E.C. Swan

Profiling healthy eaters. Determining factors that predict healthy eating practices among Dutch adults

Research has identified multiple factors that predict unhealthy eating practices. However what remains poorly understood are factors that promote healthy eating practices. This study aimed to determine a set of factors that represent a profile of healthy eaters. This research applied Antonovskys salutogenic framework for health development to examine a set of factors that predict healthy eating in a cross-sectional study of Dutch adults. Data were analyzed from participants (n = 703) who completed the studys survey in January 2013. Logistic regression analysis was performed to test the association of survey factors on the outcome variable high dietary score. In the multivariate logistic regression model, five factors contributed significantly (p < .05) to the predictive ability of the overall model: being female; living with a partner; a strong sense of coherence (construct from the salutogenic framework), flexible restraint of eating, and self-efficacy for healthy eating. Findings complement what is already known of the factors that relate to poor eating practices. This can provide nutrition promotion with a more comprehensive picture of the factors that both support and hinder healthy eating practices. Future research should explore these factors to better understand their origins and mechanisms in relation to healthy eating practices.

How science thinks and practice acts: bridging the gap in weight management interventions for adolescents

BACKGROUND Adolescent obesity calls for evidence-based treatment approaches given its long-term physical and psychosocial consequences. However, research shows there are many problems in the translation of scientific evidence into practice. OBJECTIVE The aim of this study was to develop science- and practice-based recommendations for the planning of future adolescent weight management interventions. METHODS We performed (i) literature reviews on intervention studies targeting treatment of obesity in adolescents and Dutch clinical guidelines for obesity as well as practice-based documents and grey literature on treating obesity and delivering health programs for adolescents and (ii) semi-structured interviews with eight clinicians and four non-clinicians working in obesity treatment, management and prevention to explore perspectives on treating adolescent obesity and using evidence in practice. RESULTS After merging the results from the literature reviews and interviews, four issues emerged: (i) little reporting on theoretical models used in intervention studies, Dutch clinical guidelines and semi-structured interviews; (ii) inconsistency on age-specific considerations for treating obesity in adolescents in intervention studies and Dutch clinical guidelines; (iii) inconsistency on addressing the social nature of obesity in intervention studies and Dutch clinical guidelines and (iv) how professional responsibility should be divided is unclear from intervention studies, Dutch clinical guidelines and semi-structured interviews. CONCLUSIONS Joined action of science and practice is required for future interventions. Future interventions should include topics relevant to the stage of adolescence and give greater focus to the complex social nature of obesity. Lastly, practitioners can generate more practice-based evidence by starting their own practice-based research.

Passie voor gezondheid

Het bevorderen van gezondheid is vaak gericht op het voorkómen en bestrijden van ziekte, waarbij het zoeken naar determinanten van ziekte en gezondheidsrisico’s voorop staat, zowel op individueel als maatschappelijke niveau. Met deze benadering is op zichzelf niets mis. Er zijn zo onmiskenbaar grote successen geboekt. Toch knaagt er iets omdat deze benadering van gezondheid vooral focust op ziekte, beperkingen en ongezonde keuzes, terwijl gezondheid op zich een positief concept is.

Individual, social-environmental, and physical-environmental factors that underlie sense of coherence in Dutch adults

Antonovsky’s salutogenesis is a theoretical perspective on health development that explores physical, mental, and social factors that contribute to a ‘healthy life orientation’ and also a theoretical approach to behavior change. Previous studies applying salutogenesis show that a high sense of coherence (SOC), a composite measure from salutogenesis indicating one’s capacity to cope with stress, is associated with a healthy life orientation and lifestyle behaviors, including healthy eating patterns. However, limited evidence exists on the factors that underlie SOC, which could be used to strengthen this capacity as a means to enable healthier eating. Dutch adults (N = 781) participated in a cross-sectional study examining the relationship between SOC and a set of individual, social-environmental, and physical-environmental factors. The main findings indicate that high SOC was associated with a diverse set of factors including lower doctor-oriented health locus of control; higher satisfaction with weight; higher perceived levels of neighborhood collective efficacy; higher situational self-efficacy for healthy eating; lower social discouragement for healthy eating; and higher neighborhood affordability, accessibility and availability of healthy foods. These findings can inform the design of nutrition interventions that target these factors that strengthen SOC and provide the building blocks for a healthier life orientation.

Applying the salutogenic framework to nutrition research and practice.

Much research has identified a sea of factors related to unhealthy diets to make sense of why people struggle to eat healthy diets. However, little is known of factors that empower healthy eating. Antonovskys salutogenesis provides an innovative framework to study these factors and identify resources and mechanisms underlying healthy eating practices. We give recommendations for future research and provide examples of how salutogenesis has inspired our own research to gain new insights into the origins of healthy eating. Lastly, implications of using future findings in designing novel nutrition promotion strategies are outlined.