Background: The environment affects children’s energy balance-related behaviors to a considerable extent. A context-based physical activity and nutrition school- and family-based intervention, named KEIGAAF, is being implemented in low socio-economic neighborhoods in Eindhoven, The Netherlands. The aim of this study was to investigate: 1) the effectiveness of the KEIGAAF intervention on BMI z-score, waist circumference, physical activity, sedentary behavior, nutrition behavior, and physical fitness of primary school children, and 2) the process related to the implementation of the intervention. Methods: A quasi-experimental, controlled study with eight intervention schools and three control schools was conducted. The KEIGAAF intervention consists of a combined top-down and bottom-up school intervention: a steering committee developed the general KEIGAAF principles (top-down), and in accordance with these principles, KEIGAAF working groups subsequently develop and implement the intervention in their local context (bottom-up). Parents are also invited to participate in a family-based parenting program, i.e., Triple P Lifestyle. Children aged 7 to 10 years old (grades 4 to 6 in the Netherlands) are included in the study. Effect evaluation data is collected at baseline, after one year, and after two years by using a child questionnaire, accelerometers, anthropometry, a physical fitness test, and a parent questionnaire. A mixed methods approach is applied for the process evaluation: quantitative (checklists, questionnaires) and qualitative methods (observations, interviews) are used. To analyze intervention effectiveness, multilevel regression analyses will be conducted. Content analyses will be conducted on the qualitative process data. Discussion: Two important environmental settings, the school environment and the family environment, are simultaneously targeted in the KEIGAAF intervention. The combined top-down and bottom-up approach is expected to make the intervention an effective and sustainable version of the Health Promoting Schools framework. An elaborate process evaluation will be conducted alongside an effect evaluation in which multiple data collection sources (both qualitative and quantitative) are used.
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Background: The aims of this systematic review were to study the effectiveness of primary school-based physical activity, sedentary behavior and nutrition interventions with direct parental involvement on children’s BMI or BMI z-score, physical activity, sedentary behavior and nutrition behavior and categorize intervention components into targeted socio-cognitive determinants and environmental types using the Environmental Research framework for weight Gain prevention. Methods: In March 2018, a systematic search was conducted in four electronic literature databases. Articles written in English about effectiveness studies on school-based interventions with direct parental involvement targeting 4–12 year olds were included. Interventions with indirect parental involvement, interventions not targeting the school environment, and pilot studies were excluded. Study and intervention characteristics were extracted. Study quality and study effectiveness were assessed and effect sizes (Cohen’s d) were calculated for the outcome measures. Types of socio-cognitive factors and environmental types targeted were distinguished. Results: In total, 25 studies were included. Most studies on BMI or BMI z-score, physical activity and sedentary behavior found favorable results: 61.1%, 81.1% and 75%, respectively. Results regarding nutrition behavior were inconclusive. Methodological study quality varied. All interventions targeted multiple environmental types in the school and family environment. Five targeted socio-cognitive determinants (knowledge, awareness, attitude, self-efficacy and intrinsic motivation) of the children were identified. No consistent pattern was found between either type of environment targeted, number of type of environment targeted, or the child’s targeted socio-cognitive determinants and intervention effectiveness. Discussion: School-based interventions with direct parental involvement have the potential to improve children’s weight status, physical activity and sedentary behavior. Based on the results, it is recommended that school-based interventions with direct parental involvement target more than one EBRB, last at least one year, and focus particularly on the physical and social environment within both the school and the family environment
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Diet related non-communicable diseases (NCDs), as well as micronutrient deficiencies, are of widespread and growing importance to public health. Authorities are developing programs to improve nutrient intakes via foods. To estimate the potential health andeconomic impact of these programs there is a wide variety of models. The aim of this review is to evaluate existing models to estimate the health and/or economic impact of nutrition interventions with a focus on reducing salt and sugar intake andincreasing vitamin D, iron, and folate/folic acid intake. The protocol of this systematic review has been registered with the International Prospective Register of Systematic Reviews (PROSPERO: CRD42016050873). The final search was conducted onPubMed and Scopus electronic databases and search strings were developed for salt/sodium, sugar, vitamin D, iron, and folic acid intake. Predefined criteria related to scientific quality, applicability, and funding/interest were used to evaluate the publications. In total 122 publications were included for a critical appraisal: 45 for salt/sodium, 61 for sugar, 4 for vitamin D, 9 for folic acid, and 3 for iron. The complexity of modelling the health and economic impact of nutrition interventions is dependent on the purpose and data availability. Although most of the models have the potential to provide projections of future impact, the methodological challenges are considerable. There is a substantial need for more guidance and standardization for future modelling, to compare results ofdifferent studies and draw conclusions about the health and economic impact of nutrition interventions.
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Despite policy efforts, consumers' well-informed healthful choice is a challenge. Due to increasing number of benefit claims advertising taste or health front of pack (FOP), consumers face the dilemma to trade taste for health. To understand the mechanisms underlying food evaluation, this study investigates the health-pleasure trade-off and its effect on consumers' choice. 240 EU consumers took part in a taste experiment, after being presented with the product FOP. Half of the products carried a nutrition label FOP, respectively, reduced fat for potato chips, reduced sugar for cereal bars. Further, one third of the products carried health benefit claim, one third taste benefit claim, and one third no additional claim FOP. Attention to information and its effect on experienced taste, health perception and the buying intention were measured. The results show that the message displayed FOP altered consumers evaluation and choice. The effectiveness of the FOP message further depended on consumers' health motivation and the healthfulness perception of carrier products. The outcomes are summarized in a framework of health-pleasure trade-off. Current findings call for the establishment of standards to avoid the use of misleading information FOP.
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Equitable access to healthy food is a critical challenge in urban Asia. Food safety governance promotes modern supermarkets over more traditional markets, but supermarkets are associated with unequal access to food. This study investigates how retail policies driven by food safety impact the diets of the urban poor in Hanoi, Vietnam. We do this by linking food retail infrastructures with the food shopping practices and measured dietary intake of 400 women. Our results reveal sub-optimal dietary diversity and reliance on foods sourced through traditional markets, which do not provide formal food safety guarantees. Modern channels supply formal food safety guarantees, but are mainly frequented for purchasing ultra-processed foods. The paper uncovers a conflicting duality governing food security and suggests that the public responsibility for ensuring access of the poor to nutritious and safe foods requires a more diverse retail policy approach.
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In this article, we examine the relationship between important types of policies for asylum permit holders in the Netherlands and the improvement in their command of Dutch. As far as asylum policy is concerned, we find that participation in activities in the asylum seekers reception centre – and in particular, following Dutch language classes – contribute to an improvement in Syrian asylum permit holders’ command of Dutch. On the other hand, a prolonged period of stay and frequent relocations between reception centres are not favourable. Asylum permit holders who have successfully completed the civic integration programme have a better command of the language than asylum permit holders who are still undergoing the programme. An important finding is that there seems to be a sort of double deficit in the area of civic integration: not only do the elderly and lower educated make less progress in learning Dutch, but they are also the ones more likely to receive a dispensation from the civic integration requirement, which places them at a further disadvantage. Third, we find that early participation in the labour market or as a volunteer is also beneficial for language proficiency.
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This article addresses European energy policy through conventional and transformative sustainability approaches. The reader is guided towards an understanding of different renewable energy options that are available on the policy making table and how the policy choices have been shaped. In arguing that so far, European energy policy has been guided by conventional sustainability framework that focuses on eco-efficiency and ‘energy mix’, this article proposes greater reliance on circular economy (CE) and Cradle to Cradle (C2C) frameworks. Exploring the current European reliance on biofuels as a source of renewable energy, this article will provide recommendations for transition to transformative energy choices. http://dx.doi.org/10.13135/2384-8677/2331 https://www.linkedin.com/in/helenkopnina/
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Obesity and other lifestyle-related diseases are, amongst others, the result of an unbalanced diet and lifestyle. Excessive intake of energy, salt, saturated fat and sugar are leading to increased risk of chronic diseases, such as cardiovascular diseases, cancer and diabetes (WHO/FAO). Therefore, a healthier food intake (diet) is needed. But when is a food product healthier? From a nutritional perspective it is clear: the lower the levels of nutrients with a negative public health impact, the better the product fits in a healthy diet. However, when it comes to improving the health impact of the food supply through reformulation, other aspects are important as well. This article describes the ‘framework for product reformulation’, which integrates four essential disciplines: Nutrition & health, Foodtechnology, Legislation and Consumer perspective.
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Lifestyle related health problems are a tremendous burden for European societies that demands a shift towards prevention and a professional to guide this process. Therefore a new bachelor program PAL was developed. A consortium of seven universities from the Netherlands, Denmark, Portugal, Italy, Lithuania and Great Britain developed a competence-based curriculum. Six semesters were developed: 1) Basic Program, 2) Health Enhancing Physical Activity (HEPA), 3) Changing Behaviour, 4) Nutrition, 5) Policy & Entrepreneurship and 6) the Final Project. From 2012-2013, Changing Behaviour, HEPA and Nutrition were tested. Meanwhile, Portugal received full accreditation and Lithuania started the accreditation process. From September 2013, the program will start in Groningen/NL, Rio Maior/POR and Kaunas/LIT.
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Lifestyle related health problems are a tremendous burden for European societies that demands a shift towards prevention and a professional to guide this process. Therefore a new bachelor program PALC was developed. A consortium of seven universities from the Netherlands, Denmark, Portugal, Italy, Lithuania and Great Britain developed a competence-based curriculum. Six semesters were developed: 1) Basic Program, 2) Health Enhancing Physical Activity (HEPA), 3) Changing Behaviour, 4) Nutrition, 5) Policy & Entrepreneurship and 6) the Final Project. From 2012-2013, Changing Behaviour, HEPA and Nutrition were tested. Meanwhile, Portugal received full accreditation and Lithuania started the accreditation process. From September 2013, the program will start in Groningen/NL, Rio Maior/POR and Kaunas/LIT.
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