors (breastfeeding duration, milk feeding frequency, as well as the timing, frequency and variety of complementary feeding (CF)). We used data from 244 children (116 Dutch and 128 Turkish) participating in a prospective study in the Netherlands. BMI was measured at 2, 3 and 5 years and standard deviation scores (sds) were derived using WHO references. Using linear mixed regression analyses, we examined ethnic differences in BMI-sds between 2 and 5 years, and the role of infant feeding in separate models including milk or CF factors, or both (full model). Relative to Dutch children, Turkish children had higher BMI-sds at age 3 (mean difference: 0.26; 95%CI: 0.04, 0.48) and 5 (0.63; 0.39, 0.88), but not at 2 years (0.08; −0.16, 0.31). Ethnic differences in BMI-sds were somewhat attenuated by CF factors at age 3 (0.16; −0.07, 0.40) ...
Nutrients, 2021
Limited and inconsistent evidence exists on the associations between dietary patterns and overwei... more Limited and inconsistent evidence exists on the associations between dietary patterns and overweight during childhood. The present study describes dietary patterns of three-year-old Dutch children and associations between childhood overweight and body mass index (BMI) development between 3 and 10 years. In the GECKO Drenthe birth cohort (N = 1306), body height and weight were measured around the age of 3, 4, 5, and 10 years, and overweight was defined according to Cole and Lobstein. A validated food frequency questionnaire (FFQ) was used to measure diet at 3 years. Dietary patterns were derived using principal components analysis (PCA). Using logistic regression analyses, pattern scores were related to overweight at 3 and 10 years. A linear mixed-effect model was used to estimate BMI-SDS development between 3 to 10 years according to quartiles of adherence to the pattern scores. Two dietary patterns were identified: (1) ‘minimally processed foods’, indicating high intakes of vegetab...
Obesity Facts, 2020
Background: As in many other countries around the world, the Netherlands has a high prevalence of... more Background: As in many other countries around the world, the Netherlands has a high prevalence of overweight and obesity in children. About 1 in 7 of children aged 2–19 years has either overweight or obesity. Summary: In this paper the national and local activities aimed at the prevention and management of obesity in children and adolescents in the Netherlands are reviewed. It is recommended to, nationally as well as locally, take an integrated-systems approach that tackles the obesogenic food environment as well as upstream and downstream determinants of obesity. Efforts should take a life course approach and be focused on promoting obesity prevention as well as improving the management of children who already have obesity. The national policies in the Netherlands rely heavily on self-regulation by stakeholders such as supermarkets, restaurants, and the food industry. Local policies and actions such as the whole-systems approach in Amsterdam are promising. Future directions include...
Nature Reviews Endocrinology, 2016
Recent data from surveys in the USA have shown that 37.7% of adult individuals and 17.0% of child... more Recent data from surveys in the USA have shown that 37.7% of adult individuals and 17.0% of children currently have obesity, with no sign of a reduction despite federal and local obesity prevention strategies. In particular, severe obesity seems to be increasing. Obesity, therefore, remains a major public health problem that requires drastic action.
International Journal of Environmental Research and Public Health
Despite policy intentions and many interventions aimed at reducing socioeconomic health inequalit... more Despite policy intentions and many interventions aimed at reducing socioeconomic health inequalities in recent decades in the Netherlands and other affluent countries, these inequalities have not been reduced. Based on a narrative literature review, this paper aims to increase insight into why socioeconomic health inequalities are so persistent and build a way forward for improved approaches from a theoretical perspective. Firstly, we present relevant theories focusing on individual determinants of health-related behaviors. Thereafter, we present theories that take into account determinants of the individual level and the environmental level. Lastly, we show the complexity of the system of individual determinants, environmental determinants and behavior change for low socioeconomic position (SEP) groups and describe the next steps in developing and evaluating future effective approaches. These steps include systems thinking, a complex whole-system approach and participation of all s...
Supportive Care in Cancer, 2021
Objective Two-third of colorectal cancer (CRC) survivors are overweight or obese. Psychological d... more Objective Two-third of colorectal cancer (CRC) survivors are overweight or obese. Psychological distress and low health-related quality of life (HRQoL) may be barriers to improving diet. We aimed to assess associations between psychological distress and HRQoL and the need for dietary support in CRC survivors with overweight or obesity. Methods All alive individuals diagnosed with CRC between 2000 and 2009, as registered by the Dutch population-based Eindhoven Cancer Registry, were eligible for participation and received a questionnaire. Multivariable logistic regression analyses were conducted to assess associations between HRQoL (EORTC QLQ-C30), symptoms of anxiety and depression (HADS), and self-reported need for dietary support (single-item). Results A total of 1458 completed the questionnaire (response rate 82%), and 756 (43%) had a BMI of 25.0 or higher and complete data on “need for dietary support” and were included for analyses. BMI ranged between 25.0 and 60.6 (mean, 28.9; ...
International Journal of Environmental Research and Public Health, 2021
To ensure that health behavior interventions for children living in low socioeconomic position (S... more To ensure that health behavior interventions for children living in low socioeconomic position (SEP) neighborhoods are in line with children’s wishes and needs, participation of the children in the development, implementation, and evaluation is crucial. In this paper, we show how children living in three low-SEP neighborhoods in the Netherlands can be involved in Participatory Action Research (PAR) by using the photovoice method, and what influences this research process. Observations, informal chats, semi-structured interviews, and focus group discussions with children and professionals were done to evaluate the research process. The photovoice method provided comprehensive information from the children’s perspectives. With the help of the community workers, the children identified feasible actions. We found that it is important to constantly discuss the research process with participants, start with a concrete question or problem, and adapt the project to the local context and ski...
Appetite, 2020
Background: Supermarkets are a key point of purchase for groceries and can therefore have a consi... more Background: Supermarkets are a key point of purchase for groceries and can therefore have a considerable influence on eating behaviours. Evidence suggests that descriptive social norm nudges in shopping trolleys can be effective in stimulating vegetable purchases in supermarkets. Objective: We investigated the effect of a combination of two nudging strategies in shopping trolleysa social norm about vegetable purchases and a designated place to put vegetableson the amount of vegetables purchased in a supermarket in a deprived urban area in the Netherlands. Design: A quasi-experimental study was conducted with two conditions: 1) intervention days on which the shopping trolleys in the supermarket had a green nudge inlay indicating a place for vegetables and a social norm message and 2) control days on which the regular shopping trolleys (no inlay or social norm) were used in the supermarket. During both the intervention and control days, vegetable purchases were measured by means of the cash receipts collected from customers at the checkouts. In addition, individual and purchase characteristics were assessed by means of short surveys. Results: In total, 244 customers participated in the study. Ordinal logistic regression analyses showed that customers on the intervention days (n = 123) were in a higher tertile for grams of vegetables purchased compared to the customers on the control days (OR: 1.66, 95% CI: 1.03-2.69, p = 0.03), especially those who bought groceries for less than three days (OR: 3.24, 95% CI: 1.43-7.35, p = 0.003). Sensitivity analyses also showed that intervention customers who noticed the green inlay were even more likely to purchase more vegetables (OR: 1.86, 95% CI: 1.06-3.25, p = 0.02). Conclusions: This quasi-experimental study showed that a nudge inlay in shopping trolleys communicating a social norm on vegetable purchases and indicating a distinct place to put vegetables in the trolley increased vegetable purchases among supermarket customers.
Nutrition Journal, 2019
Background: Healthier dietary patterns are generally more costly than less healthy patterns, but ... more Background: Healthier dietary patterns are generally more costly than less healthy patterns, but dietary costs may be more important for dietary quality in lower educated and ethnic minority groups. The aim of this study was to investigate the association between dietary costs and dietary quality and interactions with ethnicity and socioeconomic position (SEP). Methods: We used cross-sectional data from 4717 Dutch, Surinamese, Turkish and Moroccan origin participants of the multi-ethnic HELIUS study (the Netherlands), who completed an ethnic-specific food frequency questionnaire (FFQ). The primary outcome measure was dietary quality according to adherence to the Dutch Healthy Diet index 2015 (DHD15-index, range 0-130). Individual dietary costs (the monetary value attached to consumed diets in Euros) were estimated by merging a food price variable with the FFQ nutrient composition database. Regression analyses were used to examine main and interaction effects. Analyses were adjusted for age, sex, smoking, energy intake, physical activity, ethnicity and educational level. Results: Having higher dietary costs was associated with higher dietary quality. Analyses stratified by educational level showed that associations were stronger in higher educated (B tertile3 = 8.06, 95%CI = 5.63; 10.48) than in lower educated participants (B tertile3 = 5.09, 95%CI = 2.74; 7.44). Stratification by ethnic origin showed strongest associations in Turkish participants (B tertile2 = 9.31, 95%CI = 5.96; 12.65) and weakest associations in Moroccan participants (B tertile3 = 4.29, 95%CI = 0.58; 8.01). Regardless of their level of education, Turkish and Moroccan individuals consumed higher quality diets at the lowest cost than Dutch participants. Conclusions: The importance of dietary costs for dietary quality differs between socioeconomic and ethnic subgroups. Increasing individual food budgets or decreasing food prices may be effective for the promotion of healthy diets, but differential effects across socioeconomic and ethnic subgroups may be expected.
Research Square (Research Square), Mar 11, 2022
Background Childhood obesity is a complex disease resulting from the interaction of multiple fact... more Background Childhood obesity is a complex disease resulting from the interaction of multiple factors. The effective management of childhood obesity requires assessing the psychosocial and lifestyle factors that may play a role in the development and maintenance of obesity. This study centers on available scientific literature on psychosocial and lifestyle assessments for childhood obesity, and experiences and views of healthcare professionals with regard to assessing psychosocial and lifestyle factors within Dutch integrated care. Methods Two methods were used. First, a scoping review (in PubMed, Embase, PsycInfo, IBSS, Scopus and Web of Science) was performed by systematically searching for scientific literature on psychosocial and lifestyle assessments for childhood obesity. Data were analysed by extracting data in Microsoft Excel. Second, focus group discussions were held with healthcare professionals from a variety of disciplines and domains to explore their experiences and views about assessing psychosocial and lifestyle factors within Dutch integrated care. Data were analysed using template analysis, complemented with open coding in MAXQDA. Results The results provide an overview of relevant psychosocial and lifestyle factors that should be assessed and were classified as child, family, parental and lifestyle (e.g. nutrition, physical activity and sleep factors) and structured into psychological and social aspects. Insights into how to assess psychosocial and lifestyle factors were identified as well, including talking about psychosocial factors, lifestyle and weight; the professional-patient relationship; and attitudes of healthcare professionals. Conclusions This study provides an overview of psychosocial and lifestyle factors that should be identified within the context of childhood obesity care, as they may contribute to the development and maintenance of obesity. The results highlight the importance of both what is assessed and how it is assessed. The results of this study can be used to develop practical tools for facilitating healthcare professionals in conducting a psychosocial and lifestyle assessment.
IntroductionHealthcare professionals (HCPs) play an important role in childhood overweight and ob... more IntroductionHealthcare professionals (HCPs) play an important role in childhood overweight and obesity care, yet they often feel ill-equipped to manage this complex and sensitive health problem. As part of Dutch integrated care for childhood overweight and obesity, a training for coordinating professionals (CPs) was designed and carried out. This study evaluates the training based on the four levels of Kirkpatrick’s model of training evaluation: (1) reaction, (2) learning, (3) behaviour, and (4) results.MethodEleven CPs who completed the training participated in this mixed-methods study. First, completed questionnaires on the four levels were analysed with Qualtrics. Next, the transcripts of semi-structured interviews on levels 1, 3 and 4 were analysed in MAXQDA using thematic analysis. ResultsOn level 1, participants were satisfied with the training as it stimulated their professional and personal development, for instance awareness of prejudices about people with overweight and ob...
Maturitas, 1991
In 452 Pre-and post-menopausal women aged 41-75. participating in a breast cancer screening progr... more In 452 Pre-and post-menopausal women aged 41-75. participating in a breast cancer screening programme. we studied the associations between several factors and waist/hip ratio. Differences in waist/hiip ratio bet_
Public Health Nutrition
Objective:To investigate the content of lunchboxes of primary school children and to examine chil... more Objective:To investigate the content of lunchboxes of primary school children and to examine children’s support and preferences for alternative healthy school lunch concepts.Design:A cross-sectional study among Dutch children from seven primary schools. The content of the lunchboxes was assessed by photographs. Support and preferences for alternative lunch concepts were examined via a self-reported questionnaire. Linear regression analyses were used to investigate the associations between children’s support and preferences and sex, educational group and migration background.Setting:The Netherlands.Participants:Primary school children.Results:A total of 660 children were included (average 9·9 years old). Most lunchboxes contained sandwiches and a drink. Few lunchboxes contained fruit or vegetables. The alternative school lunch concepts elicited mixed support among children. The lunch concepts ‘Sandwiches prepared by the children themselves’ and a ‘hot lunch buffet’ had the highest me...
Appetite, 2016
The main purpose of this prospective intervention study was to determine whether eating styles af... more The main purpose of this prospective intervention study was to determine whether eating styles after an intensive, partly inpatient, one year combined lifestyle intervention are associated with weight change in the following year in severely obese children and adolescents. A total of 120 participants (8e19 years) with an average SDS-BMI of 3.41 (SD ¼ 0.38) was included. Measurements were conducted at baseline (T0), at the end of treatment (T12) and at the end of follow up two years after baseline (T24). The primary outcome measurement was the DSDS-BMI between T12 and
Nederlands tijdschrift voor geneeskunde, 2010
The Dutch College of General Practitioners (Dutch acronym: NHG) recently published a summary of t... more The Dutch College of General Practitioners (Dutch acronym: NHG) recently published a summary of their practice guidelines for the treatment of obesity in this journal. In the Netherlands, these guidelines form part of an integrated approach towards the prevention and management of obesity. The management section approaches obesity as a chronic disease that requires self-management by the patient with support from the healthcare system. The aim of treatment is improved quality of life and societal participation. Weight loss of 5-10% is an indicator of the success of the management strategy; this is accompanied by improvement in health and a substantial reduction of the risk of comorbidities. Management strategies currently require the general practitioner to play a central role, but care could possibly be organised more efficiently in the future.
TSG - Tijdschrift voor gezondheidswetenschappen
SamenvattingDit artikel bevat een samenvatting van en achtergrondinformatie over het in 2022 vers... more SamenvattingDit artikel bevat een samenvatting van en achtergrondinformatie over het in 2022 verschenen kinderdeel van de nieuwe overkoepelende multidisciplinaire richtlijn rond diagnostiek, ondersteuning en zorg voor mensen met overgewicht en obesitas. Deze richtlijn, waarvan het deel over volwassenen in 2023 verschijnt, is bestemd voor alle hulp- en zorgverleners die betrokken zijn bij de ondersteuning en zorg voor mensen met obesitas of overgewicht in combinatie met risicofactoren en/of comorbiditeit, en voor degenen die zorgdragen voor de organisatie en bekostiging van de benodigde ondersteuning en zorg.De kernboodschap van het kinderdeel van de nieuwe richtlijn is in lijn met het Landelijk model ketenaanpak voor kinderen met overgewicht en obesitas uit 2018 en ook met gerelateerde richtlijnen en zorgstandaarden: het behandelaanbod dient aan te sluiten bij de wensen, behoeften en mogelijkheden van kind en gezin. Voorafgaand aan de behandeling is het daarom belangrijk om niet all...
Nederlands tijdschrift voor geneeskunde, 2019
Many chronic non-communicable diseases are at least partly caused by unhealthy lifestyles; an exa... more Many chronic non-communicable diseases are at least partly caused by unhealthy lifestyles; an example is type 2 diabetes mellitus (T2DM). Lifestyle interventions have been shown to substantially reduce the risk of T2DM in high-risk patients. The risk reduction diminishes over time, but a long-term (> ten years) reduction is still achieved. Better compliance with the intervention and higher quality of lifestyle counselling during a longer period of time are predictors of improved long-term risk reduction. In patients with established T2DM, lifestyle intervention can be of great benefit as well. This can result in remission in a substantial proportion of the patients (12-46%) over a one-year period. A Mediterranean diet, which is low in both refined, starch-rich foods and high-sugar drinks, seems to result in the best outcomes. However, again the compliance and quality of lifestyle counselling are of crucial importance. Lifestyle medicine deserves serious attention in clinical prac...
Nutrients, 2021
This study investigated ethnic differences in childhood body mass index (BMI) in children from Du... more This study investigated ethnic differences in childhood body mass index (BMI) in children from Dutch and Turkish descent and the role of infant feeding factors (breastfeeding duration, milk feeding frequency, as well as the timing, frequency and variety of complementary feeding (CF)). We used data from 244 children (116 Dutch and 128 Turkish) participating in a prospective study in the Netherlands. BMI was measured at 2, 3 and 5 years and standard deviation scores (sds) were derived using WHO references. Using linear mixed regression analyses, we examined ethnic differences in BMI-sds between 2 and 5 years, and the role of infant feeding in separate models including milk or CF factors, or both (full model). Relative to Dutch children, Turkish children had higher BMI-sds at age 3 (mean difference: 0.26; 95%CI: 0.04, 0.48) and 5 (0.63; 0.39, 0.88), but not at 2 years (0.08; −0.16, 0.31). Ethnic differences in BMI-sds were somewhat attenuated by CF factors at age 3 (0.16; −0.07, 0.40) ...
Nutrients, 2021
Limited and inconsistent evidence exists on the associations between dietary patterns and overwei... more Limited and inconsistent evidence exists on the associations between dietary patterns and overweight during childhood. The present study describes dietary patterns of three-year-old Dutch children and associations between childhood overweight and body mass index (BMI) development between 3 and 10 years. In the GECKO Drenthe birth cohort (N = 1306), body height and weight were measured around the age of 3, 4, 5, and 10 years, and overweight was defined according to Cole and Lobstein. A validated food frequency questionnaire (FFQ) was used to measure diet at 3 years. Dietary patterns were derived using principal components analysis (PCA). Using logistic regression analyses, pattern scores were related to overweight at 3 and 10 years. A linear mixed-effect model was used to estimate BMI-SDS development between 3 to 10 years according to quartiles of adherence to the pattern scores. Two dietary patterns were identified: (1) ‘minimally processed foods’, indicating high intakes of vegetab...
Obesity Facts, 2020
Background: As in many other countries around the world, the Netherlands has a high prevalence of... more Background: As in many other countries around the world, the Netherlands has a high prevalence of overweight and obesity in children. About 1 in 7 of children aged 2–19 years has either overweight or obesity. Summary: In this paper the national and local activities aimed at the prevention and management of obesity in children and adolescents in the Netherlands are reviewed. It is recommended to, nationally as well as locally, take an integrated-systems approach that tackles the obesogenic food environment as well as upstream and downstream determinants of obesity. Efforts should take a life course approach and be focused on promoting obesity prevention as well as improving the management of children who already have obesity. The national policies in the Netherlands rely heavily on self-regulation by stakeholders such as supermarkets, restaurants, and the food industry. Local policies and actions such as the whole-systems approach in Amsterdam are promising. Future directions include...
Nature Reviews Endocrinology, 2016
Recent data from surveys in the USA have shown that 37.7% of adult individuals and 17.0% of child... more Recent data from surveys in the USA have shown that 37.7% of adult individuals and 17.0% of children currently have obesity, with no sign of a reduction despite federal and local obesity prevention strategies. In particular, severe obesity seems to be increasing. Obesity, therefore, remains a major public health problem that requires drastic action.
International Journal of Environmental Research and Public Health
Despite policy intentions and many interventions aimed at reducing socioeconomic health inequalit... more Despite policy intentions and many interventions aimed at reducing socioeconomic health inequalities in recent decades in the Netherlands and other affluent countries, these inequalities have not been reduced. Based on a narrative literature review, this paper aims to increase insight into why socioeconomic health inequalities are so persistent and build a way forward for improved approaches from a theoretical perspective. Firstly, we present relevant theories focusing on individual determinants of health-related behaviors. Thereafter, we present theories that take into account determinants of the individual level and the environmental level. Lastly, we show the complexity of the system of individual determinants, environmental determinants and behavior change for low socioeconomic position (SEP) groups and describe the next steps in developing and evaluating future effective approaches. These steps include systems thinking, a complex whole-system approach and participation of all s...
Supportive Care in Cancer, 2021
Objective Two-third of colorectal cancer (CRC) survivors are overweight or obese. Psychological d... more Objective Two-third of colorectal cancer (CRC) survivors are overweight or obese. Psychological distress and low health-related quality of life (HRQoL) may be barriers to improving diet. We aimed to assess associations between psychological distress and HRQoL and the need for dietary support in CRC survivors with overweight or obesity. Methods All alive individuals diagnosed with CRC between 2000 and 2009, as registered by the Dutch population-based Eindhoven Cancer Registry, were eligible for participation and received a questionnaire. Multivariable logistic regression analyses were conducted to assess associations between HRQoL (EORTC QLQ-C30), symptoms of anxiety and depression (HADS), and self-reported need for dietary support (single-item). Results A total of 1458 completed the questionnaire (response rate 82%), and 756 (43%) had a BMI of 25.0 or higher and complete data on “need for dietary support” and were included for analyses. BMI ranged between 25.0 and 60.6 (mean, 28.9; ...
International Journal of Environmental Research and Public Health, 2021
To ensure that health behavior interventions for children living in low socioeconomic position (S... more To ensure that health behavior interventions for children living in low socioeconomic position (SEP) neighborhoods are in line with children’s wishes and needs, participation of the children in the development, implementation, and evaluation is crucial. In this paper, we show how children living in three low-SEP neighborhoods in the Netherlands can be involved in Participatory Action Research (PAR) by using the photovoice method, and what influences this research process. Observations, informal chats, semi-structured interviews, and focus group discussions with children and professionals were done to evaluate the research process. The photovoice method provided comprehensive information from the children’s perspectives. With the help of the community workers, the children identified feasible actions. We found that it is important to constantly discuss the research process with participants, start with a concrete question or problem, and adapt the project to the local context and ski...
Appetite, 2020
Background: Supermarkets are a key point of purchase for groceries and can therefore have a consi... more Background: Supermarkets are a key point of purchase for groceries and can therefore have a considerable influence on eating behaviours. Evidence suggests that descriptive social norm nudges in shopping trolleys can be effective in stimulating vegetable purchases in supermarkets. Objective: We investigated the effect of a combination of two nudging strategies in shopping trolleysa social norm about vegetable purchases and a designated place to put vegetableson the amount of vegetables purchased in a supermarket in a deprived urban area in the Netherlands. Design: A quasi-experimental study was conducted with two conditions: 1) intervention days on which the shopping trolleys in the supermarket had a green nudge inlay indicating a place for vegetables and a social norm message and 2) control days on which the regular shopping trolleys (no inlay or social norm) were used in the supermarket. During both the intervention and control days, vegetable purchases were measured by means of the cash receipts collected from customers at the checkouts. In addition, individual and purchase characteristics were assessed by means of short surveys. Results: In total, 244 customers participated in the study. Ordinal logistic regression analyses showed that customers on the intervention days (n = 123) were in a higher tertile for grams of vegetables purchased compared to the customers on the control days (OR: 1.66, 95% CI: 1.03-2.69, p = 0.03), especially those who bought groceries for less than three days (OR: 3.24, 95% CI: 1.43-7.35, p = 0.003). Sensitivity analyses also showed that intervention customers who noticed the green inlay were even more likely to purchase more vegetables (OR: 1.86, 95% CI: 1.06-3.25, p = 0.02). Conclusions: This quasi-experimental study showed that a nudge inlay in shopping trolleys communicating a social norm on vegetable purchases and indicating a distinct place to put vegetables in the trolley increased vegetable purchases among supermarket customers.
Nutrition Journal, 2019
Background: Healthier dietary patterns are generally more costly than less healthy patterns, but ... more Background: Healthier dietary patterns are generally more costly than less healthy patterns, but dietary costs may be more important for dietary quality in lower educated and ethnic minority groups. The aim of this study was to investigate the association between dietary costs and dietary quality and interactions with ethnicity and socioeconomic position (SEP). Methods: We used cross-sectional data from 4717 Dutch, Surinamese, Turkish and Moroccan origin participants of the multi-ethnic HELIUS study (the Netherlands), who completed an ethnic-specific food frequency questionnaire (FFQ). The primary outcome measure was dietary quality according to adherence to the Dutch Healthy Diet index 2015 (DHD15-index, range 0-130). Individual dietary costs (the monetary value attached to consumed diets in Euros) were estimated by merging a food price variable with the FFQ nutrient composition database. Regression analyses were used to examine main and interaction effects. Analyses were adjusted for age, sex, smoking, energy intake, physical activity, ethnicity and educational level. Results: Having higher dietary costs was associated with higher dietary quality. Analyses stratified by educational level showed that associations were stronger in higher educated (B tertile3 = 8.06, 95%CI = 5.63; 10.48) than in lower educated participants (B tertile3 = 5.09, 95%CI = 2.74; 7.44). Stratification by ethnic origin showed strongest associations in Turkish participants (B tertile2 = 9.31, 95%CI = 5.96; 12.65) and weakest associations in Moroccan participants (B tertile3 = 4.29, 95%CI = 0.58; 8.01). Regardless of their level of education, Turkish and Moroccan individuals consumed higher quality diets at the lowest cost than Dutch participants. Conclusions: The importance of dietary costs for dietary quality differs between socioeconomic and ethnic subgroups. Increasing individual food budgets or decreasing food prices may be effective for the promotion of healthy diets, but differential effects across socioeconomic and ethnic subgroups may be expected.