Intra-national variation in trends in overweight and leisure time physical activities in The Netherlands since 1980

Centre for Prevention and Health Services Research, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
International Journal of Obesity (Impact Factor: 5). 04/2007; 31(3):515-20. DOI: 10.1038/sj.ijo.0803429
Source: PubMed


To investigate time trends in overweight and Leisure Time Physical Activities (LTPA) in The Netherlands since 1980. Intra-national differences were examined stratified for sex, age and urbanisation degree.
We used a random sample of about 140,000 respondents aged 20-69 years from the Health Interview Survey (Nethhis) and subsequent Permanent Survey on Living Conditions (POLS). Self-reported data on weight and height and demographic characteristics were gathered through interviews (every year) and data on LTPA were collected by self-administered questionnaires (1990-1997, 2001-2004). Linear regression analysis was performed for trend analyses.
During 1981-2004, mean body mass index (BMI) increased significantly by 1.0 kg/m(2) (average per year=0.05 kg/m(2)). Trends were similar across sex and different degrees of urbanisation, but varied across age groups. In 20-to 39-year-old women, mean BMI increased by 1.7 kg/m(2), which was more than in older age groups (P<or=0.05). With respect to LTPA, no clear trend was observed during 1990-1997 and 2001-2004. The (absence of) trends were similar across sex and urbanisation degrees, but varied across age groups. During 2001-2004, 20-to 39-year-old women spent approximately 150 min/week less on LTPA compared to older women, while this difference was smaller during 1990-1997.
Mean BMI increased more in younger women, which is consistent with the observation that this group spent less time on LTPA during recent years. Although the overall increase in overweight could not be explained by trends in LTPA, the younger women should be considered as a target group for future physical activity interventions. The influence of the 'obesogenic environment' seems to be similar across different degrees of urbanisation.

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    • "Twenty-one studies calculated split results for men and women and four studies analyzed data for separate subgroups. Only one study [43] provided longitudinal data. Regarding PA measurement methods, six studies used objective data, compared to 59 studies using subjective data. "
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    ABSTRACT: Background In the past decade, various reviews described the relationship between the physical environment and different physical activity (PA) domains. Yet, the majority of the current review evidence relies on North American/Australian studies, while only a small proportion of findings refer to European studies. Given some clear environmental differences across continents, this raises questions about the applicability of those results in European settings. This systematic review aimed at summarizing Europe-specific evidence on the relationship between the physical environment and different PA domains in adults. Methods Seventy eligible papers were identified through systematic searches across six electronic databases. Included papers were observational studies assessing the relationship between several aspects of the physical environment and PA in European adults (18-65y). Summary scores were calculated to express the strength of the relationship between each environmental factor and different PA domains. Results Convincing evidence on positive relationships with several PA domains was found for following environmental factors: walkability, access to shops/services/work and the composite factor environmental quality. Convincing evidence considering urbanization degree showed contradictory results, dependent on the observed PA domain. Transportation PA was more frequently related to the physical environment than recreational PA. Possible evidence for a positive relationship with transportation PA emerged for walking/cycling facilities, while a negative relationship was found for hilliness. Some environmental factors, such as access to recreational facilities, aesthetics, traffic- and crime-related safety were unrelated to different PA domains in Europe. Conclusions Generally, findings from this review of European studies are in accordance with results from North American/Australian reviews and may contribute to a generalization of the relationship between the physical environment and PA. Nevertheless, the lack of associations found regarding access to recreational facilities, aesthetics and different forms of safety are likely to be Europe-specific findings and need to be considered when appropriate interventions are developed. More research assessing domain-specific relationships with several understudied environmental attributes (e.g., residential density) is needed.
    Full-text · Article · Sep 2012 · BMC Public Health
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    • "Alternatively, the current analysis may provide some support for the hypothesis that the observed flattening of the CHD mortality rate in those under age 55 in countries such as the US and UK reflects increased prevalence of obesity and diabetes [3, 10, 11]. The Netherlands has a markedly lower prevalence of adult obesity than countries such as the UK and US, has experienced lower absolute increases in obesity over the past decade [12–14] and consequently has a lower prevalence of diabetes in adults [15]. It will be important to continue to monitor trends in the Netherlands to see whether the mortality rate decline in younger adults continues. "
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    ABSTRACT: Recent analyses suggest the decline in coronary heart disease mortality rates is slowing in younger age groups in countries such as the US and the UK. This work aimed to analyse recent trends in cardiovascular mortality rates in the Netherlands. Analysis was of annual all circulatory, ischaemic heart disease (IHD), and cerebrovascular disease mortality rates between 1980 and 2009 for the Netherlands. Data were stratified by sex and 10-year age group (age 35-85+). The annual rate of change and significant changes in the trend were identified using join point Poisson regression. For almost all age and sex groups examined the rate of IHD and cerebrovascular disease mortality in the Netherlands has more than halved between 1980 and 2009. The decline in mortality from both IHD and cerebrovascular disease is continuing for all ages and sex groups, with an acceleration in the decline apparent from the late 1990s/early 2000s. The decline in age-specific all circulatory, coronary heart disease and cerebrovascular disease mortality rates continues for all age and sex groups in the Netherlands.
    Full-text · Article · Feb 2011 · European Journal of Epidemiology
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    • "Same conclusions were drawn by another European study by Pfitzenmaier et al. [22]. In contrast with the USA, where 30% of the population is obese, only 9% to 14% of the European population was obese [23, 24]. Thereby, obese patients are less obese than the obese men in the USA and a relatively large proportion of the USA population consists of Afro-Americans who are more prone to be obese and more frequently have aggressive tumours compared with white men. "
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    ABSTRACT: Several reports found that obesity was associated with prostate cancer (PC) aggressiveness among men treated with radical prostatectomy or radiotherapy. Studies concerning this issue have basically relied on body mass index (BMI), as a marker for general obesity. Because visceral fat is the most metabolic active fat, we sought to evaluate if periprostatic fat measured on a computed tomography (CT) is a better marker than BMI to predict PC aggressiveness in a Dutch population who underwent brachytherapy for localized PC. Of the 902 patients who underwent brachytherapy, 725 CT scans were available. Subcutaneous fat thickness (CFT), periprostatic fat area (cm(2)) and fat-density (%) were determined on the CT scan. Patients were stratified into three groups: <25, 25-75 and >75 percentile of the fat-density. Associations between the three fat-density subgroups and BMI and PC aggressiveness were examined. 237 patients were classified as having normal weight (37.2%), 320 as overweight (50.2%) and 80 as obese (12.6%). There was a strong significant association between BMI and fat-density and CFT. The strongest correlation was seen between BMI and CFT (Pearson r coefficient = 0.71). Logistic regression analysis revealed no statistically significant association between the different fat measurements and the risk of having a high-risk disease. Periprostatic fat and fat-density as measured with CT were not correlated with PC aggressiveness in patients receiving brachytherapy. However, 31% of the patients with a normal BMI had a fat-density of >75 percentile of the periprostatic fat-density.
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