Downward trends in the prevalence of childhood overweight in two pilot towns taking part in the VIASANO community-based programme in Belgium: data from a national school health monitoring system.

BACKGROUND: Multilevel approaches involving environmental strategies are considered to be good practice to help reduce the prevalence of childhood overweight. OBJECTIVES: The objective of this study was to evaluate the effects of VIASANO, a community-based programme using the EPODE methodology, on the prevalence of overweight in two pilot towns in Belgium. METHODS: We analysed data from a national school health monitoring system to compare changes in the prevalence of overweight and obesity over a 3-year period (2007-2010) in children aged 3-4 and 5-6 years in the pilot towns with those of children of the same ages from the whole French-speaking community of Belgium. Heights and weights of all participants were measured by trained school nurses using a standardized method. RESULTS: The prevalence of overweight (-2.1%) and overweight + obesity (-2.4%) decreased in the pilot towns, but remained stable in the comparison population (+0.1% and +0.2%, respectively). After adjustment for lack of homogeneity between the study populations, there was a trend towards a decrease in overweight (P = 0.054) and overweight + obesity (P = 0.058) in the pilot towns compared with the general population. CONCLUSIONS: These results suggest that a community-based programme, such as VIASANO, may be a promising strategy for reducing the prevalence of childhood overweight even over a short period of time.

EPODE - A Model for Reducing the Incidence of Obesity and Weight-related Comorbidities.

Obesity is a global epidemic: it is estimated that the majority of the world's adults will be overweight or obese by 2030. It is therefore important to reverse trends towards increasing childhood obesity by interventions at the community level. Ensemble Prévenons l'obésité Des Enfants (EPODE, Together Let's Prevent Childhood Obesity) is a large-scale, coordinated, capacity-building approach for communities to implement effective and sustainable strategies to address this challenge. EPODE comprises four critical components: political commitment, public and private partnerships, community-based actions, and evaluation. The multi-stakeholder approach promoted through the EPODE methodology has already shown encouraging results in preventing childhood obesity in France and Belgium and has reduced the socioeconomic gap in obesity prevalence in France. The EPODE methodology has now been implemented in a number of countries worldwide, and provides a valuable model that may be applicable to other lifestyle-related diseases.

[The nutrition situation of young children in Flanders]. / Onderzoek naar de voedingssituatie van jonge kinderen in Vlaanderen.

Knowledge of the present feeding habits and the impact of different information channels are mandatory for developing an appropriate feeding policy. The" Socio-Economisch Instituut (SEIN)", the "Universiteit Hasselt", and paediatricians of the Virga Jesse Hospital conducted a study on the feeding habits of young children between the age of 0 and 2 years in Flanders. This study was ordered by Kind en Gezin. Special attention was paid to breastfeeding. The study uses qualitative and quantitative methods. The qualitative research is limited to questions about breastfeeding such as which factors influence initiating, maintaining and ending breastfeeding. The quantitative research investigates through diaries the dietary composition, the eating habits and the parental educational support. Parents of young children aged 3, 6, 12 and 24 months throughout Flanders were questioned. The response rate was 71%, resulting in 2925 diaries that were analyzed. The study gives a comprehensive profile of the dietary habits of young children in the Flanders. Overall, feeding habits in these young infants seem to be appropriate. Concrete proposals to promote breastfeeding and to further improve healthy feeding habits in this age group are made.

[Health promotion by sports and physical activity: politics, behavior and infrastructures in a European comparison]. / Gesundheitsförderung durch Sport und körperliche Aktivität: Politik, Verhalten und Infrastrukturen im europäischen Vergleich.

OBJECTIVES: The focus of physical activity promotion is moving from measures to increase health-enhancing physical activity on the individual level to higher-level strategies including policy and environmental approaches. Scientific evidence, traditionally related to individual-based strategies, calls for adaptation and refinement when environmental and policy changes become more relevant. METHODS: This paper investigates differences in physical activity promotion and public policy among six European countries. Data from a European study on public health promotion policy and health behaviours (MAREPS) is analysed to study behaviour, community-based opportunities for physical activity, and populations' perception of the effectiveness of their national policies in promoting physical activity. RESULTS: Analyses show significant differences in both involvement in and perceived opportunities for physical activity among the investigated countries. Populations in Finland, Switzerland, and The Netherlands show comparably higher participation and, at the same time, perceive better opportunities for physical activity within the residential environment than people in East Germany, Belgium, and Spain. Moreover, respondents from the former group of nations report considerably greater contribution of health policy in their country to the promotion of physical activity than respondents from the latter group. CONCLUSIONS: In conclusion, the results provide empirical support for the significance of environmental and policy approaches with regard to physical activity. Opportunities created by implementing such approaches may enable populations to develop more active lifestyles conducive to health. Further research employing longitudinal designs could be especially helpful to explore the causalities of the relationship between policy, environment and physical activity.

The importance of the social environment for physically active lifestyle--results from an international study.

Physically active lifestyles are regularly associated with improved health and quality of life. Differences in lifestyles in society can partly be understood through the differences in the social and physical environment. This study examines the relationships between reported physical activity, and the extent of perceived support for physical activity in the physical and policy environment (e.g. facilities, programmes and other opportunities), and in the social environment. The data for the study come from a cross-cultural health policy study called MAREPS. In total, 3342 adults, 18 years or older, from six countries (Belgium, Finland, Germany, The Netherlands, Spain, Switzerland) were interviewed via telephone. Respondents were categorised as active or inactive according to self-reported physical activity. Social environmental factors and physical and policy environmental factors were also assessed. The analysis of the data was informed by social cognitive theory, although the study was not originally designed for this purpose. Sixty-eight percent of females and 70% of males were active. The proportions of active and inactive varied by countries to a great extent. The strongest independent predictor of being physically active was social environment. Those who perceived low social support from their personal environment (i.e. family, friends, school and workplace) were more than twice as likely to be sedentary compared to those who reported high social support from their personal environment. Specific knowledge of the programmes and actions for physical activity and sport was also a strong predictor of being active. A supportive physical and policy environment was not associated with participation in physical activity as strongly as had been anticipated. The variation between countries was stronger predictor of being active than the physical and policy environment variables. This study generates the hypotheses and raises the questions that in a preliminary way, there appears to be some relationships between aspects of physical and social environment and physical activity participation. However, future research is needed to refine and clarify this.

Self reported physical activity, public health, and perceived environment: results from a comparative European study.

STUDY OBJECTIVE: The focus of physical activity promotion is moving from methods for increasing health enhancing physical activity on the individual level to higher level strategies including environmental and policy approaches. Scientific inquiry, traditionally related to individual-based strategies, requires adaptation and refinement when environmental and policy changes become more relevant. The objective of this study is to investigate the significance for behaviour and health of community-based environments that encourage physical activity. DESIGN AND SETTING: The article presents data and results from a cross sectional comparative survey of the general population in six European countries (Belgium, Finland, Germany (East and West), Netherlands, Spain, Switzerland). Specifically, the relation between perceived community-based opportunities for physical activity, self reported physical activity, and self rated health status is investigated. PARTICIPANTS: Representative samples of general populations (adults 18 years or older). Overall response rate: 53.5%. Sample sizes realised: Belgium: n = 389; Finland: n = 400; Germany (East): n = 913; Germany (West): n = 489; Netherlands: n = 366; Spain: n = 380; Switzerland: n =406. MAIN RESULTS: Analyses show that best opportunities are reported by people who are lightly to moderately physically active. People's self rated health is moderately, but significantly associated with both perceived opportunities, and physical activity itself. These predictors interact in that especially for women, the health impact of physical activity is more pronounced in case of good opportunities. CONCLUSIONS: The paper shows the potential of opportunities within residential and community environments with regard to physical activity, both for behaviour and health. Opportunities may enable the population, especially women, to develop an active lifestyle, and thus improve their health. Future studies with objective indicators for physical activity related environments should test the findings that are based on perceptions.

Health concerns in households.

In a group of 330 participants from 147 different households, we examined the hypothesis that the importance of health concerns differs according to the kind of household task at hand and according to the position one takes in the household organization. Results show (1) that health concerns are generally more important than concern for other values; (2) that the importance of health concerns varies largely from one household task to another. Health is considered especially important in body care, nutrition and the organization of leisure time, but much less important in the domains of social contact, clothing and maintenance; (3) that the perceived importance of health differs according to the position one takes within the household, health being most important for household members with intermediate levels of responsibility. Results are interpreted as supporting the idea that health behaviour is partly regulated at a 'supra-individual' level of control.

Health locus of control and quality of life in lung cancer patients.

This article presents the results of a pilot-study concerning the quality of life and the health locus of control beliefs of a group of 16 lung cancer patients before they were informed about their diagnosis and a comparison group of healthy persons. The results indicate a significant difference in health locus of control beliefs between both groups: whereas all the lung cancer patients report a more internally oriented health locus of control belief, healthy persons report a more externally oriented locus of control belief. Furthermore, the quality of life of the lung cancer group changed significantly over time, which was due to an increase in physical complaints. There was no significant relation between the health locus of control beliefs and the quality of life of the patients. The findings of this preliminary investigation are discussed in view of future research concerning cancer, quality of life and locus of control.

Tobacco smoking in young adults from 21 European countries: association with attitudes and risk awareness.

Information concerning tobacco smoking was obtained in a survey of 16,483 students aged 18-30 years from 21 European countries. Belief in the benefits to health of not smoking were also assessed. Risk awareness was measured in terms of knowledge of the links between smoking and disease. The overall age-adjusted prevalence of smoking was 33.1% in men and 29.0% in women, but wide variations were observed across country samples. Significant sex differences were found in only a minority of cases. The inclusion of respondents who stated that they had sometimes smoked in the past substantially reduced variations in prevalence across country samples. Beliefs in the health benefits of not smoking were consistently associated with smoking behaviour. Awareness of the link between smoking and lung cancer was uniformly high, but awareness of the role of smoking in heart disease varied considerably across country samples, and averaged only 64.4% in men and 62.9% in women. In the majority of countries, risk awareness was greater among smokers than non-smokers. The results suggest that in this selected sector of the population of young adults in Europe, sex differences in smoking are relatively minor, robust associations between attitudes and smoking behaviour can be identified, and there are major gaps in risk awareness.

Predicting interindividual differences in blood-pressure response to relaxation training in normotensives.

In groups of hypertensives blood-pressure (BP) reductions after relaxation training (RT) are generally moderate. One possibility to explain this relative weakness of RT follows from the observation of large interindividual differences in BP response after RT. In a first study we observed this same variability of BP response after RT in normotensives. Subsequently a method was developed to predict individual BP response after RT. The validity of this method was then established in three samples of normotensives: both systolic and diastolic BP changes appear to be predictable after progressive relaxation as well as after autogenic training.

Body awareness and personality.

The relation between personality characteristics and body awareness, defined as the attention paid to different body zones and measured by means of the Fisher Body Focus Questionnaire, is examined in two ways in groups of medical and dental students: (1) Our results replicate fairly well the relation, reported by Fisher, between back and head awareness and anal characteristics. (2) Exploration of the relations between body awareness and descriptive personality characteristics (neuroticism, extraversion, etc.) reveals differences between sexes: in women back awareness correlates positively with neuroticism and negatively with extraversion; in men higher awareness of the right side of the body is related to lower neuroticism but also to higher scores for test-taking attitude and social desirability. Some implications for our understanding of the position of the body and for psychosomatic research are briefly discussed.

Body image boundary definiteness and psychopathology.

In an attempt to clarify the relation between body image boundary definiteness and psychopathology, the hypothesis that at each level of psychic adaptation groups with stronger and groups with weaker body image boundaries should be found, is examined. The hypothesis that hysterics as well as nonparanoid schizophrenics would have weaker, whereas obsessive compulsives and paranoid schizophrenics would have stronger body image boundaries receives only indirect empirical support. A short theoretical discussion is presented.