Evaluation of Nutri-Score in Relation to Dietary Guidelines and Food Reformulation in The Netherlands.

An unhealthy dietary pattern is an important risk factor for non-communicable diseases. Front-of-Pack nutritional labels such as Nutri-Score can be used to improve food choices. In addition, products can be improved through reformulation.

Salt Reductions in Some Foods in The Netherlands: Monitoring of Food Composition and Salt Intake.

Background And Objectives: High salt intake increases blood pressure and thereby the risk of chronic diseases. Food reformulation (or food product improvement) may lower the dietary intake of salt. This study describes the changes in salt contents of foods in the Dutch market over a five-year period (2011-2016) and differences in estimated salt intake over a 10-year period (2006-2015).

Greener living environment healthier people?: Exploring green space, physical activity and health in the Doetinchem Cohort Study.

Background: Evidence is emerging that more green space in the living environment is associated with better health, partly via the pathway of physical activity.

Objectives: We explored the cross-sectional and longitudinal associations between green space and physical activity and several health indicators in the Doetinchem Cohort Study.

Methods: A random sample of men and women aged 20-59years at baseline was measured max 5 times with 5year-intervals in the period 1987-2012.

Diet and cognitive decline at middle age: the role of antioxidants.

To assess the relationship between dietary intake of antioxidants (vitamin C, vitamin E, β-carotene, lutein, flavonoids and lignans) and cognitive decline at middle age, analyses were performed on data from the population based Doetinchem Cohort Study. Habitual diet and cognitive function were assessed twice with a 5-year interval in 2613 persons aged 43-70 year at baseline (1995-2002). Diet was assessed with a validated 178-item semi-quantitative FFQ.

Food supply and actions to improve dietary behaviour of students - a comparison between secondary schools participating or not participating in the 'Healthy School Canteen Program'.

Objective: (i) To identify determinants of participation in the 'Healthy School Canteen Program', a programme that encourages schools to set up their canteen in a way that promotes healthy dietary behaviour. (ii) To compare food supply and actions between participating and non-participating schools. (iii) To investigate what reasons schools have to increase attention for nutrition in the curriculum.

Changes in weight and health-related quality of life. The Doetinchem Cohort Study.

Background: The cross-sectional association between obesity and a lower health-related quality of life (HRQL) is clear. However, less is known about the association between changes in weight and HRQL. We examined the association between weight changes and changes in HRQL in a population-based sample of 2005 men and 2130 women aged 26-70 years.

The impact of long-term body mass index patterns on health-related quality of life: the Doetinchem Cohort Study.

Overweight is associated with a reduced health-related quality of life (QOL), but less is known about the impact of long-term body mass index (BMI, calculated as weight (kg)/height (m)(2)) patterns on QOL in adults. In the Dutch Doetinchem Cohort Study (1989-2009) that included 1,677 men and 1,731 women aged 20-66 years, 6 BMI patterns were defined by using 4 measurements over a 15-year period: 1) persistent healthy weight (18.5-24.

Behavior change in a lifestyle intervention for type 2 diabetes prevention in Dutch primary care: opportunities for intervention content.

Background: Despite the favorable effects of behavior change interventions on diabetes risk, lifestyle modification is a complicated process. In this study we therefore investigated opportunities for refining a lifestyle intervention for type 2 diabetes prevention, based on participant perceptions of behavior change progress.

Methods: A 30 month intervention was performed in Dutch primary care among high-risk individuals (FINDRISC-score ≥ 13) and was compared to usual care.

Exploring the reach and program use of Hello World, an email-based health promotion program for pregnant women in the Netherlands.

Background: In 2006, the Dutch government initiated Hello World, an email-based program promoting healthy lifestyles among pregnant women through quizzes with pregnancy-related questions. In 2008, an updated version was released.The present study aimed to (1) examine the reach of Hello World and the representativeness of its users for all pregnant women in the Netherlands, (2) explore the relationship between program engagement and lifestyle characteristics, and (3) explore the relationship between the program content participants accessed (content on smoking, physical activity, and nutrition) and their lifestyle characteristics.

Implementation of a lifestyle intervention for type 2 diabetes prevention in Dutch primary care: opportunities for intervention delivery.

Background: As in clinical practice resources may be limited compared to experimental settings, translation of evidence-based lifestyle interventions into daily life settings is challenging. In this study we therefore evaluated the implementation of the APHRODITE lifestyle intervention for the prevention of type 2 diabetes in Dutch primary care. Based on this evaluation we discuss opportunities for refining intervention delivery.

A lifestyle intervention to reduce Type 2 diabetes risk in Dutch primary care: 2.5-year results of a randomized controlled trial.

Aims: To determine the effectiveness of a 2.5-year lifestyle intervention for Type 2 diabetes prevention in Dutch general practice compared with usual care.

Methods: A randomized controlled trial of 925 individuals at high risk for Type 2 diabetes (FINDRISC-score ≥ 13) in 14 general practices in the Netherlands.

Lifestyle counseling for type 2 diabetes risk reduction in Dutch primary care: results of the APHRODITE study after 0.5 and 1.5 years.

OBJECTIVE To study the overall effect of the Active Prevention in High-Risk Individuals of Diabetes Type 2 in and Around Eindhoven (APHRODITE) lifestyle intervention on type 2 diabetes risk reduction in Dutch primary care after 0.5 and 1.5 years and to evaluate the variability between general practices.

Changes in lifestyle habits after counselling by nurse practitioners: 1-year results of the Groningen Overweight and Lifestyle study.

Objectives: The Groningen Overweight and Lifestyle (GOAL) study primarily aims at preventing weight gain by nurse practitioners (NP) guided by a standardized computerized software program. Since favourable changes in physical activity (PA) and diet may improve health independently of weight (loss), insight into effects on lifestyle habits is essential. We examined the 1-year effects of lifestyle counselling by NP on PA and diet, compared with usual care from the general practitioner (GP-UC).

Relation between body mass index, physical inactivity and use of prescription drugs: the Doetinchem Cohort Study.

Background: Obesity and physical inactivity are associated with several diseases such as diabetes, cardiovascular diseases, musculoskeletal complaints, osteoporosis, certain types of cancer and depression. However, few data are available on the specific types of medication associated with obesity and physical inactivity.

Objective: The aim of this study was to determine the independent association of body mass index (BMI) and physical inactivity with use of specific classes of prescription drugs, and the interaction between BMI and physical inactivity.

An active strategy to identify individuals eligible for type 2 diabetes prevention by lifestyle intervention in Dutch primary care: the APHRODITE study.

Background: Several trials have shown the potential of lifestyle intervention programmes for prevention of type 2 diabetes. The effectiveness of implementation of these programmes into daily practice is now being studied in several countries. The 'Active Prevention in High Risk individuals of Diabetes Type 2 in Eindhoven' (APHRODITE) study investigates whether type 2 diabetes prevention by lifestyle intervention is effective in Dutch primary care.

Relationship between costs of lifestyle interventions and weight loss in overweight adults.

Lifestyle interventions in a healthcare setting are effective for weight loss, but it is unclear whether more expensive interventions result in more weight loss. Our objective was to explore the relationship between intervention costs and effectiveness in a systematic review of randomized trials. Intervention studies were selected from 14 reviews and from a systematic MEDLINE-search.

Nationwide implementation of Hello World: a Dutch email-based health promotion program for pregnant women.

Background: In November 2006, an email-based health promotion program for pregnant women was implemented nationally in the Netherlands. The program consisted of emails containing quizzes with pregnancy-related questions tailored to the number of weeks of pregnancy. Emails were sent out once every 4 weeks, up to a maximum of nine emails.

Integrating an eHealth program for pregnant women in midwifery care: a feasibility study among midwives and program users.

Background: Health messages may have the highest impact if they are given early in life. Therefore, the Dutch Ministry of Health identified pregnant women as a target population and initiated an innovative eHealth program to serve as a communication channel of health messages to pregnant women.

Objective: The aim was to study the feasibility of implementing this eHealth program into standard midwifery care and to investigate use and user perceptions of the online program among pregnant women.

Lifestyle counseling in hypertension-related visits--analysis of video-taped general practice visits.

Background: The general practitioner (GP) can play an important role in promoting a healthy lifestyle, which is especially relevant in people with an elevated risk of cardiovascular diseases due to hypertension. Therefore, the aim of this study was to determine the frequency and content of lifestyle counseling about weight loss, nutrition, physical activity, and smoking by GPs in hypertension-related visits. A distinction was made between the assessment of lifestyle (gathering information or measuring weight or waist circumference) and giving lifestyle advice (giving a specific advice to change the patient's behavior or referring the patient to other sources of information or other health professionals).

Usage of an online healthy lifestyle program by pregnant women attending midwifery practices in Amsterdam.

Objective: To determine reach, attrition and program engagement and their associations with user characteristics for an online healthy lifestyle program for pregnant women.

Methods: From March to August 2006, 1382 pregnant women visiting 20 midwifery practices in Amsterdam were invited to enroll in a healthy lifestyle program through registration on the program website (at home). User characteristics were self-reported upon enrollment, while program use was objectively monitored until January 2007.

Relation between plasma enterodiol and enterolactone and dietary intake of lignans in a Dutch endoscopy-based population.

Enterolignans are phytoestrogenic compounds derived from the conversion of dietary lignans by the intestinal microflora that may be protective against cardiovascular diseases and cancer. To evaluate the use of enterolignans as biomarkers of dietary lignan intake, we studied the relation between plasma and dietary lignans. We determined the dietary intake of 4 lignans (secoisolariciresinol (SECO), matairesinol (MAT), pinoresinol, and lariciresinol) using the European Prospective Investigation into Cancer and Nutrition FFQ, and plasma enterodiol (END) and enterolactone (ENL) concentrations were determined by liquid chromatography-tandem mass spectrometry.

Intakes of 4 dietary lignans and cause-specific and all-cause mortality in the Zutphen Elderly Study.

Background: Plant lignans are converted to enterolignans that have antioxidant and weak estrogen-like activities, and therefore they may lower cardiovascular disease and cancer risks.

Objective: We investigated whether the intakes of 4 plant lignans (lariciresinol, pinoresinol, secoisolariciresinol, and matairesinol) were inversely associated with coronary heart disease (CHD), cardiovascular diseases (CVD), cancer, and all-cause mortality.

Design: The Zutphen Elderly Study is a prospective cohort study in which 570 men aged 64-84 y were followed for 15 y.

Lignan contents of Dutch plant foods: a database including lariciresinol, pinoresinol, secoisolariciresinol and matairesinol.

Enterolignans (enterodiol and enterolactone) can potentially reduce the risk of certain cancers and cardiovascular diseases. Enterolignans are formed by the intestinal microflora after the consumption of plant lignans. Until recently, only secoisolariciresinol and matairesinol were considered enterolignan precursors, but now several new precursors have been identified, of which lariciresinol and pinoresinol have a high degree of conversion.

Intake of the plant lignans secoisolariciresinol, matairesinol, lariciresinol, and pinoresinol in Dutch men and women.

Enterolignans (enterolactone and enterodiol) are phytoestrogens that are formed by the colonic microflora from plant lignans. They may reduce the risk of certain types of cancer and cardiovascular diseases. Initially, only secoisolariciresinol and matairesinol were considered to be enterolignan precursors, but recently, new precursors such as lariciresinol and pinoresinol were identified.