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3Background: Poor motor skill competence may influence energy balance with childhood overweight as a result. Our aim was to investigate whether the age of motor milestone achievement has changed over the past decades and whether this change may contribute to the increasing trend observed in childhood overweight. Methods: Motor skill competence was assessed in children from the Young Netherlands Twin Register born between 1987 and 2007. Follow-up ranged from 4 up to 10 years. Weight and height were assessed at birth, 6 months, 14 months, and 2, 4, 7, and 10 years. Results: Babies born in later cohorts achieved their motor milestones ‘crawling’, ‘standing’, and ‘walking
unassisted’ later compared to babies born in earlier cohorts (N = 18,514, p <0.001). The prevalence of overweight at age 10 was higher in later cohorts (p = 0.033). The increase in overweight at age 10 was not explained by achieving motor milestones at a later age and this persisted after adjusting for gestational age, sex, and socioeconomic status. Conclusion: Comparing children born in 1987 to those born in 2007, we conclude that children nowadays achieve their motor milestones at a later age. This does not however, explain the increasing trend in childhood overweight.
ARTIKEL
Objective: Health beliefs of overweight adults who did and did not enter an exercise program were compared to identify possible factors that hamper people to increase physical exercise. Method: Participants (n = 116, 78 women and 38 men) were overweight adults without comorbidities. Self-report instruments examined the burden of suffering, beliefs related to physical exercise and obesity, somatic complaints, and obesity-related quality of life of new participants of exercise programs versus sedentary non-exercisers. Results: Mean BMI of exercisers was and of non-exercisers was 34.6 (7.0) and 32.8 (5.8) respectively. The exercisers were more often female, had fathers with less overweight, and considered overweight a more serious health problem. Fear of injury was higher and perceived health benefits were lower in the non-exercisers, who also more often attributed their overweight to physical causes and believed overweight to be irreversible. Body weight, age, education level, somatic complaints, and quality of life of the groups were comparable. Conclusion: With respect to health beliefs, overweight non-exercisers reported more fear of injury and perceived their overweight as more irreversible than exercisers. Considering these factors in intervention and public health promotion may help overweight sedentary people to start physical exercise.
ARTIKEL
Depression is a common mental health disorder which frequently co-occurs with increased body mass index or increased waist circumference (hereafter ‘overweight’), causing heightened cardiovascular risk. Unhealthy lifestyle behaviours underlie both conditions. The Multimodal Lifestyle Intervention (MLI) LEEF integrates physical activity, nutrition, and behavioural strategies, tailored to motivational challenges common in depression, offering a dual focus on mental and physical health. However, unpublished process data revealed very limited referral to MLI‑LEEF from both primary and secondary care, and consequently low initiation rates, signalling clear implementation challenges. This study addresses this gap by translating prioritised implementation determinants into conceptually and empirically grounded implementation strategies and examining what works, how, and under which conditions.
ARTIKEL
PROMOTIEONDERZOEK INTERN, AFSTUDEREN EXTERN
Objective: This study evaluated the effect of an after-school group-based medium-intensity multicomponent behavioural intervention programme for children aged 8–12 years classified as overweight, obese or at risk for overweight on body mass index standard deviation score (BMI SDS). In accordance with standardized protocols body weight and height were measured in 195 participants (88 boys, 107 girls) at baseline and at the end of the programme. A total of 166 children derived from a school-based monitoring system served as control group. Multivariate regression analyses examined the effect of the intervention and the independent factors associated with better outcomes in the intervention group. Results: Analysis of covariance showed a significant intervention effect on BMO SDS in favour of the intervention group (b-coefficient - 0.13 ± 0.03; p < 0.01) compared with the control group. Change in BMI SDS between baseline and follow-up in the intervention group was associated with baseline age (b-coefficient 0.03 ± 0.02; p=0.04) but was independent from gender, ethnicity, baseline BMI SDS, time between baseline and follow-up, school year and attendance rate.
ARTIKEL
Background. One of the stakeholders in tackling the rise and health consequences of overweight and obesity is the general practice physician (GP). GPs are in a good position to inform and give nutrition guidance to overweight patients. Objective. Assessment of working mechanism of determinants of the nutrition guidance practice: noticing patients’ overweight and guidance of treatment by GPs [linear analysis of structural relations (LISREL) path model] in a longitudinal study. Methods. This longitudinal study measured data in 1992, 1997 and 2007. The 1992 LISREL path model (Hiddink GJ, Hautvast J, vanWoerkumCMJ, Fieren CJ, vantHofMA. Nutrition guidance by primary-care physicians: LISREL analysis improves understanding. Prev Med 1997; 26: 29–36.) demonstrated that ‘noticing patients’ overweight and guidance of treatment’ was directly and indirectly influenced by predisposing factors, driving forces and perceived barriers. This article defines and discusses the path analysis of the 2007 data (compared with 1997). Results. This analysis shows both similarity and differences inworking mechanism of determinants of noticing patients’ overweight and guidance of treatment between 1997 and 2007. The backbone of themechanism with four predisposing factors is the similarity. The number of driving forces and of paths through intermediary factors to the dependent variable constitutes the difference. Conclusions. The backbone of the working mechanism of determinants of the nutrition guidance practice: noticing patients’ overweight and guidance of treatment by GPs was similar in 2007 and 1997. The influence of GPs task perception on noticing patients’ overweight and guidance of treatment considerably increased in 2007 compared to 1997. The longitudinal character of this article gives a strong practice-based evidence for weight management by GPs.
ARTIKEL
The retirement phase is an opportunity to integrate healthy (nutrition/exercise) habits into daily life. We conducted this systematic review to assess which nutrition and exercise interventions most effectively improve body composition (fat/muscle mass), body mass index (BMI), and waist circumference (WC) in persons with obesity/overweight near retirement age (ages 55–70 y). We conducted a systematic review and network meta-analysis (NMA) of randomized controlled trials, searching 4 databases from their inception up to July 12, 2022. The NMA was based on a random effects model, pooled mean differences, standardized mean differences, their 95% confidence intervals, and correlations with multi-arm studies. Subgroup and sensitivity analyses were also conducted. Ninety-two studies were included, 66 of which with 4957 participants could be used for the NMA. Identified interventions were clustered into 12 groups: no intervention, energy restriction (i.e., 500–1000 kcal), energy restriction plus high-protein intake (1.1–1.7 g/kg/body weight), intermittent fasting, mixed exercise (aerobic and resistance), resistance training, aerobic training, high protein plus resistance training, energy restriction plus high protein plus exercise, energy restriction plus resistance training, energy restriction plus aerobic training, and energy restriction plus mixed exercise. Intervention durations ranged from 8 wk to 6 mo. Body fat was reduced with energy restriction plus any exercise or plus high-protein intake. Energy restriction alone was less effective and tended to decrease muscle mass. Muscle mass was only significantly increased with mixed exercise. All other interventions including exercise effectively preserved muscle mass. A BMI and/or WC decrease was achieved with all interventions except aerobic training/resistance training alone or resistance training plus high protein. Overall, the most effective strategy for nearly all outcomes was combining energy restriction with resistance training or mixed exercise and high protein. Health care professionals involved in the management of persons with obesity need to be aware that an energy-restricted diet alone may contribute to sarcopenic obesity in persons near retirement age.
This network meta-analysis is registered at https://www.crd.york.ac.uk/prospero/ as CRD42021276465.
OVERZICHTSARTIKEL
Objective: To systematically assess contemporary knowledge regarding behavioral physical activity interventions including an activity monitor (BPAI+) in adults with overweight or obesity.
Methods: PubMed/MEDLINE, Embase, CINAHL, PsycINFO, CENTRAL and PEDro were searched for eligible full text articles up to July 1st 2015. Studies eligible for inclusion were (randomized) controlled trials describing physical activity outcomes in adults with overweight or obesity. Methodological quality was independently assessed employing the Cochrane Collaboration's tool for risk of bias. PROSPERO registration: CRD42015024086.
Results: Fourteen studies (1157 participants) were included for systematic review and eleven for meta-analysis. A positive trend in BPAI+ effects on several measures of physical activity was ascertained compared to both waitlist or usual care (WL/UC) and behavioral physical activity interventions without an activity monitor (BPAI-). No convincing evidence of BPAI+ effectiveness on weight loss was found compared to BPAI-.
Conclusions: Behavioral physical activity interventions with an activity monitor increase physical activity in adults with overweight or obesity. Also, adding an activity monitor to behavioral physical activity interventions appears to increase the effect on physical activity, although current evidence has not yet provided conclusive evidence for its effectiveness.
POSTER
Background: In the Netherlands, primary care dietitians are the preferred health care professionals for weight management in patients living with overweight and obesity. A clinically relevant weight loss of ≥5% is associated with positive health outcomes. However, a significant proportion of patients fail to achieve ≥5% weight loss.
Objective: This study aimed to identify components in dietetic treatment that are associated with clinically relevant weight loss (≥5%) in patients with overweight and obesity in Dutch primary care.
Methods: In this retrospective study we analyzed data from patients with overweight and obesity in two databases: Health Risk Control (HRC) and ‘Diëtetiek Effectief En Toekomstbestendig’ (DIEET), covering treatment data from 2016 to 2020. We used multilevel logistic regression to assess associations between patient and treatment characteristics, and ≥5% weight loss upon conclusion of treatment.
Results: Data from 561 patients with overweight and obesity were analyzed. In the DIEET database (n= 383), ≥5 consultations (Odds Ratio (OR) 1.82, 95% Confidence Interval (CI): 1.17-12.80) and >3 hours of consultation (OR 1.57, 95% CI: 1.01-2.42)) were positively associated with ≥5% weight loss after 9 months. Patients on diabetes medication had lower odds of reaching effective/clinically relevant weight loss (OR 0.59, 95% CI: 0.37-0.95) compared to those not on diabetes medication. In the HRC database (n = 178), patients with a primary treatment aim to lose weight had higher odds of effective weight loss (OR 4.36; 95% CI: 1.95-9.74) than those focusing on cardiovascular or diabetes management.
Conclusion: These findings underline the importance of frequent and prolonged dietetic consultations in achieving effective weight loss in primary care settings. Special attention should be given to patients using diabetes medication, as they may require tailored approaches to overcome potential barriers to weight loss.
CONGRESABSTRACT
The aging process is often accompanied by increase in body weight. Older adults with overweight or obesity might have an overconsumption in energy that is accompanied by inadequate intake of protein, vitamin D, and calcium. It is unclear if intake of protein and vitamin D and calcium is sufficient in older adults with overweight/obesity, and whether it differs from older adults with normal weight, since a recent overview of the literature review is lacking. Therefore, we systematically analyzed the current evidence on differences in nutrient intake/status of protein, vitamin D and calcium between older adults with different body mass index (BMI) categories. Randomized controlled trials and prospective cohort studies were identified from PubMed and EMBASE. Studies reporting nutrient intake/status in older adults aged ≥50 years with overweight/obesity and studies comparing between overweight/obesity and normal weight were included. Nutrient intake/status baseline values were reviewed and when possible calculated for one BMI category (single-group meta-analysis), or compared between BMI categories (meta-analysis). Nutrient intake/status was compared with international recommendations. Mean protein (N = 8) and calcium intake (N = 5) was 0.98 gram/kilogram body weight/day (g/kg/d) [95% Confidence Interval (CI) 0.89–1.08] and 965 mg [95% CI: 704–1225] in overweight/obese. Vitamin D intake was insufficient in all BMI categories (N = 5). The pooled mean for vitamin D intake was 6 ug [95% CI 4–9]. For 25(OH)D, the pooled mean was 54 nmol/L [95% CI 45–62], 52 nmol/L [95% CI 46–58], and 48 nmol/l [95% CI 33–62] in normal (N = 7), combined overweight and obese (N = 12), and obese older adults (N = 4), respectively. In conclusion, older adults with overweight and obesity have a borderline sufficient protein and sufficient calcium intake, but insufficient vitamin D intake. The 25(OH)D concentration is deficient for the obese older adults.
OVERZICHTSARTIKEL
