HealthyLIFE, a Combined Lifestyle Intervention for Overweight and Obese Adults: A Descriptive Case Series Study
Abstract
:1. Introduction
1.1. Combined Lifestyle Interventions
1.2. Positive Health
1.3. Our Approach
2. Materials and Methods
2.1. CooL: A Combined Lifestyle Intervention
2.2. HealthyLIFE
2.3. Design and Study Population
2.4. Data Collection
2.5. Demographic Characteristics
2.6. Weight and BMI
2.7. Physical Fitness
2.8. Motivation to Be Physically Active
2.9. Personal Needs and Satisfaction on Physical Activity
2.10. Barriers
2.11. Self-Efficacy
2.12. Social Influence
2.13. Dietary Behavior
2.14. Positive Health
2.15. Statistical Analyses
2.16. Ethics
3. Results
3.1. Participants
3.2. BMI and Physical Fitness
3.3. Lifestyle Questionnaire
3.3.1. Physical Activity-Related Factors
3.3.2. Dietary Behavior and Dietary Behavior-Related Factors
3.4. Positive Health
4. Discussion
4.1. Changes over Time of HealthyLIFE
4.2. Limitations and Strengths of the HealthyLIFE Study
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
Category | Demographic | Dataset Lifestyle/Physical Fitness | Subset Positive Health |
---|---|---|---|
Gender | Male | 39% | 39% |
Female | 61% | 61% | |
Age | Until 35 | 3% | 5% |
35 until 45 | 7% | 3% | |
45 until 55 | 24% | 16% | |
55 until 65 | 32% | 36% | |
65+ | 34% | 40% | |
Living situation | Single | 28% | 27% |
Living together | 72% | 73% | |
Land of birth | Dutch | 92% | 90% |
Non-Dutch | 8% | 10% | |
Work situation | Employed | 47% | 40% |
Unemployed | 53% | 60% | |
Education | Lower level | 32% | 31% |
Medium level | 43% | 42% | |
Higher level | 25% | 27% |
References
- Centrum Gezondheid en Maatschappij van het Rijksinstituut voor Volksgezondheid en Milieu. Ziekten en Aandoeningen die Samenhangen met Overgewicht en/of Obesitas. Available online: https://www.volksgezondheidenzorg.info/onderwerp/overgewicht/cijfers-context/gevolgen#!node-samenhang-met-ziekten (accessed on 6 June 2021).
- Boeing, H. Obesity and cancer—The update 2013. Best Pract. Res. Clin. Endocrinol. Metab. 2013, 27, 219–227. [Google Scholar] [CrossRef]
- Martin-Rodriguez, E.; Guillen-Grima, F.; Marti, A.; Brugos-Larumbe, A. Comorbidity Associated with Obesity in a Large Population: The APNA study. Obes. Res. Clin. Pract. 2015, 9, 435–447. [Google Scholar] [CrossRef]
- Centrum Gezondheid en Maatschappij van het Rijksinstituut voor Volksgezondheid en Milieu. Volwassenen met Overgewicht en Obesitas 2020. Available online: https://www.volksgezondheidenzorg.info/onderwerp/overgewicht/cijfers-context/huidige-situatie#node-overgewicht-volwassenen (accessed on 3 June 2021).
- Luppino, F.S.; de Wit, L.M.; Bouvy, P.F.; Stijnen, T.; Cuijpers, P.; Penninx, B.W.; Zitman, F.G. Overweight, obesity, and depression: A systematic review and meta-analysis of longitudinal studies. Arch. Gen. Psychiatry 2010, 67, 220–229. [Google Scholar] [CrossRef]
- Taylor, V.H.; Forhan, M.; Vigod, S.N.; McIntyre, R.S.; Morrison, K.M. The impact of obesity on quality of life. Best Pract. Res. Clin. Endocrinol. Metab. 2013, 27, 139–146. [Google Scholar] [CrossRef] [PubMed]
- Heuch, I.; Heuch, I.; Hagen, K.; Zwart, J.A. Body mass index as a risk factor for developing chronic low back pain: A follow-up in the Nord-Trøndelag Health Study. Spine 2013, 38, 133–139. [Google Scholar] [CrossRef]
- Talmor, A.; Dunphy, B. Female obesity and infertility. Best Pract. Res. Clin. Obstet. Gynaecol. 2015, 29, 498–506. [Google Scholar] [CrossRef] [PubMed]
- Campbell, J.M.; Lane, M.; Owens, J.; Bakos, H.W. Paternal obesity negatively affects male fertility and assisted reproduction outcomes: A systematic review and meta-analysis. Reprod. Biomed. Online 2015, 31, 593–604. [Google Scholar] [CrossRef] [Green Version]
- Jayawardena, R.; Jeyakumar, D.T.; Misra, A.; Hills, A.P.; Ranasinghe, P. Obesity: A potential risk factor for infection and mortality in the current COVID-19 epidemic. Diabetes Metab. Syndr. Clin. Res. Rev. 2020, 14, 2199–2203. [Google Scholar] [CrossRef] [PubMed]
- van Rinsum, C.; Gerards, S.; Rutten, G.; Philippens, N.; Janssen, E.; Winkens, B.; van de Goor, I.; Kremers, S. The Coaching on Lifestyle (CooL) Intervention for Overweight and Obesity: A Longitudinal Study into Participants’ Lifestyle Changes. Int. J. Environ. Res. Public Health 2018, 15, 680. [Google Scholar] [CrossRef] [Green Version]
- Duijzer, G.; Haveman-Nies, A.; Jansen, S.C.; Ter Beek, J.; Van Bruggen, R.; Willink, M.G.J.; Hiddink, G.J.; Feskens, E.J.M. Effect and maintenance of the SLIMMER diabetes prevention lifestyle intervention in Dutch primary healthcare: A randomised controlled trial. Nutr. Diabetes 2017, 7, e268. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Schutte, B.A.; Haveman-Nies, A.; Preller, L. One-Year Results of the BeweegKuur Lifestyle Intervention Implemented in Dutch Primary Healthcare Settings. Biomed. Res. Int. 2015, 2015, 484823. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Mölenberg, F.; Mesch, A.; Burdorf, A. Effect Studie Samen Sportief in Beweging, een Gecombineerde Leefstijl Interventie Gericht op Lagere Sociaal Economische Groepen; CEPHIR: Rotterdam, The Netherlands, 2018. [Google Scholar]
- Huber, M.; van Vliet, M.; Giezenberg, M.; Winkens, B.; Heerkens, Y.; Dagnelie, P.C.; Knottnerus, J.A. Towards a ‘patient-centred’ operationalisation of the new dynamic concept of health: A mixed methods study. BMJ Open 2016, 6, e010091. [Google Scholar] [CrossRef] [Green Version]
- van Rinsum, C.E.; Gerards, S.M.P.L.; Rutten, G.M.; van de Goor, I.A.M.; Kremers, S.P.J. The coaching on lifestyle (CooL) intervention for obesity, a study protocol for an action-oriented mixed-methods study. BMC Public Health 2018, 18, 117. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- De Jong, J.; Lemmink, K.A.; King, A.C.; Huisman, M.; Stevens, M. Twelve-month effects of the Groningen active living model (GALM) on physical activity, health and fitness outcomes in sedentary and underactive older adults aged 55–65. Patient Educ. Couns. 2007, 66, 167–176. [Google Scholar] [CrossRef] [Green Version]
- Markland, D.; Tobin, V. A modification to the behavioural regulation in exercise questionnaire to include an assessment of amoti-vation. J. Sport Exerc. Psychol. 2004, 26, 191–196. [Google Scholar] [CrossRef] [Green Version]
- Wilson, P.M.; Sabiston, C.M.; Mack, D.E.; Blanchard, C.M. On the nature and function of scoring protocols used in exercise motivation research: An empirical study of the behavioral regulation in exercise questionnaire. Psychol. Sport Exerc. 2012, 13, 614–622. [Google Scholar] [CrossRef]
- Deci, E.L.; Ryan, R.M. Handbook of Self-Determination Research; University of Rochester Press: Rochester, NY, USA, 2002. [Google Scholar]
- Wilson, P.M.; Rogers, W.T.; Rodgers, W.M.; Wild, T.C. The Psychological Need Satisfaction in Exercise Scale. J. Sport Exerc. Psychol. 2006, 28, 231–251. [Google Scholar] [CrossRef]
- Institute for Positive Health. Volwassentool Mijn Positieve Gezondheid. Available online: https://www.iph.nl/volwassentool-mijn-positieve-gezondheid (accessed on 15 June 2021).
- Van Vliet, M.; Doornenbal, B.M.; Boerema, S.; Marle, E.M.V.D.A.-V. Development and psychometric evaluation of a Positive Health measurement scale: A factor analysis study based on a Dutch population. BMJ Open 2021, 11, e040816. [Google Scholar] [CrossRef]
- Crutzen, R.; Peters, G.-J.Y. Scale quality: Alpha is an inadequate estimate and factor-analytic evidence is needed first of all. Health Psychol. Rev. 2015, 11, 242–247. [Google Scholar] [CrossRef]
- Cohen, J. Statistical Power Analysis for the Behavioral Sciences, 2nd ed.; Lawrence Erlbaum Associates: Hillsdale, NJ, USA, 1988. [Google Scholar]
- Publiekzaken, Kennis-en Exploitatiecentrum Officiële Overheids-en Publiekzaken. Wet Medisch-Wetenschappelijk Onderzoek met Mensen. Available online: https://wetten.overheid.nl/BWBR0009408/2021-07-01 (accessed on 1 July 2021).
- Warkentin, L.; Das, D.; Majumdar, S.R.; Johnson, J.; Padwal, R.S. The effect of weight loss on health-related quality of life: Systematic review and meta-analysis of randomized trials. Obes. Rev. 2013, 15, 169–182. [Google Scholar] [CrossRef]
- Payne, M.E.; Starr, K.N.P.; Orenduff, M.; Mulder, H.S.; McDonald, S.R.; Spira, A.P.; Pieper, C.F.; Bales, C.W. Quality of Life and Mental Health in Older Adults with Obesity and Frailty: Associations with a Weight Loss Intervention. J. Nutr. Health Aging 2018, 22, 1259–1265. [Google Scholar] [CrossRef]
- Clark, M.; Hampson, S.E.; Avery, L.; Simpson, R. Effects of a tailored lifestyle self-management intervention in patients with Type 2 diabetes. Br. J. Health Psychol. 2004, 9, 365–379. [Google Scholar] [CrossRef]
- Mischel, W.; Cantor, N.; Feldman, S. Principles of self-regulation: The nature of willpower and self-control. In Social Psychology: Handbook of Basic Principles; Higgins, E.T., Kruglanski, A.W., Eds.; Guilford Press: New York, NY, USA, 1996; pp. 329–360. [Google Scholar]
- Thoolen, B.J.; de Ridder, D.; Bensing, J.; Gorter, K.; Rutten, G. Beyond good intentions: The role of proactive coping in achieving sustained behavioural change in the context of diabetes management. Psychol. Health 2009, 24, 237–254. [Google Scholar] [CrossRef] [Green Version]
- Dingemanse, C. Hoe Positieve Gezondheid Wijkbewoners Ondersteunt bij Zelfmanagement van Gezondheid. Master’s Thesis, Utrecht University, Utrecht, The Netherlands, 2020. [Google Scholar]
- Portugal, E.M.M.; Cevada, T.; Monteiro-Junior, R.; Guimarães, T.T.; Rubini, E.; Lattari, E.; Blois, C.; Deslandes, A.C. Neuroscience of Exercise: From Neurobiology Mechanisms to Mental Health. Neuropsychobiology 2013, 68, 1–14. [Google Scholar] [CrossRef] [Green Version]
- Liegro, D.; Schiera, G.; Proia, P.; Di Liegro, C.M.; Di Liegro, I. Physical Activity and Brain Health. Genes 2019, 10, 720. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Södergren, M.; McNaughton, S.; Salmon, J.; Ball, K.; Crawford, D. Associations between fruit and vegetable intake, leisure-time physical activity, sitting time and self-rated health among older adults: Cross-sectional data from the WELL study. BMC Public Health 2012, 12, 551. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Shibamoto, T. Functional Food and Health; American Chemical Society: Washington, DC, USA, 2008. [Google Scholar]
- Karlsen, T.I.; Lund, R.S.; Røislien, J.; Tonstad, S.; Natvig, G.K.; Sandbu, R.; Hjelmesæth, J. Health related quality of life after gastric bypass or intensive lifestyle intervention: A controlled clinical study. Health Qual. Life Outcomes 2013, 11, 17. [Google Scholar] [CrossRef] [Green Version]
- Molema, H.; van Erk, M.; van Ommen, B.; Pijl, H.; Wopereis, S.; Kiefte-de Jong, J.; Chavannes, N.; Kremer, B.; van Bilsen, J.; van Winkelhof, M. Wetenschappelijke Notitie over de Relaties Tussen COVID-19, Metabole Ontregeling, Weerstand en Leefstijlinterventies; TNO: The Hague, The Netherlands; Leiden University Medical Center: Leiden, The Netherlands, 2020. [Google Scholar]
- Pellegrini, M.; Ponzo, V.; Rosato, R.; Scumaci, E.; Goitre, I.; Benso, A.; Belcastro, S.; Crespi, C.; De Michieli, F.; Ghigo, E.; et al. Changes in Weight and Nutritional Habits in Adults with Obesity during the “Lockdown” Period Caused by the COVID-19 Virus Emergency. Nutrients 2020, 12, 2016. [Google Scholar] [CrossRef] [PubMed]
- Biamonte, E.; Pegoraro, F.; Carrone, F.; Facchi, I.; Favacchio, G.; Lania, A.G.; Mazziotti, G.; Mirani, M. Weight change and glycemic control in type 2 diabetes patients during COVID-19 pandemic: The lockdown effect. Endocrine 2021, 72, 604–610. [Google Scholar] [CrossRef]
- Bailey, P.; Purcell, S.; Calvar, J.; Baverstock, A. Diet and Health under COVID-19; Ipsos: London, UK, 2021. [Google Scholar]
- Helmink, J.H.M.; van Boekel, L.; van der Sluis, M.; Kremers, S. Lange Termijn Evaluatie onder Deelnemers aan de BeweegKuur. Rapportage van de Resultaten van een Follow-Up Meting bij Deelnemers; Maastricht University: Maastricht, The Netherlands, 2011. [Google Scholar]
- Chiou, W.B.; Wan, C.S. The dynamic change of self-efficacy in information searching on the Internet: Influence of valence of expe-rience and prior self-efficacy. J. Psychol. 2007, 141, 589–603. [Google Scholar] [CrossRef]
- Boon, M.T.; Rossum, L.V.; Higgins, C. Fat: The Secret Organ: The Surprising Science behind the Most Misunderstood Part of the Body; Quercus: London, UK, 2021. [Google Scholar]
- Ridder, D.D.; Wit, J.D. Self-Regulation in Health Behavior; Wiley: Chichester, UK, 2006. [Google Scholar]
Category | Demographic | Percentage of Participants in Dataset |
Gender | Male | 39% |
Female | 61% | |
Age | Until 35 | 3% |
35 until 45 | 7% | |
45 until 55 | 24% | |
55 until 65 | 32% | |
65+ | 34% | |
Living situation | Single | 28% |
Living together | 72% | |
Land of birth | Dutch | 92% |
Non-Dutch | 8% | |
Work situation | Employed | 47% |
Unemployed | 53% | |
Education | Lower level | 32% |
Medium level | 43% | |
Higher level | 25% |
Category | Construct/Factor | T0 Pre-Test (sd) | Change T0–T1 [95% CI] | Effect Size T0–T1 | Change T0–T2 [95% CI] | Effect Size T0–T2 |
---|---|---|---|---|---|---|
Physical measurement | BMI | 34.45 (5.39) | −0.43 [−0.56, −0.30] * | 0.36 | −0.85 [−1.16, −0.53] * | 0.54 |
Weight | 99.30 (18.38) | −1.26 [−1.64, −0.88] * | 0.36 | −2.44 [−3.36, −1.51] * | 0.54 | |
GALM test (physical fitness) | Stamina | 0.78 (0.16) | 0.05 [0.04, 0.07] * | 0.36 | 0.11 [0.07, 0.15] * | 0.58 |
Mobility (TUG) | 6.92 (2.08) | −0.33 [−0.59, −0.06] * | 0.14 | −0.45 [−0.78, −0.12] * | 0.28 | |
Flexibility | 21.72 (8.77) | 0.90 [0.11, 1.69] * | 0.14 | 1.27 [0.23, 2.31] * | 0.28 | |
Handgrip strength | 33.19 (11.27) | 1.08 [0.50, 1.67] * | 0.20 | 1.36 [0.15, 2.56] * | 0.23 |
Category | Construct/ Factor | T0 Pre-Test (sd) | Change T0–T1 (95% CI) | Effect Size T0–T1 | Change T0–T2 (95% CI) | Effect Size T0–T2 |
---|---|---|---|---|---|---|
Motivation | BREQ Autonomous | 15.87 (4.74) | 1.76 [1.17, 2.35] * | 0.44 | 2.21 [1.22, 3.19] * | 0.50 |
BREQ Control | −5.00 (3.91) | 1.02 [0.43, 1.60] * | 0.25 | 0.87 [−0.17, 1.91] | 0.19 | |
BREQ Total | 10.84 (6.73) | 2.77 [1.88, 3.66] * | 0.45 | 3.14 [1.47, 4.80] * | 0.43 | |
Needs satisfaction | PNSE Autonomy | 4.19 (0.63) | 0.16 [0.05, 0.26] * | 0.22 | 0.22 [0.07, 0.36] * | 0.34 |
PNSE Relatedness | 3.81 (0.80) | 0.32 [0.18, 0.45] * | 0.37 | 0.17 [−0.01, 0.36] | 0.21 | |
PNSE Competence | 3.68 (0.78) | 0.21 [0.08, 0.33] * | 0.26 | 0.14 [0.00, 0.30] | 0.21 | |
Self-efficacy | Self-Efficacy to Exercise | 2.51 (1.04) | −0.16 [−0.34, 0.02] | 0.13 | −0.29 [−0.58, 0.00] | 0.23 |
Social | Social Support | 2.04 (0.83) | 0.22 [0.10, 0.35] * | 0.26 | 0.13 [−0.08, 0.33] | 0.14 |
Social Pressure | 1.19 (0.49) | 0.06 [−0.04, 0.16] | 0.09 | 0.07 [−0.12, 0.26] | 0.08 | |
Barriers | Barriers to Exercise | 2.30 (0.64) | −0.21 [−0.29, −0.12] * | 0.36 | −0.16 [−0.32, 0.00] | 0.22 |
Category | Construct/Factor | T0 Pre-Test (sd) | Change T0–T1 (95% CI) | Effect Size T0–T1 | Change T0–T2 (95% CI) | Effect Size T0–T2 |
---|---|---|---|---|---|---|
Dietary behavior | Salt or sweet snacking | 8.09 (6.55) | −0.89 [−1.99, 0.21] | 0.12 | −1.71 [−3.58, 0.17] | 0.21 |
Takeaway or fried food | 1.66 (2.87) | −0.24 [−0.69, 0.20] | 0.08 | −0.52 [−1.38, 0.33] | 0.14 | |
Fruit | 9.40 (7.10) | 1.77 [0.64, 2.91] * | 0.23 | 2.59 [1.18, 3.99] * | 0.42 | |
Vegetables and salad | 27.92 (16.47) | 5.70 [3.31, 8.08] * | 0.35 | 2.96 [−0.55, 6.47] | 0.19 | |
Self-efficacy | Self-efficacy for a healthy diet | 2.51 (1.20) | −0.21 [−0.41, −0.01] * | 0.15 | −0.11 [−0.41, 0.19] | 0.08 |
Barriers | Barriers to eat healthy | 1.94 (0.73) | −0.04 [−0.13, 0.05] | 0.07 | −0.02 [−0.17, 0.12] | 0.04 |
Category | Factor | T0 Pre-Test (sd) | Change T0–T2 (95% CI) | Effect Size |
---|---|---|---|---|
Positive Health | Physical fitness | 5.58 (1.78) | 1.10 [0.76–1.45] * | 0.68 |
Mental functioning | 6.28 (1.79) | 0.61 [0.30–0.93] * | 0.41 | |
Future perspective | 7.09 (1.32) | 0.48 [0.23–0.72] * | 0.41 | |
Contentment | 6.52 (1.55) | 0.83 [0.53–1.13] * | 0.58 | |
Social relations | 7.39 (1.57) | 0.61 [0.38–0.84] * | 0.56 | |
Daily life management | 7.31 (1.28) | 0.67 [0.42–0.93] * | 0.56 |
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Philippens, N.; Janssen, E.; Verjans-Janssen, S.; Kremers, S.; Crutzen, R. HealthyLIFE, a Combined Lifestyle Intervention for Overweight and Obese Adults: A Descriptive Case Series Study. Int. J. Environ. Res. Public Health 2021, 18, 11861. https://doi.org/10.3390/ijerph182211861
Philippens N, Janssen E, Verjans-Janssen S, Kremers S, Crutzen R. HealthyLIFE, a Combined Lifestyle Intervention for Overweight and Obese Adults: A Descriptive Case Series Study. International Journal of Environmental Research and Public Health. 2021; 18(22):11861. https://doi.org/10.3390/ijerph182211861
Chicago/Turabian StylePhilippens, Nicole, Ester Janssen, Sacha Verjans-Janssen, Stef Kremers, and Rik Crutzen. 2021. "HealthyLIFE, a Combined Lifestyle Intervention for Overweight and Obese Adults: A Descriptive Case Series Study" International Journal of Environmental Research and Public Health 18, no. 22: 11861. https://doi.org/10.3390/ijerph182211861