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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Background: The objective of this study was to derive evidence-based physical activity guidelines for the general Dutch population. Methods: Two systematic reviews were conducted of English language meta-analyses in PubMed summarizing separately randomized controlled trials and prospective cohort studies on the relation between physical activity and sedentary behaviour on the one hand and the risk of all-cause mortality and incidence of 15 major chronic diseases and conditions on the other hand. Other outcome measures were risk factors for cardiovascular disease and type 2 diabetes, physical functioning, and fitness. On the basis of these reviews, an expert committee derived physical activity guidelines. In deriving the guidelines, the committee first selected only experimental and observational prospective findings with a strong level of evidence and then integrated both lines of evidence. Results: The evidence found for beneficial effects on a large number of the outcome measures was sufficiently strong to draw up guidelines to increase physical activity and reduce sedentary behaviour, respectively. At the same time, the current evidence did not provide a sufficient basis for quantifying how much physical activity is minimally needed to achieve beneficial health effects, or at what amount sedentary behaviour becomes detrimental. A general tenet was that at every level of current activity, further increases in physical activity provide additional health benefits, with relatively larger effects among those who are currently not active or active only at light intensity. Three specific guidelines on (1) moderate- and vigorous-intensity physical activity, (2) bone- and musclestrengthening activities, and (3) sedentary behaviour were formulated separately for adults and children. Conclusions: There is an unabated need for evidence-based physical activity guidelines that can guide public health policies. Research in which physical activity is measured both objectively (quantity) and subjectively (type and quality) is needed to provide better estimates of the type and actual amount of physical activity required for health.
Heritable Connective Tissue Disorders (HCTD) show an overlap in the physical features that can evolve in childhood. It is unclear to what extent children with HCTD experience burden of disease. This study aims to quantify fatigue, pain, disability and general health with standardized validated questionnaires.METHODS: This observational, multicenter study included 107 children, aged 4-18 years, with Marfan syndrome (MFS), 58%; Loeys-Dietz syndrome (LDS), 7%; Ehlers-Danlos syndromes (EDS), 8%; and hypermobile Ehlers-Danlos syndrome (hEDS), 27%. The assessments included PROMIS Fatigue Parent-Proxy and Pediatric self-report, pain and general health Visual-Analogue-Scales (VAS) and a Childhood Health Assessment Questionnaire (CHAQ).RESULTS: Compared to normative data, the total HCTD-group showed significantly higher parent-rated fatigue T-scores (M = 53 (SD = 12), p = 0.004, d = 0.3), pain VAS scores (M = 2.8 (SD = 3.1), p < 0.001, d = 1.27), general health VAS scores (M = 2.5 (SD = 1.8), p < 0.001, d = 2.04) and CHAQ disability index scores (M = 0.9 (SD = 0.7), p < 0.001, d = 1.23). HCTD-subgroups showed similar results. The most adverse sequels were reported in children with hEDS, whereas the least were reported in those with MFS. Disability showed significant relationships with fatigue (p < 0.001, rs = 0.68), pain (p < 0.001, rs = 0.64) and general health (p < 0.001, rs = 0.59).CONCLUSIONS: Compared to normative data, children and adolescents with HCTD reported increased fatigue, pain, disability and decreased general health, with most differences translating into very large-sized effects. This new knowledge calls for systematic monitoring with standardized validated questionnaires, physical assessments and tailored interventions in clinical care.
Lichamelijke activiteiten waarbij het skelet wordt belast, zoals wandelen of hardlopen, hebben een positief effect op de botgezondheid. Activiteiten waarbij niet of nauwelijks belasting van het skelet plaatsvindt, zoals fietsen of zwemmen, worden vaker in verband gebracht met een verminderde botgezondheid. Dit is met name een probleem voor (prof-)wielrenners, waarbij lange dagen op de fiets worden doorgebracht. Alarmerend is het feit dat de meerderheid van de profwielrenners te maken heeft met broze botten (osteopenie of osteoporose). Broze botten verhogen het risico op botbreuken. Dat is niet alleen zorgwekkend tijdens de actieve wielercarrière, maar vooral ook daarna. Een lage botdichtheid op jonge leeftijd verhoogt de kans op osteoporose en botbreuken in het latere leven. De vraag vanuit de beroepspraktijk is hoe de botgezondheid van (jonge) wielrenners verbeterd kan worden. Ondanks dat verschillende bewegings- en voedingsinterventies effectief zijn bevonden bij ouderen, is het niet bekend of zulke interventies ook effectief kunnen zijn voor (jonge) wielrenners. Bovendien moet een interventie inpasbaar zijn in het dagelijkse leven van (prof-)wielrenners en niet interfereren met de reguliere trainingsarbeid. Een veelbelovende strategie die aan deze eisen voldoet zijn korte dagelijkse springsessies gecombineerd met collageensuppletie. In dit innovatief pilotonderzoek zullen we testen of deze strategie daadwerkelijk een positief effect heeft op het botmetabolisme. Vervolgens kan de strategie geïmplementeerd worden binnen het profwielrennen, waarbij ook de botgezondheid op langere termijn onderzocht kan worden. Het project wordt uitgevoerd door de Hogeschool van Arnhem en Nijmegen, in samenwerking met wierlerteams Jumbo-Visma en Parkhotel Valkenburg (profploegen), KNWU (wielerunie), Niche4Health (collageensupplementen), en Universiteit Maastricht (wetenschappelijke input en bloedanalyse).
Along with the rapidly growing number of disabled people participating in competitive sports, there is an increased need for (para)medical support in disability sports. Disabled athletes experience differences in body composition, metabolism, training load and habitual activity patterns compared with non-disabled athletes. Moreover, it has been suggested that the well-recognized athlete triad, and low energy availability and low bone mineral density in particular, is even a greater challenge in disabled athletes. Therefore, it is not surprising that sport nutritionists of disabled athletes have expressed an urgency for increased knowledge and insights on the nutritional demands of this group. This project aims to investigate energy expenditure, dietary intake, body composition and bone health of disabled athletes, ultimately leading to nutritional guidelines that promote health and optimal sports performance for this unique population. For this purpose, we will conduct a series of studies and implementation activities that are inter-related and build on the latest insights from sports practice, technology and science. Our international consortium is highly qualified to achieve this goal. It consists of knowledge institutes including world-leading experts in sport and nutrition research, complemented with practical insights from nutritionists working with disabled athletes and the involvement of athletes and teams through the Dutch and Norwegian Olympic committees. The international collaboration, which is a clear strength of this project, is not only focused on research, but also on the optimization of professional practice and educational activities. In this regard, the outcomes of this project will be directly available for practical use by the (para)medical staff working with disabled athletes, and will be extensively communicated to sport teams to ensure that the new insights are directly embedded into daily practice. The project outcomes will also be incorporated in educational activities for dietetics and sport and exercise students, thereby increasing knowledge of future practitioners.
Pectcof B.V heeft een bio-raffinagetechnologie ontwikkeld waardoor koffiepulp, de reststroom die vrijkomt nadat de pitten (koffiebonen) onder mechanische druk uit de koffiebes zijn geperst, gebruikt kan worden. Het doel van het huidige Pectcof-raffinageproces is het isoleren van Dutch Gum, een emulgator die bestaat uit eiwitten en pectine. Bij winning van dit product ontstaan twee zijstromen: een vaste, onoplosbare stroom en een waterige stroom. Het plan is deze zijstromen volledig te benutten. Allereerst wordt de aandacht gericht op de isolatie en identificatie van de hoogwaardige polyfenolen daaruit. Healthy People B.V. is producent van onder andere vruchtensappen met natuurlijke antioxidanten, vitaminen en suikers. Samen met Pectcof willen zij de potentie van polyfenolen onderzoeken, waarbij onder andere het valoriseren van de antioxidanten van belang is. Pectcof en Healthy People bundelen hun krachten hiervoor met Avans Center of Expertise Biobased Economy (CoE BBE) en HAS Hogeschool. De Biobased Products groep, onder leiding van Dr. Dorien Derksen, heeft de expertise in natuurlijke inhoudsstoffen en antioxidanten die noodzakelijk is voor het onderzoek naar de polyfenolen om de MKB-bedrijven te helpen om de waardevolle inhoudsstoffen in de raffinagezijstromen en de toepassingsmogelijkheden verder te definiëren. HAS Hogeschool levert specifieke expertise op het gebied van voedselgericht sensorische testen. Het doel van het OxiCof project is om de antioxidanten in de waterige zijstroom van het huidige Pectcof-raffinageproces te identificeren en kwantificeren voor verder onderzoek en valorisatie. Tevens worden de sensorische eigenschappen van een selectie van producten getest. Op basis van de resultaten kan de valorisatie van deze antioxidanten goed onderbouwd worden.
