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Netherlands Research programme weight Gain prevention (NHF-NRG): rationale, objectives and strategies

Abstract

Objective:

To outline the rationale, objectives and strategies used in a systematically designed research programmme to study specific weight gain-inducing behaviours, their social–psychological as well as environmental determinants, and the effects of interventions aimed at the prevention of weight gain.

Design:

The evidence for potential behavioural determinants and strategies to prevent weight gain was reviewed, and the methods applied within the Netherlands Research programme weight gain prevention (NHF-NRG) project were described. The project is designed according to the Intervention Mapping protocol.

Setting:

The Netherlands.

Subjects:

The main target groups are (a) adolescents (12–16 y) in secondary school, (b) young adults (20–40 y) at the workplace and (c) recently retired people (55–65 y) at home.

Interventions:

Each intervention includes an individual component, in which computer-tailored information is provided. Additionally, interventions are aimed at changing environmental components.

Results:

The short-term results of this project can be expected by the beginning of 2005. Guidelines for nationwide weight gain prevention, based on this research programme, will become available in 2007.

Conclusions:

Based on the few interventions that were evaluated to date, no robust conclusions can be drawn regarding the effectiveness of obesity prevention. The systematic and multidisciplinary design of the NHF-NRG programme enables the identification of potentially effective methods and strategies for the prevention of weight gain.

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Notes

  1. Institute for Health Sciences, Free University, Amsterdam

  2. Centre for Prevention and Health Care Research, National Institute for Public Health and the Environment, Bilthoven

  3. Department of Social Medicine and Institute for Research in Extramural Medicine, VU University Medical Centre, Amsterdam

  4. Knowledge Centre Overweight, VU University Medical Centre, Amsterdam

  5. Department of Health Education and Promotion, Maastricht University

  6. Department of Public Health, Erasmus MC, Rotterdam

  7. Department of Human Biology, Maastricht University

  8. Division of Human Nutrition, Wageningen University

References

  • Astrup A (2001): Healthy lifestyles in Europe: prevention of obesity and type II diabetes by diet and physical activity. Public Health Nutr. 4, 499–515.

    Article  CAS  Google Scholar 

  • Bar-Or O, Foreyt J, Bouchard C, Brownell KD, Dietz WH, Ravussin E, Salbe AD, Schwenger S, St Jeor S & Torun B (1998): Physical activity, genetic, and nutritional considerations in childhood weight management. Med. Sci. Sports Exerc. 30, 2–10.

    Article  CAS  Google Scholar 

  • Bartholomew LK, Parcel GS, Kok G & Gottlieb NH (2001): Intervention Mapping: Designing Theory- and Eveidence-Based Health Promotion Programs. Mountain View: Mayfield Publishing Company.

    Google Scholar 

  • Basdevant A, Boute D & Borys JM (1999): Who should be educated? Education strategies: could children educate their parents? Int. J. Obes. Relat. Metab. Disord. 23 (Suppl), S10–S12; S12–S13.

    Article  Google Scholar 

  • Booth SL, Ritenbaugh C, Sallis JF, Hill JO, Birch LL, Frank LD, Glanz K, Himmelgreen DA, Mudd M, Popkin BM, Rickard KA, St Jeor S & Hays NP (2001): Environmental and societal factors affect food choice and physical activity: rationale, influences, and leverage points. Nutr. Rev. 59 (Suppl), S21–S39.

    CAS  PubMed  Google Scholar 

  • Brown WJ & Trost SG (2003): Life transitions and changing physical activity patterns in young women. Am. J. Prev. Med. 25, 140–143.

    Article  Google Scholar 

  • Brug J, Campbell M & Van Assema P (1999): The application and impact of computer-generated personalised nutrition education: a review of the literature. Patient Educ. Couns. 36, 145–156.

    Article  CAS  Google Scholar 

  • Brug J, Glanz K & Kok GJ (1997): The relationship between self-efficacy, attitudes, intake compared to others, consumption, and stages of change related to fruit and vegetables. Am. J. Health Promot. 12, 25–30.

    Article  CAS  Google Scholar 

  • Campbell K, Water E, O’Meara S & Summerbell C (2001): Interventions for preventing obesity in children (Cochrane Review). In The Cochrane Library Issue 2 Oxford: Update Software.

    Google Scholar 

  • Carraro R & Garcia Cebrian M (2003): Role of prevention in the contention of the obesity epidemic. Eur. J. Clin. Nutr. 57 (Suppl), S94–S96.

    Article  Google Scholar 

  • Colditz GA (1999): Economic costs of obesity and inactivity. Med. Sci. Sports Exerc. 31 (Suppl), S663–S667.

    Article  CAS  Google Scholar 

  • Darmon N, Ferguson E & Briend A (2003): Do economic constraints encourage the selection of energy dense diets? Appetite 41, 315–322.

    Article  Google Scholar 

  • Douketis JD, Feightner JW, Attia J, Feldman WF & with the Canadian Task Force on Preventive Health Care (1999): Periodic health examination, 1999 update: 1. Detection, prevention and treatment of obesity. CMAJ 160, 513–525.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Felson DT, Zhang Y, Hannan MT, Naimark A, Weissman B, Aliabadi P & Levy D (1997): Risk factors for incident radiographic knee osteoarthritis in the elderly: The Framingham Study. Arthritis Rheum. 40, 728–733.

    Article  CAS  Google Scholar 

  • Flay BR & Petraitis J (1994): The theory of triadic influence: a new theory of health behaviour with implications for preventive interventions. Adv. Med. Soc. 4, 19–44.

    Google Scholar 

  • Flegal KM (1999): The obesity epidemic in children and adults: current evidence and research issues. Med. Sci. Sports Exerc. 31 (Suppl), S509–S514.

    Article  CAS  Google Scholar 

  • Flegal KM, Carroll MD, Kuczmarski RJ & Johnson CL (1998): Overweight and obesity in the United States: prevalence and trends, 1960–1994. Int. J. Obes. Relat. Metab. Disord. 22, 39–47.

    Article  CAS  Google Scholar 

  • Flegal KM, Carroll MD, Ogden CL & Johnson CL (2002): Prevalence and trends in obesity among US adults, 1999–2000. JAMA 288, 1723–1727.

    Article  Google Scholar 

  • Garner DM & Wooley SC (1997): Confronting the failure of behavioural and dietary treatments for obesity. Clin. Psychol. Rev. 11, 573–578.

    Google Scholar 

  • Giles-Corti B & Donovan RJ (2003): Relative influences of individual, social environmental, and physical environmental correlates of walking. Am. J. Public Health 93, 1583–1589.

    Article  Google Scholar 

  • Giles-Corti B, Macintyre S, Clarkson JP, Pikora T & Donovan RJ (2003): Environmental and lifestyle factors associated with overweight and obesity in Perth, Australia. Am. J. Health Promot. 18, 93–102.

    Article  Google Scholar 

  • Glasgow RE & Terborg JR (1988): Occupational health promotion programs to reduce cardiovascular risk. J. Cons. Clin. Psych. 56, 365–373.

    Article  CAS  Google Scholar 

  • Glenny AM, O’Meara S, Melville A, Sheldon TA & Wilson C (1997): The treatment and prevention of obesity: a systematic review of the literature. Int. J. Obes. Relat. Metab. Disord. 21, 715–737.

    Article  CAS  Google Scholar 

  • Golan M & Crow S (2004): Parents are key players in the prevention and treatment of weight-related problems. Nutr. Rev. 62, 39–50.

    Article  Google Scholar 

  • Green LW & Kreuter MW (1999): Health Promotion Planning: An Educational and Ecological Approach, 3rd edition. Mountain View, California: Mayfield Publishing Company.

    Google Scholar 

  • Hardeman W, Griffin S, Johnston M, Kinmonth AL & Wareman NJ (2000): Interventions to prevent weight gain: a systematic review of psychological models and behaviour change methods. Int. J. Obes. Relat. Metab. Disord. 24, 131–143.

    Article  CAS  Google Scholar 

  • Hill JO & Peters JC (1998): Environmental contributions to the obesity epidemic. Science 280, 1371–1374.

    Article  CAS  Google Scholar 

  • Hirasing RA, Fredriks AM, van Buuren S, Verloove-Vanhorick SP & Wit JM (2001): Increased prevalence of overweight and obesity in Dutch children, and the detection of overweight and obesity using international criteria and new reference diagrams. Ned. Tijdschr. Geneeskd. 145, 1303–1308 (in Dutch).

    CAS  PubMed  Google Scholar 

  • Hoelscher DM, Evans A, Parcel GS & Kelder SH (2002): Designing effective nutrition interventions for adolescents. J. Am. Diet. Assoc. 102 (Suppl), S52–S63.

    Article  Google Scholar 

  • Jeffery RW (1998): Prevention of obesity. In Handbook of Obesity, eds G Bray, C Bouchard & P James pp 819–830. New York: Dekker.

    Google Scholar 

  • Jeffery RW, Gray CW, French SA, Hellerstedt WL, Murray D, Luepker RV & Blackburn H (1995): Evaluation of weight reduction in a community intervention for cardiovascular disease risk: changes in body mass index in the Minnesota Heart Health Program. Int. J. Obes. Relat. Metab. Disord. 19, 30–39.

    CAS  PubMed  Google Scholar 

  • Kayman S, Bruvold W & Stern JS (1990): Maintenance and relapse after weight loss in women: behavioral aspects. Am. J. Clin. Nutr. 52, 800–807.

    Article  CAS  Google Scholar 

  • Kemper HC, Stasse-Wolthuis M & Bosman W (2004): The prevention and treatment of overweight and obesity. Summary of the advisory report by the Health Council of The Netherlands. Neth. J. Med. 62, 10–17.

    CAS  PubMed  Google Scholar 

  • Kirk TR (2000): Role of dietary carbohydrate and frequent eating in body-weight control. Proc. Nutr. Soc. 59, 348–358.

    Article  Google Scholar 

  • Kohrt WM, Malley MT, Dalskey GP & Holloszy JO (1992): Body composition of healthy sedentary and trained young and older men and women. Med. Sci. Sports Exerc. 24, 832–837.

    Article  CAS  Google Scholar 

  • Kremers SPJ, Brug J, De Vries H & Engels RCME (2003): Parenting style and adolescent fruit consumption. Appetite 41, 43–50.

    Article  Google Scholar 

  • Kromhout D, Bloemberg B, Seidell JC, Nissinen A & Menotti A (2001): Physical activity and dietary fiber determine population body fat levels: the Seven Countries Study. Int. J. Obes. Relat. Metab. Disord. 25, 301–306.

    Article  CAS  Google Scholar 

  • Kromhout D, Saris WH & Horst CH (1988): Energy intake, energy expenditure, and smoking in relation to body fatness: the Zutphen Study. Am. J. Clin. Nutr. 47, 668–674.

    Article  CAS  Google Scholar 

  • Lechner L, Brug J, De Vries H, Van Assema P & Mudde AN (1998): Stages of change for fruit, vegetable and fat intake: consequences of misconception. Health Educ. Res. 13, 1–11.

    Article  Google Scholar 

  • Ludwig DS, Peterson KE & Gortmaker SL (2001): Relation between consumption of sweetend drinks and childhood obesity: a prospective, observational analysis. Lancet 357, 505–508.

    Article  CAS  Google Scholar 

  • Madsen J, Sallis JF, Rupp JW, Senn KL, Patterson TL, Atkins CJ & Nader PR (1993): Relationship between self-monitoring of diet and exercise change and subsequent risk factor changes in children and adults. Patient Educ. Couns. 21, 61–69.

    Article  CAS  Google Scholar 

  • Manson JE, Skerrett PJ, Greenland P & VanItallie TB (2004): The escalating pandemics of obesity and sedentary lifestyle: a call to action for clinicians. Arch. Intern. Med. 164, 249–258.

    Article  Google Scholar 

  • Müller MJ, Mast M, Asbeck I, Langnase K & Grund A (2001): Prevention of obesity—is it possible? Obes. Rev. 2, 15–28.

    Article  Google Scholar 

  • NHS Centre for Reviews and Dissemination (NHS CRD) (1997): A systematic review of the interventions for the prevention and treatment of obesity, and the maintenance of weight loss CRD Report 10 University of York.

  • NHS Health Development Agency (NHS HDA) (2003): The Management of Obesity and Overweight. An Analysis of Reviews of Diet, Physical Activity and Behavioural Approaches. London: Health Development Agency.

  • Oenema A & Brug J (2003): Feedback strategies to raise awareness of personal dietary intake: results of a randomized controlled trial. Prev. Med. 36, 429–439.

    Article  Google Scholar 

  • Oster G, Thompson D, Edelsberg J, Bird AP & Colditz GA (1999): Lifetime health and economic benefits of weight loss among obese persons. Am. J. Public Health 89, 1536–1542.

    Article  CAS  Google Scholar 

  • Owen N, Humpel N, Leslie E, Bauman A & Sallis JF (2004): Understanding environmental influences on walking. Review and research agenda. Am. J. Prev. Med. 27, 67–76.

    Article  Google Scholar 

  • Pikora T, Giles-Corti B, Bull F, Jamrozik K & Donovan R (2003): Developing a framework for assesment of environmental determinants of walking and cycling. Soc. Sci. Med. 56, 1693–1703.

    Article  Google Scholar 

  • Povey R, Conner M, Sparks P, James R & Shepherd R (1999): A critical examination of the application of the transtheoretical model's stages of change to dietary behaviours. Health Educ. Res. 14, 641–651.

    Article  CAS  Google Scholar 

  • Rogers EM (1995): Diffusion of innovations, (4th Edition) New York: Free Press.

    Google Scholar 

  • Ronda G, Van Assema P & Brug J (2002): Stages of change, psychological factors and awareness of physical activity levels in the Netherlands. Health Promot. Int. 16, 305–314.

    Article  Google Scholar 

  • Russell CM, Williamson DF & Byers T (1995): Can the Year 2000 objective for reducing overweight in the United States be reached?: a simulation study of the required changes in body weight. Int. J. Obes. Relat. Metab. Disord. 19, 149–153.

    CAS  PubMed  Google Scholar 

  • Schmitz MK & Jeffery RW (2000): Public health interventions for the prevention and treatment of obesity. Med. Clin. North Am. 84, 491–512.

    Article  CAS  Google Scholar 

  • Seidell JC (1995): The impact of obesity on health status: some implications for health care costs. Int. J. Obes. Relat. Metab. Disord. 19 (Suppl 6), S13–S16.

    Google Scholar 

  • Seidell JC (2000): The current epidemic of obesity. In Physical Activity and Obesity ed C Bouchard pp 21–30. Campaign, IL: Human Kinetics.

    Google Scholar 

  • Statistics Netherlands [Homepage on the Internet] (2004): Voorburg/Heerlen, CBS Webmagazine c2004 [updated 2004 April 06; cited 2004 September 01]. Available fromhttp://www.cbs.nl/en/publications/articles/webmagazine/2004/1428k.htm.

  • Sturm R & Wells KB (2001): Does obesity contribute as much to morbidity as poverty or smoking? Public Health 115, 229–235.

    Article  CAS  Google Scholar 

  • Swinburn B, Egger G & Raza F (1999): Dissecting obesogenic environments: the development and application of a framework for identifying and prioritizing environmental interventions for obesity. Prev. Med. 29, 563–570.

    Article  CAS  Google Scholar 

  • Tones K (2000): Evaluating health promotion—beyond the RCT. In Best Practices: a Selection of Papers on Quality and Effectiveness in Health Promotion eds L Norheim & M Waller pp 86–101. Helsinki: Finnish Centre for Health Promotion.

    Google Scholar 

  • U.S. Department of Health and Human Services (USDHHS) (2001): The Surgeon General's Call to Action to Prevent and Decrease Overweight and Obesity. U.S. Department of Health and Human Services, Public Health Service, Office of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services.

  • Van Lenthe FJ, Kemper HC, van Mechelen W & Twisk JW (1996): Development and tracking of central patterns of subcutaneous fat in adolescence and adulthood: the Amsterdam Growth and Health Study. Int. J. Epidemiol. 25, 1162–1171.

    Article  CAS  Google Scholar 

  • Van Mechelen W, Twisk JW, Post GB, Snel J & Kemper HC (2000): Physical activity of young people: the Amsterdam Longitudinal Growth and Health Study. Med. Sci. Sports Exerc. 32, 1610–1616.

    Article  CAS  Google Scholar 

  • Visscher TLS, Kromhout D & Seidell JC (2002): Long-term and recent time trends in the prevalence of obesity among Dutch men and women. Int. J. Obes. Relat. Metab. Disord. 26, 218–224.

    Article  Google Scholar 

  • Visscher TLS, Rissanen A, Seidell JC, Heliövaara M, Knekt P, Reunanen A & Aromaa A (2004): Obesity and unhealthy life years in adult Finns. An empirical approach. Arch. Int. Med. 164, 1413–1420.

    Article  Google Scholar 

  • Visscher TLS & Seidell JC (2001): The public health impact of obesity. Annu. Rev. Public Health 22, 355–375.

    Article  CAS  Google Scholar 

  • Voedingscentrum (1998): Zo eet Nederland. Delft: Van Marken.

  • Westerterp KR (2001): Pattern and intensity of physical activity. Nature 410, 539.

    Article  CAS  Google Scholar 

  • Wolf AM (2002): Economic outcomes of the obese patient. Obes. Res. 10 (Suppl 1), S58–S62.

    Article  Google Scholar 

  • Wolf AM & Colditz GA (1998): Current estimates of the economic cost of obesity in the United States. Obes. Res. 6, 97–106.

    Article  CAS  Google Scholar 

  • World Health Organisation (WHO) (1997): Obesity — Preventing and Managing the Global Epidemic, Report of a WHO Consulation on Obesity. Geneva: WHO.

  • World Health Organisation/UN Food and Agriculture Organisation (WHO/FAO) (2002): Diet, Nutrition and the Prevention of Chronic Diseases: Report of a Joint WHO/FAO Expert Consultation. Geneva: WHO/FAO.

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Acknowledgements

This study is funded by the Netherlands Heart Foundation (No: 2000Z002).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to S P J Kremers.

Additional information

Guarantors: SPJ Kremers, TLS Visscher and D Kromhout.

Contributors: SPJK and TLSV were the main authors of the manuscript and assisted in the design of each of the studies presented in the manuscript. JB, MJMCAP, EGS, AJS, JCS, MAVB and WVM are supervisors of the separate studies within NHF-NRG and assisted in writing. HCGK, FJK, WHMS and DK are members of the programme committee and assisted in writing of the manuscript. DK is the principal investigator of the project.

Appendix A: Organisational structure of the NHF-NRG project

Appendix A: Organisational structure of the NHF-NRG project

Programme Committee

D Kromhout, (Principal Investigator), National Institute for Public Health and the Environment, Bilthoven

HCG Kemper, EMGO Institute, VU University Medical Centre, Amsterdam

WHM Saris, Department of Human Biology, Maastricht University

FJ Kok, Division of Human Nutrition, Wageningen University

Postdocs

TLS Visscher, Institute for Health Sciences, Free University, Amsterdam/Centre for Prevention and Health Care Research, National Institute for Public Health and the Environment, Bilthoven/Knowledge Centre Overweight, VU University Medical Centre, Amsterdam/Prevention centre Overweight, Zwolle

SPJ Kremers, Department of Health Education and Promotion, Maastricht University

Studies within NHF-NRG

Study 1. ACJ NooyensFootnote 1,Footnote 2, PhD student. Senior researchers: TLS Visscher, AJ Schuit2, W van MechelenFootnote 3,Footnote 4, JC Seidell2,4

Study 2. GJ De BruijnFootnote 5, PhD student. Senior researchers: SPJ Kremers, W van Mechelen, J Brug5,Footnote 6

Study 3. AS Singh3, PhD student. Senior researchers: MJM Chin A Paw3, J Brug, W van Mechelen

Study 4. L KwakFootnote 7, PhD student. Senior researchers: MA van Baak7, SPJ Kremers, J Brug

Study 5. AM WerkmanFootnote 8, PhD student. Senior researchers: EG Schouten8, AJ Schuit

Advisory board

L Vaandrager, Dutch Centre Workplace Health Promotion

B Breedveld, Netherlands Nutrition Centre

R Westerhof, Royal Association of Teachers of Physical Education

B Sorgdrager, Dutch Association of Occupational Medicine

J Joosten, ‘Pensioen in Zicht’, Future Retirement Courses, Odyssee Group

G op het Veld, Netherlands Olympic Committee/Netherlands Sport Confederation (NOC/NSF)

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Kremers, S., Visscher, T., Brug, J. et al. Netherlands Research programme weight Gain prevention (NHF-NRG): rationale, objectives and strategies. Eur J Clin Nutr 59, 498–507 (2005). https://doi.org/10.1038/sj.ejcn.1602100

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