Johannes Brug

Publications (313)720.43 Total impact

• Article: Physical activity and the risk of developing lung cancer among smokers: A meta-analysis.

  Laurien M Buffart, Amika S Singh, Edwin C P van Loon, H Ivan Vermeulen, Johannes Brug, Mai J M Chinapaw
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  ABSTRACT: OBJECTIVE: To investigate the relationship between physical activity and lung cancer among smokers and whether this relationship differed according to physical activity intensity, smoking status, and gender. DESIGN: Meta-analysis. METHODS: A computerized bibliographical search was conducted in five databases. Study inclusion criteria were: (i) the study population was not diagnosed with lung cancer at baseline; (ii) the study provided information concerning the effect size of physical activity on the risk of developing lung cancer in smokers; and (iii) the study distinguished different physical activity intensity levels. Two authors independently extracted data and assessed the methodological quality. Pooled rate ratios (RR) were calculated for all data, and for subgroups of physical activity intensity, smoking status, and gender. RESULTS: Pooled RRs of 7 cohort studies showed that physical activity was associated with a reduced risk of lung cancer in smokers (RR=0.82, 95% CI=0.77; 0.87). We did not find clear dose-response relationship regarding exercise or smoking intensity, i.e. high levels of physical activity did not show a higher risk reduction than moderate physical activity levels, and the association between physical activity and risk reduction did not differ between heavy and light smokers. The reduced risk associated with physical activity was greater in women than in men (p=0.03), but this finding was based on only one study that reported data on women. CONCLUSION: Results of this meta-analysis indicate that leisure time physical activity is associated with reduced risk of developing lung cancer among smokers. Future studies should provide insight into a potential dose-response relationship, and should use reliable and valid physical activity measurements.
  Journal of science and medicine in sport / Sports Medicine Australia. 03/2013;
• Article: The association of breakfast skipping and television viewing at breakfast with weight status among parents of 10-12-year-olds in eight European countries; the ENERGY (EuropeaN Energy balance Research to prevent excessive weight Gain among Youth) cross-sectional study.

  Helga Birgit Bjørnarå, Frøydis N Vik, Johannes Brug, Yannis Manios, Ilse De Bourdeaudhuij, Natasa Jan, Lea Maes, Luis A Moreno, Alain Dössegger, Elling Bere
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  ABSTRACT: OBJECTIVE: The main objective was to assess the relationship of breakfast skipping, television (TV) viewing at breakfast and breakfast without TV with weight status among parents of 10-12-year-olds in eight European countries. DESIGN: A cross-sectional survey assessed breakfast eating and TV viewing at breakfast by three frequency questions and parents were categorized into: (i) breakfast skippers; (ii) breakfast with TV (TV watchers at breakfast); and (iii) breakfast without TV (breakfast eaters who do not watch TV during breakfast). Self-reported weight and height were used to categorize weight status as underweight, normal weight, overweight and obese. Multinomial logistic regression analyses were conducted with weight status as the dependent variable and breakfast habits as predictors, adjusting for sex, ethnicity and level of education. SETTING: The survey was conducted in 2010 in 199 primary schools across eight European countries participating in the ENERGY (EuropeaN Energy balance Research to prevent excessive weight Gain among Youth) cross-sectional study. SUBJECTS: Parents (n 6512) of 10-12-year-olds responded to the questionnaire. RESULTS: In the total study sample, with breakfast without TV as the reference group and adjusting for sex, ethnicity and level of education, the OR of being respectively overweight or obese (compared with normal weight) was 1·2 (95 % CI 1·0, 1·4) or 1·8 (95 % CI 1·5, 2·3) for breakfast skippers. The OR of being respectively underweight or obese was 0·5 (95 % CI 0·2, 0·9) or 1·4 (95 % CI 1·1, 1·8) for breakfast with TV. CONCLUSIONS: Breakfast skippers were significantly more likely to be overweight and obese, and those eating breakfast while watching TV were significantly more likely to be obese and less likely to be underweight.
  Public Health Nutrition 03/2013; · 2.17 Impact Factor
• Article: Effects of exercise in patients treated with stem cell transplantation for a hematologic malignancy: A systematic review and meta-analysis.

  Saskia Persoon, Marie José Kersten, Karen van der Weiden, Laurien M Buffart, Frans Nollet, Johannes Brug, Mai J M Chinapaw
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  ABSTRACT: We performed a systematic review and meta-analysis evaluating the effectiveness of exercise interventions compared with usual care on physical fitness, fatigue and health-related quality of life in patients with hematologic malignancies treated with stem cell transplantation. Electronic databases were searched up to June 2012. We included randomized controlled trials comparing exercise with usual care, in which at least 75% of the patients had a hematologic malignancy. Standard mean differences were calculated and pooled to generate summary effect sizes (ES) and 95% confidence intervals (CI). The Cochrane Collaboration Risk of Bias Tool was used to assess the methodological quality of the studies. Eight studies met our inclusion criteria. Exercise had a statistically significant moderately favourable effect on cardiorespiratory fitness (ES=0.53, 95% CI=0.13-0.94), lower extremity muscle strength (ES=0.56, 95% CI=0.18-0.94) and fatigue (ES=0.53, 95% CI=0.27-0.79). Significant small positive effects were found for upper extremity muscle strength, global quality of life, and physical, emotional and cognitive functioning. In conclusion, exercise seems to have beneficial effects in patients treated with stem cell transplantation. However, all studies had at least some risk of bias, and for cardiorespiratory fitness and lower extremity muscle strength substantial heterogeneity in effect sizes were observed. Further high quality research is needed to determine the optimal exercise intervention and clinical implications.
  Cancer treatment reviews 02/2013; · 5.30 Impact Factor
• Article: Direct and indirect associations between the family physical activity environment and sports participation among 10--12 year-old European children: testing the EnRG framework in the ENERGY project.

  Anna F Timperio, Maartje M van Stralen, Johannes Brug, Elling Bere, Mai Jm Chinapaw, Ilse De Bourdeaudhuij, Nata A Jan, Lea Maes, Yannis Manios, Luis A Moreno, Jo Salmon, Saskia J Te Velde
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  ABSTRACT: BACKGROUND: Sport participation makes an important contribution to children's overall physical activity. Understanding influences on sports participation is important and the family environment is considered key, however few studies have explored the mechanisms by which the family environment influences children's sport participation. The purpose of this study was to examine whether attitude, perceive behavioural control, health belief and enjoyment mediate associations between the family environment and 10--12 year-old children's sports participation. METHODS: Children aged 10--12 years (n=7234) and one of their parents (n=6002) were recruited from 175 schools in seven European countries in 2010. Children self-reported their weekly duration of sports participation, physical activity equipment items at home and the four potential mediator variables. Parents responded to items on financial, logistic and emotional support, reinforcement, modelling and co-participation in physical activity. Cross-sectional single and multiple mediation analyses were performed for 4952 children with complete data using multi-level regression analyses. RESULTS: Availability of equipment (OR=1.16), financial (OR=1.53), logistic (OR=1.47) and emotional (OR=1.51) support, and parental modelling (OR=1.07) were positively associated with participation in >=30mins/wk of sport. Attitude, beliefs, perceived behavioural control and enjoyment mediated and explained between 21-34% of these associations. Perceived behavioural control contributed the most to the mediated effect for each aspect of the family environment. CONCLUSIONS: Both direct (unmediated) and indirect (mediated) associations were found between most family environment variables and children's sports participation. Thus, family-based physical activity interventions that focus on enhancing the family environment to support children's sport participation are warranted.
  International Journal of Behavioral Nutrition and Physical Activity 02/2013; 10(1):15. · 3.83 Impact Factor
• Article: Daily Variations in Weather and the Relationship with Physical Activity and Sedentary Time in European 10-12yr olds: The ENERGY-Project.

  Mine Yildirim, Anna Schoeni, Amika S Singh, Teatske Altenburg, Johannes Brug, Ilse De Bourdeaudhuij, Eva Kovacs, Bettina Bringolf, Yannis Manios, Mai Chinapaw
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  ABSTRACT: BACKGROUND: The aim of the study was to examine the association of daily variations in rainfall and temperature with sedentary time (ST) and physical activity (PA) in European children. METHODS: Children were included from five countries (Belgium, Greece, Hungary, the Netherlands, Switzerland) as part of the ENERGY- project. We used cross-sectional data from 722 children aged 10-12 years (47% boys). ST and PA were measured by accelerometers for six consecutive days, including weekend days. Weather data was collected from online national weather reports. Multilevel regression models were used for data analyses. RESULTS: Maximum temperature was positively associated with light PA (b=3.1 min/day; 95% CI=2.4; 3.8), moderate-to-vigorous PA (b=0.6 min/day; 95% CI=0.4; 0.8) and average PA (b=4.1 counts per minute (cpm); 95% CI=1.6; 6.5, quadratic relationship). Rainfall was inversely and quadratically associated with light PA (b=-1.3 min/day; 95% CI=-1.9; -0.6), moderate-to-vigorous PA (b=-0.6 min/day; 95% CI=-0.8; -0.3) and average PA (b=-1.6 cpm; 95% CI=-2.2; -0.9). Maximum temperature was not significantly associated with ST (b=-0.2 min/day; 95% CI=-1.0; 0.6), while rainfall was positively associated with ST (b=0.9 min/day; 95% CI=0.6, 1.3). CONCLUSION: The present study shows that temperature and rainfall are significantly associated with PA and ST in 10-12 years European children.
  Journal of Physical Activity and Health 01/2013;
• Article: Clustering of energy balance-related behaviors and parental education in European children: the ENERGY-project.

  Juan M Fernández-Alvira, Ilse De Bourdeaudhuij, Amika S Singh, Frøydis N Vik, Yannis Manios, Eva Kovacs, Natasa Jan, Johannes Brug, Luis A Moreno
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  ABSTRACT: BACKGROUND: Recent research and literature reviews show that, among schoolchildren, some specific energy balance-related behaviors (EBRBs) are relevant for overweight and obesity prevention. It is also well known that the prevalence of overweight and obesity is considerably higher among schoolchildren from lower socio-economic backgrounds. This study examines whether sugared drinks intake, physical activity, screen time and usual sleep duration cluster in reliable and meaningful ways among European children, and whether the identified clusters could be characterized by parental education. METHODS: The cross-sectional study comprised a total of 5284 children (46% male), from seven European countries participating in the ENERGY-project ("EuropeaN Energy balance Research to prevent excessive weight Gain among Youth"). Information on sugared drinks intake, physical activity, screen time and usual sleep duration was obtained using validated self-report questionnaires. Based on these behaviors, gender-specific cluster analysis was performed. Associations with parental education were identified using chi-square tests and odds ratios. RESULTS: Five meaningful and stable clusters were found for both genders. The cluster with high physical activity level showed the highest proportion of participants with highly educated parents, while clusters with high sugared drinks consumption, high screen time and low sleep duration were more prevalent in the group with lower educated parents. Odds ratio showed that children with lower educated parents were less likely to be allocated in the active cluster and more likely to be allocated in the low activity/sedentary pattern cluster. CONCLUSIONS: Children with lower educated parents seemed to be more likely to present unhealthier EBRBs clustering, mainly characterized by their self-reported time spent on physical activity and screen viewing. Therefore, special focus should be given to lower educated parents and their children in order to develop effective primary prevention strategies.
  International Journal of Behavioral Nutrition and Physical Activity 01/2013; 10(1):5. · 3.83 Impact Factor
• Article: Explaining socio-demographic differences in disengagement from sports in adolescence.

  Richard G Prins, Carlijn B M Kamphuis, Pepijn van Empelen, Mariëlle A Beenackers, Johannes Brug, Johan P Mackenbach, Anke Oenema
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  ABSTRACT: Purpose: The purpose of this longitudinal study is to identify risk groups for disengagement from sports during adolescence. In addition, it will be explored whether cognitive and environmental factors can explain socio-demographic differences in disengagement from sports. METHODS: Data were obtained from the Environmental Determinants of Obesity in Rotterdam Schoolchildren study, and 357 adolescents were eligible for analysis. Socio-demographics (gender, ethnicity, education), individual cognitions and neighbourhood perceptions were assessed at baseline (2005/2006), and sports participation at baseline and at follow-up (2007/2008). Two dichotomous outcome variables were constructed: (i) disengagement from sports (yes/no) and (ii) ceased compliance with the fitnorm (i.e. cease engaging in sports ≥3 times/wk) (yes/no). In logistic regression and mediation analyses, we identified socio-demographic differences in the two outcomes. Subsequently, we applied mediation analyses to identify the contribution of cognitive and environmental explanatory factors of the socio-demographic differences. RESULTS: Girls [odds ratio (OR): 2.5, 95% confidence interval (CI): 1.5-4.5] were more likely than boys to disengage from sports. Girls (OR: 2.5, 95% CI: 1.4-4.2), adolescents of non-Western background (OR: 1.8, 95% CI: 1.0-3.0) and those in lower educational levels (OR: 1.7, 95% CI: 1.0-2.9) were more likely to cease compliance with the fitnorm. Perceived neighbourhood safety partly explained gender differences in disengagement from sports (8%). Intention partly explained ethnical (32%) and educational differences (37%) in ceasing compliance with the fitnorm. CONCLUSIONS: Girls, lower-educated adolescents and those with a non-Western background showed more pronounced reductions in sports participation and compliance with the fitnorm. Intention and perceived neighbourhood safety could partially explain these differences.
  The European Journal of Public Health 01/2013; · 2.73 Impact Factor
• Article: Longer Sleep - Slimmer Kids: The ENERGY-Project.

  Teatske M Altenburg, Mai J M Chinapaw, Elise T W van der Knaap, Johannes Brug, Yannis Manios, Amika S Singh
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  ABSTRACT: Few studies have differentiated between weekday and weekend day sleep duration in their association with indicators of weight status in children. Therefore, we examined the association of week and weekend day sleep duration with indicators of body composition in 10-12 year old European school children. Multi-level linear regression analysis was performed to examine the association between parent-reported week and weekend day sleep duration and objectively assessed child BMI and WC, adjusting for socio-demographic variables and energy balanced related behaviours EBRBs (i.e. dietary, physical and sedentary behaviour). Compared to sleeping 10 hrs/night or more, sleeping on average less than 10 hrs/night during weekdays was associated with higher BMI (for example, B = 0.86 and CI = [0.27;1.45] when sleeping ≤7 hrs) and WC (for example, B = 1.99 and CI = [0.32;3.65] when sleeping ≤7 hrs). Sleeping 9 hrs/night during weekend days, but not ≤8 hrs, was associated with higher WC (B = 0.66; CI = [0.04;1.28]) compared to sleeping more than 10 hrs/night. Average (week and weekend) sleep duration less than 10 hrs/night was associated with higher values for BMI (B = 0.98; CI = [0.24;1.73] and WC (B = 2.35; CI = [0.08;4.31]). Weekday sleep duration seems more strongly associated with body composition in European school children than weekend day sleep duration. Promoting adequate sleep duration may contribute to healthy weight in children.
  PLoS ONE 01/2013; 8(3):e59522. · 4.09 Impact Factor
• Article: Cohort Profile: The Resilience for Eating and Activity Despite Inequality (READI) study.

  Kylie Ball, Verity Cleland, Jo Salmon, Anna F Timperio, Sarah McNaughton, Lukar Thornton, Karen Campbell, Michelle Jackson, Louise A Baur, Gita Mishra, Johannes Brug, Robert W Jeffery, Abby King, Ichiro Kawachi, David A Crawford
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  ABSTRACT: The Resilience for Eating and Activity Despite Inequality (READI) cohort was established to address the following two key aims: to investigate the pathways (personal, social and structural) by which socio-economic disadvantage influences lifestyle choices associated with obesity risk (physical inactivity, poor dietary choices) and to explore mechanisms underlying 'resilience' to obesity risk in socio-economically disadvantaged women and children. A total of 4349 women aged 18-46 years and 685 children aged 5-12 years were recruited from 80 socio-economically disadvantaged urban and rural neighbourhoods of Victoria, Australia, and provided baseline (T1: 2007-08) measures of adiposity, physical activity, sedentary and dietary behaviours; socio-economic and demographic factors; and psychological, social and perceived environmental factors that might impact on obesity risk. Audits of the 80 neighbourhoods were undertaken at baseline to provide objective neighbourhood environmental data. Three-year follow-up data (2010-11) have recently been collected from 1912 women and 382 children. Investigators welcome enquiries regarding data access and collaboration.
  International Journal of Epidemiology 12/2012; · 6.41 Impact Factor
• Article: Test-retest reliability and construct validity of the DOiT (Dutch Obesity Intervention in Teenagers) questionnaire: measuring energy balance-related behaviours in Dutch adolescents.

  Evelien Hc Janssen, Amika S Singh, Femke van Nassau, Johannes Brug, Willem van Mechelen, Mai Jm Chinapaw
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  ABSTRACT: OBJECTIVE: Adequate assessment of energy balance-related behaviours in adolescents is essential to develop and evaluate effective obesity prevention programmes. The present study examined the test-retest reliability and construct validity of a questionnaire assessing energy balance-related behaviours in adolescents during the evaluation of the DOiT (Dutch Obesity Intervention in Teenagers) intervention. DESIGN: To assess test-retest reliability, adolescents filled in the questionnaire twice (n 111). To assess construct validity, the results from the first test were compared with data collected in a personal cognitive interview (n 20, independent from the reliability study). For both reliability and validity, intraclass correlation coefficients for continuous data or Cohen's kappa coefficients for categorical data were calculated as well as percentage agreement. SETTING: Data were collected during school time from February to May 2010. SUBJECTS: Study participants were Dutch adolescents aged 12-14 years attending pre-vocational secondary schools. RESULTS: In more than three-quarters of the ninety-five questionnaire items the test-retest reliability appeared to be good to excellent. Moderate reliability was found for all other twenty-one items. Fifty-one items (of ninety-five items) showed good to excellent construct validity. Construct validity appeared moderate in twenty-three items and poor in twenty-one items. Most items with poor construct validity concerned consumption of sugar-containing beverages and high-energy snacks/sweets. CONCLUSIONS: Our study showed good test-retest reliability and largely moderate to good construct validity for the majority of items of the DOiT questionnaire. Items with poor construct validity (most of them found for items concerning energy intake-related behaviours) should be revised and tested again to improve the questionnaire for future use.
  Public Health Nutrition 12/2012; · 2.17 Impact Factor
• Article: Methodological quality of front-of-pack labeling studies: a review plus identification of research challenges.

  Ellis L Vyth, Ingrid Hm Steenhuis, Hella E Brandt, Annet Jc Roodenburg, Johannes Brug, Jacob C Seidell
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  ABSTRACT: This review evaluates the methodological quality of current front-of-pack labeling research and discusses future research challenges. Peer-reviewed articles were identified using a computerized search of the databases PubMed and Web of Science (ISI) from 1990 to February 2011; reference lists from key published articles were used as well. The quality of the 31 included studies was assessed. The results showed that the methodological quality of published front-of-pack labeling research is generally low to mediocre; objective observational data-based consumer studies were of higher quality than consumer studies relying on self-reports. Experimental studies that included a control group were lacking. The review further revealed a lack of a validated methodology to measure the use of front-of-pack labels and the effects of these labels in real-life settings. In conclusion, few methodologically sound front-of-pack labeling studies are presently available. The highest methodological quality and the greatest public health relevance are achieved by measuring the health effects of front-of-pack labels using biomarkers in a longitudinal, randomized, controlled design in a real-life setting.
  Nutrition Reviews 12/2012; 70(12):709-20. · 4.47 Impact Factor
• Source

  Available from: Bettina Bringolf-Isler

  Article: Differences in weight status and energy-balance related behaviors among schoolchildren in German-speaking Switzerland compared to seven countries in Europe.

  Michael Herzig, Alain Dössegger, Urs Mäder, Susi Kriemler, Tina Wunderlin, Leticia Grize, Johannes Brug, Yannis Manios, Charlotte Braun-Fahrländer, Bettina Bringolf-Isler
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  ABSTRACT: BACKGROUND: Overweight in children and adolescents have increased significantly and are a major public health problem. To allow international comparisons, Switzerland joined the European study 'ENERGY' cross sectional survey consortium that investigated the prevalence of overweight and obesity as well as selected dietary, physical and sedentary behaviors of 10--12 years old pupils across seven other countries in Europe. The aims of the present study was to compare body composition and energy-balance related behaviors of Swiss schoolchildren to those of the seven European ENERGY-countries and to analyze overweight and energy-balance related behaviors of Swiss children according to socio-demographic factors. METHODS: A school-based cross-sectional study among 10--12 year old children was conducted in Switzerland and seven other European countries using a standardized protocol. Body height, weight and waist-circumference were measured by trained research assistants. Energy-balance related behaviors --i.e. selected dietary, physical activity and screen-viewing behaviors were assessed by questionnaires. Weight status and behaviors in Switzerland were compared to the seven European ENERGY countries. Within the Swiss sample, analyses stratified by gender, parental education and ethnicity were performed. RESULTS: Data of 546 Swiss children (mean age 11.6+/-0.8y, 48% girls) were obtained and compared to the ENERGY- results (N=7.148; mean age 11.5+/-0.8y, 48% girls). In Switzerland significantly less children were overweight (13.9%) or obese (2.3%) compared to the average across the ENERGY-countries (23.7% and 4.7%, respectively), and were even somewhat lower than the ENERGY countries with the lowest prevalence. Sugar sweetened beverage intakes and breakfast habits of Swiss children did not differ significantly from those of ENERGY. However, the mean time devoted by Swiss children to walking or cycling to school and attending sports activities was significantly higher and screen time significantly lower compared to the other ENERGY-countries. Within the Swiss, sample relatively large and consistent differences were observed between children from native and non-native ethnicity. CONCLUSIONS: The prevalence of overweight and obesity among Swiss children are substantial but significantly lower compared to all other European ENERGY-Partners, probably due to the fact that Swiss children were found to be more active and less sedentary comparing to the rest of the European sample.
  International Journal of Behavioral Nutrition and Physical Activity 11/2012; 9(1):139. · 3.83 Impact Factor
• Article: Physical and psychosocial benefits of yoga in cancer patients and survivors, a systematic review and meta-analysis of randomized controlled trials.

  Laurien M Buffart, Jannique Gz van Uffelen, Ingrid I Riphagen, Johannes Brug, Willem van Mechelen, Wendy J Brown, Mai Jm Chinapaw
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  ABSTRACT: BACKGROUND: This study aimed to systematically review the evidence from randomized controlled trials (RCTs) and to conduct a meta-analysis of the effects of yoga on physical and psychosocial outcomes in cancer patients and survivors. METHODS: A systematic literature search in ten databases was conducted in November 2011. Studies were included if they had an RCT design, focused on cancer patients or survivors, included physical postures in the yoga program, compared yoga with a non-exercise or waitlist control group, and evaluated physical and/or psychosocial outcomes. Two researchers independently rated the quality of the included RCTs, and high quality was defined as >50% of the total possible score. Effect sizes (Cohen's d) were calculated for outcomes studied in more than three studies among patients with breast cancer using means and standard deviations of post-test scores of the intervention and control groups. RESULTS: Sixteen publications of 13 RCTs met the inclusion criteria, of which one included patients with lymphomas and the others focused on patients with breast cancer. The median quality score was 67% (range: 22--89%). The included studies evaluated 23 physical and 20 psychosocial outcomes. Of the outcomes studied in more than three studies among patients with breast cancer, we found large reductions in distress, anxiety, and depression (d = -0.69 to -0.75), moderate reductions in fatigue (d = -0.51), moderate increases in general quality of life, emotional function and social function (d = 0.33 to 0.49), and a small increase in functional well-being (d = 0.31). Effects on physical function and sleep were small and not significant. CONCLUSION: Yoga appeared to be a feasible intervention and beneficial effects on several physical and psychosocial symptoms were reported. In patients with breast cancer, effect size on functional well-being was small, and they were moderate to large for psychosocial outcomes.
  BMC Cancer 11/2012; 12(1):559. · 3.01 Impact Factor
• Source

  Available from: Marielle A Beenackers

  Dataset: Additional file - Beenackers et al 2011 - IJBNPA

  Mariëlle A Beenackers, Carlijn B M Kamphuis, Katrina Giskes, Johannes Brug, Anton E Kunst, Alex Burdorf, Frank J van Lenthe
• Article: Micro-level economic factors and incentives in Children's energy balance related behaviours - findings from the ENERGY European cross-section questionnaire survey.

  Jørgen Dejgård Jensen, Elling Bere, Ilse De Bourdeaudhuij, Natasa Jan, Lea Maes, Yannis Manios, Marloes K Martens, Denes Molnar, Luis A Moreno, Amika S Singh, Saskia Te Velde, Johannes Brug
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  ABSTRACT: BACKGROUND: To date, most research on obesogenic environments facing school children has focused on physical and socio-cultural environments. The role of economic factors has been investigated to a much lesser extent. Our objective was to explore the association of micro-level economic factors and incentives with sports activities and intake of soft drinks and fruit juice in 10-12 year-old school children across Europe, and to explore price sensitivity in children's soft drink consumption and correlates of this price sensitivity. METHODS: Data for the study originate from a cross-sectional survey undertaken in seven European countries (Belgium, Greece, Hungary, Netherlands, Norway, Slovenia and Spain) in 2010 among 10-12 year-old school children and their parents. In total, 7234 child questionnaires and 6002 parent questionnaires were completed. The child questionnaire included questions addressing self-reported weekly intake of soft drinks and fruit juices and time spent on sports activities, perception of parental support for sports activities, use of pocket money for soft drinks and perceived price responsiveness. Parent questionnaires included questions addressing the role of budget and price considerations in decisions regarding children's sports activities, soft drink consumption, home practices and rules and socio-demographic background variables. Data were analysed using multiple linear regression and discrete-choice (ordered probit) modelling. RESULTS: Economic factors were found to be associated with children's sports participation and sugary drink consumption, explaining 27% of the variation in time for sports activities, and 27% and 12% of the variation in the children's soft drink and juice consumption, respectively. Parents' financial support was found to be an important correlate (Beta =0.419) of children's sports activities. Children's pocket money was a strong correlate (Beta =21.034) of soft drink consumption. The majority of the responding children reported to expect that significantly higher prices of soft drinks would lead them to buy less soft drinks with their own pocket money, but a majority of parents did not expect higher soft drink prices to reduce their children's soft drink consumption. CONCLUSIONS: We conclude that economic factors, especially parents' financial support and amount of pocket money, appear to be of importance for children's sports participation and soft drink consumption, respectively.
  International Journal of Behavioral Nutrition and Physical Activity 11/2012; 9(1):136. · 3.83 Impact Factor
• Source

  Available from: Bettina Bringolf-Isler

  Article: Associations between home- and family-related factors and fruit juice and soft drink intake among 10- to 12-year old children: the ENERGY project.

  Wendy Van Lippevelde, Saskia J Te Velde, Maïté Verloigne, Ilse De Bourdeaudhuij, Yannis Manios, Elling Bere, Nataša Jan, Juan M Fernández-Alvira, Mai J M Chinapaw, Bettina Bringolf-Isler, Eva Kovacs, Johannes Brug, Lea Maes
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  ABSTRACT: The aim of this study is to investigate associations of family-related factors with children's fruit drink/juice and soft drink consumption. A cross-sectional survey among ten- to twelve-year-old children and their parents in eight European countries was conducted to gather this data. Key variables of interest were children's self-reported fruit drink/juice and soft drink intake per day (outcome) and family-related factors (based on parents' report) related to these two behaviours (modeling, automaticity, availability, monitoring, permissiveness, negotiating, communicating health beliefs, avoid negative modeling, self-efficacy, rewarding, and family consumption). 7915 children (52% girls; mean age=11.7±0.8 years) and 6512 parents (83% women; mean age=41.4±5.3 years) completed the questionnaire. Multilevel regression analyses were used to examine the aforementioned associations. Three of the 11 family-related factors (modeling, availability, and family consumption) were positively associated with children's fruit drink/juice and soft drink intake. Additionally, three family-related factors (permissiveness, monitoring, and self-efficacy) were solely associated with soft drink intake and one family-related factor (communicating health beliefs) was related to fruit drink/juice intake. Future interventions targeting children's fruit drink/juice and soft drink intake should focus on the home environment, parents and their practices, especially on parents' fruit drink/juice and soft drink intake and availability of these beverages at home.
  Appetite 11/2012; · 2.59 Impact Factor
• Article: Hand disinfection in a neonatal intensive care unit: continuous electronic monitoring over a one-year period.

  Onno K Helder, Johannes B van Goudoever, Wim C J Hop, Johannes Brug, René F Kornelisse
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  ABSTRACT: BACKGROUND: Good hand hygiene compliance is essential to prevent nosocomial infections in healthcare settings. Direct observation of hand hygiene compliance is the gold standard but is time consuming. An electronic dispenser with built-in wireless recording equipment allows continuous monitoring of its usage. The purpose of this study was to monitor the use of alcohol-based hand rub dispensers with a built-in electronic counter in a neonatal intensive care unit (NICU) setting and to determine compliance with hand hygiene protocols by direct observation. METHODS: A one-year observational study was conducted at a 27 bed level III NICU at a university hospital. All healthcare workers employed at the NICU participated in the study. The use of bedside dispensers was continuously monitored and compliance with hand hygiene was determined by random direct observations. RESULTS: A total of 258,436 hand disinfection events were recorded; i.e. a median (interquartile range) of 697 (559-840) per day. The median (interquartile range) number of hand disinfection events performed per healthcare worker during the day, evening, and night shifts was 13.5 (10.8 - 16.7), 19.8 (16.3 - 24.1), and 16.6 (14.2 - 19.3), respectively. In 65.8% of the 1,168 observations of patient contacts requiring hand hygiene, healthcare workers fully complied with the protocol. CONCLUSIONS: We conclude that the electronic devices provide useful information on frequency, time, and location of its use, and also reveal trends in hand disinfection events over time. Direct observations offer essential data on compliance with the hand hygiene protocol. In future research, data generated by the electronic devices can be supplementary used to evaluate the effectiveness of hand hygiene promotion campaigns.
  BMC Infectious Diseases 10/2012; 12(1):248. · 3.12 Impact Factor
• Article: Family- and school-based predictors of energy balance-related behaviours in children: a 6-year longitudinal study.

  Maïté Verloigne, Wendy Van Lippevelde, Lea Maes, Johannes Brug, Ilse De Bourdeaudhuij
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  ABSTRACT: OBJECTIVE: To examine family- and school-based predictors of breakfast consumption, soft drink consumption and physical activity (PA) and moderating effects of gender and socio-economic status (SES). DESIGN: Longitudinal study (6-year follow-up), including a questionnaire about dietary and activity behaviour. SETTING: Fifty-nine Flemish elementary schools. SUBJECTS: Seven hundred and twenty-seven children (51·9 % girls, 51·9 % high SES, mean age 9·9 (sd 0·4) years at baseline). RESULTS: Having breakfast together with parents (P < 0·001) at age 10 years related to more days of eating breakfast at age 16 years. More parental soft drink consumption (P = 0·04), less soft drink availability at home (P < 0·001) and less parental permissiveness (children received soft drinks from their parents whenever they asked for it and children could take soft drinks whenever they wanted; P = 0·02 and P = 0·001, respectively) at age 10 years related to less soft drink consumption at age 16 years. A more positive parental attitude towards PA (P = 0·009), more parental encouragement (P = 0·002) and a higher rating of PA's benefit 'relaxing' (P < 0·001) at age 10 years related to more PA at age 16 years. Gender and SES did not significantly moderate any of the associations. CONCLUSIONS: Only parental factors at age 10 years were associated with breakfast consumption, soft drink consumption and PA at age 16 years. An intervention programme at age 10 years with a strong focus on the modifiable parental factors might lead to healthy behaviour in the long term.
  Public Health Nutrition 09/2012; · 2.17 Impact Factor
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  Available from: Marielle A Beenackers

  Article: Socioeconomic inequalities in occupational, leisure-time, and transport related physical activity among European adults: A systematic review.

  Mariëlle A Beenackers, Carlijn B M Kamphuis, Katrina Giskes, Johannes Brug, Anton E Kunst, Alex Burdorf, Frank J van Lenthe
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  ABSTRACT: BACKGROUND: This study systematically reviewed the evidence pertaining to socioeconomic inequalities in different domains of physical activity (PA) by European region. METHODS: Studies conducted between January 2000 and December 2010 were identified by a systematic search in Pubmed, Embase, Web of Science, Psychinfo, Sportdiscus, Sociological Abstracts, and Social Service Abstracts. English-language peer-reviewed studies undertaken in the general population of adults (18--65 years) were classified by domain of PA (total, leisure-time including sport, occupational, active transport), indicator of socioeconomic position (education, income, occupation), and European region. Distributions of reported positive, negative, and null associations were evaluated. RESULTS: A total of 131 studies met the inclusion criteria. Most studies were conducted in Scandinavia (n = 47). Leisure-time PA was the most frequently studied PA outcome (n = 112). Considerable differences in the direction of inequalities were seen for the different domains of PA. Most studies reported that those with high socioeconomic position were more physically active during leisure-time compared to those with low socioeconomic position (68% positive associations for total leisure-time PA, 76% for vigorous leisure-time PA). Occupational PA was more prevalent among the lower socioeconomic groups (63% negative associations). Socioeconomic differences in total PA and active transport PA did not show a consistent pattern (40% and 38% positive associations respectively). Some inequalities differed by European region or socioeconomic indicator, however these differences were not very pronounced. CONCLUSIONS: The direction of socioeconomic inequalities in PA in Europe differed considerably by domain of PA. The contradictory results for total PA may partly be explained by contrasting socioeconomic patterns for leisure-time PA and occupational PA.
  International Journal of Behavioral Nutrition and Physical Activity 09/2012; 9(1):116. · 3.83 Impact Factor
• Article: The effect of the UP4FUN pilot intervention on objectively measured sedentary time and physical activity in 10--12 year old children in Belgium: the ENERGY-project.

  Maïté Verloigne, Elling Bere, Wendy Van Lippevelde, Lea Maes, Nanna Lien, Froydis N Vik, Johannes Brug, Greet Cardon, Ilse De Bourdeaudhuij
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  ABSTRACT: Bakckground The first aim was to examine the effect of the UP4FUN pilot intervention on children's total sedentary time. The second aim was to investigate if the intervention had an effect on children's physical activity (PA) level. Finally, we aimed to investigate demographic differences (i.e. age, gender, ethnicity, living status and having siblings) between children in the intervention group who improved in sedentary time and PA at post-test and children in the intervention group who worsened in sedentary time and PA at post-test. METHODS: The six weeks UP4FUN intervention was tested in a randomized controlled trial with pre-test post-test design with five intervention and five control schools in Belgium and included children of the 5th and 6th grade. The children wore accelerometers for seven days at pre- and post-test. Analyses included children with valid accelerometer data for at least two weekdays with minimum 10h-wearing time and one weekend day with 8h-wearing time. Result Final analyses included 372 children (60% girls, mean age = 10.9 +/- 0.7 years). There were no significant differences in the change in sedentary time or light PA between intervention and control schools for the total sample or for the subgroup analyses by gender. However, children (specifically girls) in the intervention group had a higher decrease in moderate-to-vigorous PA than children in the control group. In the intervention group, children who lived with both parents and children with one or more siblings were less likely to reduce sedentary time after exposure to the intervention. Older children, girls and children who lived with both parents were less likely to increase light PA after the intervention. CONCLUSION: The UP4FUN intervention did not result in an effect on children's sedentary time. Based on the high amounts of accelerometer-derived sedentary time in this age group, more efforts are needed to develop strategies to reduce children's sedentary time.
  BMC Public Health 09/2012; 12(1):805. · 2.00 Impact Factor