The association between body mass index status and sick leave and the role of emotional exhaustion-a mediation analysis among a representative sample of dutch employees

OBJECTIVE: To investigate the associations between body mass index (BMI) and sick leave, and the mediating role of emotional exhaustion. METHODS: Data were collected from a large survey among Dutch employees (n = 35,022). The causal pathway approach consisting of four regression analyses was applied. RESULTS: In women, moderate overweight and obesity were associated with higher sick leave; in men, obesity, but not moderate overweight, was associated with higher sick leave. Obese workers were at increased risk for emotional exhaustion. Emotional exhaustion was also associated with higher sick leave rates. Adjustment for emotional exhaustion in the association between BMI and sick leave hardly changed the effect size and significance remained. CONCLUSIONS: The association between BMI status and sick leave can be explained partially by the presence of emotional exhaustion. Workplace health promotion initiatives should take this into account. Copyright © 2013 by American College of Occupational and Environmental Medicine

Associations between changes in anthropometric measures and mortality in old age: a role for mid-upper arm circumference?

Objectives: In elderly individuals, little is known about changes in different anthropometric measures with respect to mortality. We examined the association between changes in eight anthropometric measures and mortality in an elderly population. Design: Longitudinal study including baseline measurements in 1988-1990 and repeated measures in 1993. Setting: European towns. Participants: A total of 1061 older adults born in 1913-1918 from the Survey in Europe on Nutrition and the Elderly, A Concerted Action study were included in this study. Measurements: Weight, body mass index, waist circumference, waist to hip ratio, waist to height ratio, mid-upper arm circumference (MUAC), triceps skinfold thickness, and corrected arm muscle area were taken during both measurements. Results: A Cox regression model was used to examine the association between anthropometric changes (divided into quintiles, smallest change - reference category) and all-cause and cardiovascular disease mortality over approximately 6 years of follow-up, adjusted for baseline measurement of application, age, sex, smoking, education, physical activity, and major chronic diseases. A decrease in weight (>= 3.2 kg), waist circumference (>= 3.1 cm), and MUAC (>= 1.6 cm and 0.6-1.6 cm) were (near) significantly associated with an all-cause mortality risk of 1.48 (95% CI: 0.99-2.20), 1.52 (95% CI: 1.01-2.31), 1.81 (95% CI: 1.17-2.79), and 1.66 (95% CI: 1.10-2.49), respectively. Also for MUAC, an increase (>= 1.3 cm) was significantly associated with an increased all-cause and cardiovascular disease mortality risk [hazard ratio, 1.52 (95% CI: 1.00-2.31) and 1.94 (95% CI: 1.00-3.75), respectively]. Conclusion: Associations were observed for decreases in only 3 of 8 anthropometric measures and all-cause mortality. Decreases in MUAC had the strongest association with mortality and was the only measure in which an increase also was associated with mortality. This suggests a role for MUAC in the prediction of mortality in elderly individuals. Published by Elsevier Inc. on behalf of the American Medical Directors Association, Inc

Teacher, mentor or role model? The role of the artist in the community arts work with marginalised young people

This study investigates the delivered care in a multidisciplinary lifestyle intervention by dieticians and physiotherapists compared to the protocol of this intervention. Participants with a body mass index (BMI) between 25 and 40 kgm22 were divided over three different programs depending on their BMI and comorbidities. All these programs consisted of individual and group sessions with the dietician, while care by the physiotherapist differed by program. The dieticians and physiotherapists of 30 locations were contacted to provide data about health care use within the intervention from their health records. Data of 379 participants were available and showed that group sessions by dieticians were often not attended. Care by the physiotherapist was delivered according to the protocol to a larger extent. An average of 43–93% of the sessions was attended. The level of attendance is comparable to other interventions, but especially attendance at group sessions with dieticians should be improved. (aut. ref.

Differences in weight loss across different BMI classes: A meta-analysis of the effects of interventions with diet and exercise

Contains fulltext : 134596.pdf (publisher's version ) (Closed access)Background: Lifestyle interventions are effective for weight loss and are recommended for persons with a body mass index (BMI) of 25-40 kg m-2. However, this group is very heterogeneous, which could influence outcomes from lifestyle interventions. Purpose: In this systematic review, differences in 1-year weight change and percentage weight change after lifestyle interventions were investigated for participants varying in initial BMI using meta-analyses. Method: Twenty-two interventions with healthy Caucasian adults, a mean BMI between 25 and 40 kg m-2, a dietary as well as a physical activity component aiming at weight loss, and at least five contact sessions guided by a professional health care provider were selected from a systematic search in the MEDLINE database. Participants in each intervention were divided into one of the three BMI classes: overweight (BMI of 25-29.99 kg m-2), class-I obesity (BMI of 30-34.99 kg m-2), and class-II obesity (BMI of 35-39.99 kg m-2). Differences in weight change and percentage weight change were analyzed and compared among different BMI classes within the same intervention by calculating standardized mean differences. Results: Overweight participants lost 1.1 kg less (p < 0.01) than participants with class-I obesity and 1.5 kg less (p < 0.01) than participants with class-II obesity. For percentage weight change, no significant differences were found among the BMI classes. Conclusion: Average weight change during lifestyle interventions only differs to a small extent among people with BMI between 25 and 40 kg m-2. This implies that these interventions are equally appropriate for these BMI classes.10 p

Impact of group nutrition education and surplus value of Prochaska-based stage-matched information on health-related cognitions and on Mediterranean nutrition behavior

This study compares the effect of two interventions focussed on the promotion of Mediterranean nutrition behavior, The target groups are persons with three risk factors for development of cardiovascular disease, The study region is a socio-economically deprived area in the Netherlands, The first intervention consisted of three meetings in which the positive health effects of a Mediterranean diet were discussed in group sessions, In the additional intervention stage-matched information based on the Transtheoretical Model of behavior change was given. Both intervention groups were compared with a control group, which received only a printed leaflet with the Dutch nutritional guidelines. At baseline the three subgroups were comparable and after 16 weeks both intervention strategies resulted in significant changes in comparison with the control condition, For fish consumption, both strategics resulted in more positive attitudes, social norms, stronger intentions, more progress in stage of change and better nutritional intake, For fruit/vegetables consumption, the effects of both strategies were limited to stage of change and nutritional intake, Additional individually stage-matched tailored letters did not result in more progress on any of the dependent variables, We conclude that substantial nutritional behavior change can be achieved by interactive group education in socioeconomically deprived population groups