Hans Savelberg

• PhD
• Managing Director at Maastricht University

Purpose Low cardiorespiratory fitness (CRF) increases the risk of postoperative morbidity and mortality following major surgery. Assessing CRF preoperatively, by measuring peak oxygen uptake (VO2peak) during cardiopulmonary exercise testing (CPET), is valuable yet not widely available. This study aimed to assess whether questionnaires could be used...

Objective Glucose metabolism status (GMS) is linked to non-alcoholic fatty liver disease (NAFLD). Higher levels of advanced glycation end products (AGEs) are observed in people with type 2 diabetes mellitus (T2DM) and NAFLD. We examined the association between GMS, non-invasive tests and AGEs, with liver steatosis and fibrosis. Methods Data from T...

BACKGROUND Blood pressure (BP)–lowering effects of structured exercise are well-established. Effects of 24-hour movement behaviors captured in free-living settings have received less attention. This cross-sectional study investigated associations between a 24-hour behavior composition comprising 6 parts (sleeping, sedentary behavior, standing, slow...

Introduction Age-related declines in physical functioning have significant implications for health in later life. Physical activity (PA) volume is associated with physical function, but the importance of the pattern in which PA is accumulated is unclear. This study investigates associations between accelerometer-determined daily PA patterns, includ...

Aims/hypothesis The associations of sitting, standing, physical activity and sleep with cardiometabolic health and glycaemic control markers are interrelated. We aimed to identify 24 h time-use compositions associated with optimal metabolic and glycaemic control and determine whether these varied by diabetes status. Methods Thigh-worn activPAL dat...

Background Kidney failure has been associated with decreased physical capacity, although evidence regarding the physical performance of individuals with earlier stages of chronic kidney disease (CKD) remains limited. Methods Cross-sectional data were derived from the prospective, population-based Maastricht Study. Multivariate linear regression mo...

This study explores the experiences and the preferred schedule of face-to-face and online tutorials in a problem-based learning setting where students learn collaboratively, based on cognitive, social, and teaching presences. Seventeen experienced students and 13 tutors attended semi-structured interviews focusing on their experiences and preferenc...

Background Exercise interventions fail to increase objective physical activity (PA) in persons with Multiple Sclerosis (PwMS), while they self-report higher exercise participation. This suggests that PwMS change their non-exercise PA (NEPA). We aimed to explore NEPA changes of PwMS and healthy controls (HC), and whether these constrain exercise ada...

Background and Aims Physical inactivity, sedentary behaviour (SB), and inadequate sleep are key behavioural risk factors of cardiometabolic diseases. Each behaviour is mainly considered in isolation, despite clear behavioural and biological interdependencies. The aim of this study was to investigate associations of five-part movement compositions w...

Background and aims Physical activity (PA) constitutes an established protective factor while sedentary behavior (SB) an emerging independent risk factor for cardiovascular diseases. This study evaluated the association of PA and SB with endothelial dysfunction (ED) depending on kidney function status. Methods Cross-sectional data from the prospec...

Creativity is important for school performance. As several brain mechanisms involved in creativity are stimulated by low‐intensity physical activity, standing might influence creativity. Few studies on the relationship between standing and creativity have been executed, and none among vocational education and training (VET) students. Therefore, the...

Objectives: This study examined the cross-sectional association between sleep duration, prediabetes, and type 2 diabetes, and its independence from the traditional lifestyle risk factors diet, physical activity, smoking behavior, and alcohol consumption. Methods: Cross-sectional data from 5561 people aged 40-75 years recruited into The Maastrich...

Background Exercise interventions fail to increase objective physical activity (PA) in persons with Multiple Sclerosis (PwMS), while they self-report higher exercise participation. This suggests that PwMS change their non-exercise PA (NEPA). We aimed to explore NEPA changes of PwMS and healthy controls (HC), and whether these constrain exercise ada...

Background We investigated the association of neighborhood walkability with accelerometer‐measured physical activity (PA) and sedentary behavior (SB) and examined whether objective and subjective measures of walkability resulted in similar findings. Methods PA and SB from the first 7689 Maastricht Study participants ages 40–75 from 2010 to 2017 we...

Background: Evaluating the criterion validity and responsiveness of the self-reported FitMáx©-questionnaire, Duke Activity Status Index (DASI) and Veterans Specific Activity Questionnaire (VSAQ) to monitor aerobic capacity in cancer survivors. Methods: Cancer survivors participating in a 10-week supervised exercise program were included. The Fit...

Background If retinal indices of neurodegeneration are to be biomarkers for the monitoring of cerebral neurodegeneration, it is important to establish whether potentially modifiable risk factors for dementia are associated with retinal neurodegenerative changes. Objective To study associations of dementia risk factors with retinal sensitivity, an...

Background: Cardiac troponins and NT-proBNP are biomarkers of cardiac injury that are used clinically in the diagnosis of myocardial infarction and heart failure. It is not known whether the amount, types and patterns of physical activity (PA) and sedentary behaviour are associated with levels of cardiac biomarkers. Methods: In the population-ba...

Background Insufficient physical activity and sedentary behaviour (SB) are important factors that determine cardiometabolic health and the development of non-communicable diseases. The aim of this study was to investigate the modifying effects of moderate-to-vigorous physical activity (MVPA) on the association between SB and cardiometabolic health...

Health promotion interventions often have suboptimal effects due to implementation challenges (Deschesnes et al., Health Promot Int 18:387–396, 2003; Lee, Appl Health Econ Health Policy 7:11–17, 2009; Langford et al., Cochrane Database Syst Rev 4:CD008958, 2014; Darlington, BMC Public Health 18:163, 2018; Schaap et al., Int J Behav Nutr Phys Act 15...

Background: University students sit too much, which is detrimental to their physical and mental health. Academic schedules, including scheduled education time and self-study time, may influence their physical activity behaviors. Objectives: To investigate (1) the association between scheduled education time and students' physical activity levels...

Purpose: This study aimed to identify physical activity patterns and examine their association with cardiometabolic biomarkers in a cross-sectional design. Methods: Overall 6072 participants (mean age 60.2 years (SD 8.6), 50% women) from The Maastricht Study provided daily physical activity data collected with thigh-worn activPAL3 accelerometers...

Background: A flow limitation in the iliac arteries (FLIA) in endurance athletes is notoriously difficult to diagnose with the currently available diagnostic tools. At present, a commonly used diagnostic measure is a decrease in ankle brachial index with flex hips (ABIFlexed) following a maximal effort exercise test. Near-infrared spectroscopy (NI...

Background: University students often exhibit high levels of sedentary behavior that is negatively associated with cognition and mood. On the other hand, light-intensity physical activity (LIPA) may improve cognitive performance and mood. Therefore, this study investigated the acute effect of LIPA breaks during prolonged sitting on attention, exec...

Background Reducing sedentary behaviour significantly improves cardiometabolic health and plays an important role in the prevention and management of cardiometabolic diseases. However, limited effective strategies have been proposed to combat the negative effects of sedentary lifestyles. Although consumer wearable activity trackers (CWATs) can effe...

Objective: Endurance athletes are prone to develop flow limitations in iliac arteries (FLIA). Especially in cyclists and ice speed skaters, excessive hemodynamic loading coupled with hip hyperflexion may cause kinking in lengthened iliac arteries necessitating surgical correction. This study investigated the short-term (≤1.5 years) and long-term (...

Purpose: Persons with Multiple Sclerosis (PwMS) are physically inactive and spend more time in sedentary behaviours than healthy persons, which increases the risk of developing cardiometabolic diseases. In this randomised crossover study, the cardiometabolic health effects of replacing sitting with light-intensity physical activity (LIPA) and exer...

This study aims to compare the accelerometer‐measured daily patterns of PA and sedentary behaviour among participants with and without prevalent/incident depressive symptoms. We used data from 5,582 individuals in The Maastricht Study (59.9 ± 8.6 years, 50.3% women). Daily patterns of sedentary time, light‐intensity physical activity (LiPA), modera...

Background School-based health-promoting interventions are increasingly seen as an effective population strategy to improve health and prevent obesity. Evidence on the long-term effectiveness of school-based interventions is scarce. This study investigates the four-year effectiveness of the school-based Healthy Primary School of the Future (HPSF) i...

Objective: The main objective was to investigate whether there was an interaction between retinal nerve fibre layer (RNFL) thickness, an index of neurodegeneration, and retinal venular diameter, an index of microvascular dysfunction, in the associations of RNFL thickness and retinal venular diameter with global cognitive performance, an index of c...

Abstract Mortality in type 2 diabetes, is determined not only by classical complications, but also by comorbidities, and is linked to hyperglycaemia and apparent even in prediabetes. We aimed to comprehensively investigate, in a population-based cohort, health burden defined as the presence of comorbidities in addition to classical complications an...

Aims/hypothesis Biomarkers of endothelial dysfunction and low-grade inflammation are important in the pathogenesis of CVD and can potentially be modified by physical activity and sedentary behaviour. Effects of physical activity on biomarkers of endothelial dysfunction may be especially prominent in type 2 diabetes. Methods In the population-based...

A positive association has been found between physical activity (PA) and student mental wellbeing (SMW). This association has been mainly explored in secondary school and university students. Studies in vocational education and training (VET) are lacking, while VET students could especially benefit from exploring this association since research sho...

Research suggests that sedentary behavior (SB) is negatively associated with cognitive outcomes. Interrupting prolonged sitting has been shown to improve cognitive functions, including executive functioning (EF), which is important for academic performance. No research has been conducted on the effect of standing on EF in VET students, who make up...

The ankle‐brachial index is an accurate tool for detecting claudication in atherosclerotic patients. However, this technique fails to identify subtle flow limitations of the iliac arteries (FLIA) in endurance athletes. Near‐infrared spectroscopy (NIRS) is a noninvasive technique that measures skeletal muscle tissue oxygenation status. The aim of th...

Objective Endurance athletes may develop intermittent claudication due to sport-related flow-limitations of the iliac artery (FLIA) caused by arterial kinking. This study investigated short- and long-term efficacy of an operative release for iliac artery kinking. Methods Between 1996 and 2015, all patients diagnosed and operated with FLIA due to i...

The effects of light physical activity (LPA) interventions on adolescents’ learning were reviewed. Learning was operationalized as academic performance and academic-performance-related cognitive functions. Using PubMed, Web of Science, ERIC, PsycINFO, PsycARTICLES, Psychology and Behavioral Sciences Collection, and Cochrane Library, only English-la...

Background Closed-loop insulin delivery systems, which integrate continuous glucose monitoring (CGM) and algorithms that continuously guide insulin dosing, have been shown to improve glycaemic control. The ability to predict future glucose values can further optimize such devices. In this study, we used machine learning to train models in predictin...

Background Standing desks have been brought into the education environment to reduce sedentary behavior among students. The current study explored the effects of standing in tutorial group meetings on learning among undergraduate students. Methods Ninety-six participants were randomly allocated to a Sit or Stand group, with 2-hour tutorial group m...

Vocational education and training (VET) educates students for a broad range of occupations, which may be associated with differences in habitual physical activity behavior (PAB). Research suggests that physical activity (PA) is positively and sedentary behavior (SB) is negatively associated with cognitive performance. Therefore, we aimed to compare...

Gericht op fysiotherapeuten, een vertaling van wetenschap naar praktijk. Hoewel sporten duidelijke gezondheidsvoordelen heeft, zijn er veel mensen die niet graag sporten of niet kunnen sporten. Bovendien blijkt langdurig zitten een belangrijke risicofactor voor het ontstaan van diabetes en hart- en vaatziekten te zijn, die niet gecompenseerd kan wo...

Objectives: Cardiorespiratory fitness plays an essential role in health outcomes and quality of life. Objective assessment of cardiorespiratory fitness is costly, labour intensive and not widely available. Although patient-reported outcome measures estimate cardiorespiratory fitness more cost-efficiently, the current questionnaires lack accuracy. T...

Introduction We compared the degree of spousal concordance in a set of detailed pathophysiological markers and risk factors for type 2 diabetes to understand where in the causal cascade spousal similarities are most relevant. Research design and methods This is a cross-sectional analysis of couples who participated in The Maastricht Study (n=172)....

Objective: To study school lifestyle interventions for elementary school children (The Healthy Primary School of the Future). Research question: What are the effects of the introduction of increased physical activity with or without healthy nutrition on health behaviour and BMI of young children and what are the costs of this program? Design:...

While it has been shown that interrupting a person’s sedentary behaviour has the potential to improve cognitive, physical and mental health, a large part of time that students spend in school is sedentary. As research has shown that approximately 80% of vocational education and training (VET) students have an unhealthy sedentary lifestyle, implemen...

Introduction Distal sensorimotor polyneuropathy (DSPN) is common in people with diabetes but is also found in pre-diabetes. Peripheral nerve myelin damage, which can be assessed by reduced nerve conduction velocity (NCV), is an essential feature of DSPN. Emerging evidence indicates that the development of DSPN may involve the activation of the immu...

Background This study examined the associations between accelerometer-derived sedentary time (ST), lower intensity physical activity (LPA), higher intensity physical activity (HPA) and the incidence of depressive symptoms over 4 years of follow-up. Methods We included 2082 participants from The Maastricht Study (mean ± s.d. age 60.1 ± 8.0 years; 5...

This study explored the effects of using standing desks in tutorial meetings on the physical activity behavior (PAB) of undergraduate students. Standing desks have been introduced to minimize the detrimental health effects of prolonged sedentary behavior (SB). The effectiveness of using standing desks has not been explored among undergraduate stude...

Background Arterial stiffness is an independent risk factor for cardiovascular disease and can be beneficially influenced by physical activity. However, it is not clear how an individual’s physical activity pattern over a week is associated with arterial stiffness. Therefore, we examined the associations of the amount and pattern of higher intensit...

Background Moderate to vigorous physical activity (MVPA) can help to prevent depression, but identification of the most important psycho-biological pathways involved is unclear. The improvement of cardio-respiratory fitness (CRF) in response to MVPA can vary markedly, we therefore examined the association between CRF and the incidence of depressive...

We assessed whether objectively measured low- and high-intensity physical activity (LPA and HPA) and sedentary time (ST) were associated with white matter connectivity, both throughout the whole brain and in brain regions involved in motor function. In the large population-based Maastricht Study (n = 1715, age 59.6 ± 8.1 (mean ± standard deviation)...

Combined lifestyle interventions (CLIs) that target both physical activity (PA) and diet have been shown to improve PA and health of adults who are overweight; however, optimal amount of guidance remains unclear. This study evaluated the effects of adding PA group sessions to a standard CLI in primary care in the Netherlands. 411 participants (BMI...

Samenvatting Inleiding Scholen zijn een belangrijke setting om gezondheidsgedrag van kinderen te verbeteren. Het initiatief ‘De Gezonde Basisschool van de Toekomst (GBT)’ heeft als doel om gezondheid en welzijn te integreren in het schoolsysteem en is gebaseerd op de door de Wereldgezondheidsorganisatie ontwikkelde Health Promoting School (HPS)-be...

Aims/hypothesis: We aimed to examine associations of cardiometabolic risk factors, and (pre)diabetes, with (sensorimotor) peripheral nerve function. Methods: In 2401 adults (aged 40-75 years) we previously determined fasting glucose, HbA1c, triacylglycerol, HDL- and LDL-cholesterol, inflammation, waist circumference, blood pressure, smoking, glu...

Objectives Approximately one in five professional cycling athletes will eventually develop a sport-related vascular problem. However, detecting such flow limitation is a diagnostic challenge as the sensitivity of the currently available standard diagnostic tools is limited. Methods Here we present an athlete with exercise-induced pain and weakness...

Students starting at university tend to adopt unhealthy behaviors. With students expected to sit during classes, their academic schedule may be responsible for their activity patterns. The aim of the current study was to investigate the relationship between university students’ academic schedule and day-to-day variations in sedentary behavior (SB)...

[This corrects the article DOI: 10.3389/fpsyg.2018.02501.].

Objective: Physical activity may provide a means for the prevention of cardiovascular disease via improving microvascular function. Therefore, this study investigated whether physical activity is associated with skin and retinal microvascular function. Methods: In The Maastricht Study, a population-based cohort study enriched with Type 2 diabete...

Objectives Schools play an important role in promoting healthy behaviours in children and can offer perspective in the ongoing obesity epidemic. The ‘Healthy Primary School of the Future’ (HPSF) aims to improve children’s health and well-being by enhancing school health promotion. The current study aims to assess the effect of HPSF on children’s bo...

The ‘Healthy Primary School of the Future’ (HPSF) aims to integrate health and well-being within the whole school system. This study examined the two-year effects of HPSF on children’s dietary and physical activity (PA) behaviours at school and at home and investigated whether child characteristics or the home context moderated these effects. This...

Background: The current study investigated the moderating role of the school context on the effects of a Dutch health promoting school initiative on children’s health and health behaviors. Methods: The study used a mixed-methods design. The school context (n = 4) was assessed by the characteristics of the school population, teacher’s health-promoti...

Background: While schools have potential to contribute to children's health and healthy behaviour, embedding health promotion within complex school systems is challenging. The 'Healthy Primary School of the Future' (HPSF) is an initiative that aims to integrate health and well-being into school systems. Central to HPSF are two top-down changes tha...

Although self-regulated learning (SRL) is becoming increasingly important in modern educational contexts, disagreements exist regarding its measurement. One particularly important issue is whether self-reports represent valid ways to measure this process. Several researchers have advocated the use of behavioral indicators of SRL instead. An outstan...

Schools can help to improve children's health. The 'Healthy Primary School of the Future' (HPSF) aims to sustainably integrate health and well-being into the school system. This study examined the effects of HPSF on children's dietary and physical activity (PA) behaviours after 1 and 2 years' follow-up. The study (n = 1676 children) has a quasi-exp...

Purpose β-Blockers (BBs) have been associated with a reduced cardiorespiratory fitness (CRF). This is possibly caused by inhibition of β2-receptors in the airways. However, there are limited data available on β-receptor selectivity and CRF. We therefore aimed to assess the association between BB use and CRF and to assess the association between β-r...

Supplemental_file - The Association Between β-Blocker Use and Cardiorespiratory Fitness: The Maastricht Study

Standing classrooms could potentially counteract excessive sedentary behavior. This paper describes the protocol for an exploratory longitudinal randomized controlled trial aimed at studying the effects of standing during tutorials on learning in undergraduate students. Learning is operationally defined as the use of interactions that are conducive...

Endurance cyclists have a substantial risk to develop flow limitations in the iliac arteries during their career. These flow limitations are due to extreme hemodynamic stress which may result in functional arterial kinking and/or intravascular lesions. Early diagnosis may improve outcome and could prevent the necessity for surgical vascular repair....

Aims/hypotheses: Our aim was to examine the independent and combined (cross-sectional) associations of sedentary time (ST), higher intensity physical activity (HPA) and cardiorespiratory fitness (CRF) with metabolic syndrome and diabetes status. Methods: In 1933 adults (aged 40-75 years) ST and HPA (surrogate measure for moderate to vigorous phy...

In order to ensure long-term retention of information students must move from relying on surface-level approaches that are seemingly effective in the short-term to “building in” so called “desirable difficulties,” with the aim of achieving understanding and long-term retention of the subject matter. But how can this level of self-regulation be achi...

We examined the association of employment status, occupational status and occupational group with objectively measured sedentary time (ST) and physical activity (PA) levels in The Maastricht Study. 1,646 participants (46% men, mean age 60 ± 8 years), who were asked to wear an activPAL accelerometer for 8 days were included. Job descriptions were cl...

Background: Schools can play an important role in promoting children’s health behaviours. A Dutch initiative, ‘The Healthy Primary School of the Future’, aims to integrate health and well-being into the school system. We use a contextual action-oriented research approach (CARA) to study the implementation process. Properties of CARA are its focus o...

In this small cross-sectional study of predominantly well-treated participants with relatively short-term type 2 diabetes duration, HbA1c > 7% (53 mmol/mol) was associated with lower cortical density and thickness and higher cortical porosity at the distal radius, lower trabecular thickness at the distal tibia, and higher trabecular number at both...

Most HR-pQCT studies examining cortical bone use an automatically generated endocortical contour (AUTO), which is manually corrected if it visually deviates from the apparent endocortical margin (semi-automatic method, S-AUTO). This technique may be prone to operator-related variability and is time consuming. We examined whether the AUTO instead of...

Recent studies suggest that substituting sitting with light physical activity has beneficial metabolic effects, but it is unclear if this is associated with parallel changes in endothelial function. Data from three randomized cross-over studies were analyzed, in which 61 subjects (with normal weight, overweight and type 2 diabetes) followed differe...

Background Chronic kidney disease, which is defined as having a reduced kidney function (estimated glomerular filtration rate (eGFR)) and/or signs of kidney damage (albuminuria), is highly prevalent in Western society and is associated with adverse health outcomes, such as cardiovascular disease. This warrants a search for risk factors of lower eGF...

Associations of physical activity and sedentary behavior variables with albuminuria in subpopulation with 24h average ambulatory blood pressure data (n = 1,996). (DOCX)

Associations of physical activity and sedentary behaviour variables with eGFRcrcys in subpopulation with ≥4 valid days. (DOCX)

Associations of physical activity and sedentary behaviour variables with albuminuria in subpopulation with ≥4 valid days. (DOCX)

Associations of physical activity and sedentary behavior variables with albuminuria adjusted for body mass index instead of waist circumference (n = 2,257). (DOCX)