Wanda Wendel-Vos

National Institute for Public Health and the Environment (RIVM) | RIVM · Centre for Prevention and Health Services Research (PZO)

Background : To better understand physical activity behavior and its health benefits in people living with health conditions, we studied people with and without 20 different self-reported health conditions with regard to (1) their physical activity levels, (2) factors correlated with these physical activity levels, and (3) the association between p...

Background: Lifestyle factors often co-occur in clusters. This study examines whether clusters of lifestyle risk factors, such as smoking, alcohol use, physical inactivity, poor diet, sexual risk behaviour, cannabis and other drug use, change over time in a representative sample of Dutch adults. Additionally, the association between mental health...

Background This systematic review aims to describe the relation between physical inactivity and healthcare costs, by taking into account healthcare costs of physical-inactivity-related diseases (common practice), including physical-activity-related injuries (new) and costs in life-years gained due to avoiding diseases (new), whenever available. Mor...

Background The Short Questionnaire to Assess Health Enhancing Physical Activity (SQUASH) is a widely used questionnaire, and used for monitoring prevalence rates of physical activity(PA) in the Netherlands. To provide a standardized protocol for data processing and analysis of the SQUASH, an analysis guide was published in 2004. However, since then...

Background Sedentary time (sitting) has been associated with adverse cardio-metabolic consequences. The general recommendation is to interrupt long periods of sitting. In order to successfully develop interventions and policies to decrease sedentary behaviour, high-risk groups as well as the context of sitting should be identified. The aim of this...

Background Public policy is increasingly recognized as an important component of physical activity (PA) promotion, as policy actions to address lifestyle behaviours have the potential to in?uence the health and well-being of an entire population. However, our knowledge about the current status, implementation and effectiveness of PA policies in ind...

Issue/problem The favorable international position of the Netherlands in terms of sport an physical activity is no reason for those involved in policy to lean back. The motor skills of our children are decreasing, some population groups never engage in sports, respectful behavior in sports needs our attention and the traditional sports clubs are un...

Background This study aims to describe individual leisure-time physical activity patterns among Dutch adults over a 20-year period, and to compare baseline characteristics of participants with different patterns. Methods The study population consisted of 2,518 adults (53% women) aged 26–65 years at baseline, measured every 5 years over a 20-year p...

Objectives The aim of the study is to compare how member states of the European Union (EU) develop their national physical activity (PA) recommendations and to provide an overview of the methodologies they apply in doing so. Information was collected directly from the physical activity focal points of EU member states in 2018. Five countries were c...

Background Public policy is increasingly recognized as an important component of physical activity promotion. This paper reports on the current status of physical activity policy development and implementation in four European countries based on the Health-Enhancing Physical Activity Policy Audit Tool (HEPA PAT) developed by WHO. It compares the fi...

Recently, new physical activity (PA) guidelines were adopted in the Netherlands consisting of two components: (1) addressing duration of moderate and vigorous PA, (2) bone and muscle strengthening activities. The aim of this study is to retrospectively assess the long-term trend in fulfilling the criteria of the new PA guidelines and to gain insigh...

Background: This study aims to describe barriers and facilitators of the implementation of a combined lifestyle intervention (CLI) in primary care for patients with chronic disease. The aim of CLI to help patients to create a healthy lifestyle and to maintain this healthy lifestyle. During a CLI a patient receives advice and counselling to improve...

Background: Despite the large number of studies on beneficial effects of the natural outdoor environment (NOE) on health, the underlying mechanisms are not fully understood. Objective: This study explored the relations between amount, quality, use and experience of the NOE; and physical activity, social contacts and mental well-being. Methods:...

Background: The preferences of diabetes type 2 patients and cardiovascular disease patients for a financial incentive added to a specified combined lifestyle intervention were investigated. Methods: A discrete choice experiment questionnaire was filled out by 290 diabetes type 2 patients (response rate 29.9%). Panel-mixed-logit models were used...

Objectives Dog owners walking their dog in natural outdoor environments (NOE) may benefit from the physical activity facilitated by dog walking and from time spent in nature. However, it is unclear whether dog owners receive additional health benefits associated with having access to NOE above the physical activity benefit of walking with their dog...

Background: Physical activity has been shown to reduce side-effects of breast cancer and its treatment. As physical activity levels of patients with breast cancer are largely unknown, we investigated these levels and compared them to women from the general population. Methods: In this prospective cohort study, physical activity levels of women with...

This study investigated whether residential availability of natural outdoor environments (NOE) was associated with contact with NOE, overall physical activity and physical activity in NOE, in four different European cities using objective measures. A nested cross-sectional study was conducted in Barcelona (Spain); Stoke-on-Trent (United Kingdom); D...

Objectives Lack of physical activity (PA) has been hypothesised as an underlying mechanism in the adverse health effects of shift work. Therefore, our aim was to compare non-occupational PA levels between shift workers and non-shift workers. Furthermore, exposure–response relationships for frequency of night shifts and years of shift work regarding...

Background: According to current physical activity guidelines, a substantial percentage of the population in high-income countries is inactive, and inactivity is an important risk factor for chronic conditions and mortality. Financial incentives may encourage people to become more active. The objective of this review was to provide insight in the...

Background: Evidence is emerging that more green space in the living environment is associated with better health, partly via the pathway of physical activity. Objectives: We explored the cross-sectional and longitudinal associations between green space and physical activity and several health indicators in the Doetinchem Cohort Study. Methods:...

Stimulating active transport by encouraging replacement of short-distance car trips by active transport modes such as cycling or walking has become a popular policy strategy. It has been suggested that neighbourhoods, designed to facilitate healthy behaviour, can influence a person׳s behavioural choices such as transport choice. In the present stud...

The aim of this harmonized meta-analysis was to examine the independent and combined effects of physical activity and BMI on the incidence of type 2 diabetes. Our systematic literature review in 2011 identified 127 potentially relevant prospective studies of which 9 fulfilled the inclusion criteria (total N = 117,878, 56.2 % female, mean age = 50.0...

The aim of this review is to give an overview of the available evidence on the effects of financial incentives to stimulate physical activity. Therefore, a systematic literature search was performed for randomized trials that investigate the effects of physical-activity-related financial incentives for individuals. Twelve studies with unconditional...

Background: This study examines the association between active transport and perceived general health, perceived psychological wellbeing and a healthy body weight in the Netherlands. Methods: Data were collected by an online questionnaire (N = 3663) in the Netherlands. Data collection was conducted over a period of one calendar year starting Jul...

Physical activity and sedentary behaviour are independently associated with health outcomes, where physical activity (PA) is associated with health benefits and sedentary behaviour is associated with health risks. One possible strategy to counteract sedentary behaviour is to stimulate active transport use. As monitoring studies in the Netherlands h...

To gather insight on how Health in All Policies (HiAP) is applied in practice, we carried out a case study on transport policies intended to stimulate a shift from car use to bicycling. We reviewed 3 years (2010, 2011, and 2012) of national budgets and policy documents in the Netherlands, followed by two focus group sessions and a second round of d...

One way to increase physical activity is to stimulate a shift from car use to walking or cycling. In single-purpose trips, purpose was found to be an important predictor of transport choice. However, as far as known, no studies have been conducted to see how trips with combined purposes affect this decision. This study was designed to provide insig...

Background: Physical inactivity is a significant predictor of several chronic diseases, becoming more prevalent as people age. Since the aging population increases demands on healthcare budgets, effectively stimulating physical activity (PA) against acceptable costs is of major relevance. This study provides insight into long-term health outcomes...

Objective: To quantify the independent associations between objectively measured physical activity (PA), cardiorespiratory fitness (CRF), and anthropometry in European men and women. Methods: 2,056 volunteers from 12 centers across Europe were fitted with a heart rate and movement sensor at 2 visits 4 months apart for a total of 8 days. CRF (ml/...

Growing evidence suggests that close contact with nature brings benefits to human health and well-being, but the proposed mechanisms are still not well understood and the associations with health remain uncertain. The Positive Health Effects of the Natural Outdoor environment in Typical Populations in different regions in Europe (PHENOTYPE) project...

This explorative study examines personal and neighbourhood characteristics associated with short-distance trips made by car, bicycle or walking in order to identify target groups for future interventions. Data were derived from 'Mobility Research Netherlands (2004-2009; MON)', a dataset including information regarding trips made by household member...

Background Counseling in combination with pedometer use has proven to be effective in increasing physical activity and improving health outcomes. We investigated the cost-effectiveness of this intervention targeted at one million insufficiently active adults who visit their general practitioner in the Netherlands. Methods We used the RIVM chronic...

Objectives: We examined health-related quality of life in adults who became physically active at recommended levels over a 10-year period compared with adults with different physical activity patterns. Methods. We examined men and women aged 26 to 70 years (mean [SD] = 47.4 [10.1]) in the Doetinchem Cohort Study 3 times between 1995 and 2009. We d...

Background: Previous cross-sectional studies revealed that obesity is associated with lower health-related quality of life (HRQOL). This study aimed to investigate the longitudinal association between 5-year weight change and HRQOL. Methods: Data from 2414 Dutch men and women was collected. HRQOL was measured with the RAND-36. Weight change was...

To accurately examine associations of physical activity (PA) with disease outcomes, a valid method of assessing free-living activity is required. We examined the validity of a brief PA questionnaire (PAQ) used in the European Prospective Investigation into Cancer and Nutrition (EPIC). PA energy expenditure (PAEE) and time spent in moderate and vigo...

Objective. To explore the associations between sitting time in various domains and mental health for workers and nonworkers and the role of weight status. Design. Cross-sectional analyses were performed for 1064 respondents (47% men, mean age 59 years) from the Doetinchem Cohort Study 2008-2009. Sedentary behavior was measured by self-reported time...

To accurately examine associations of physical activity (PA) with disease outcomes, a valid method of assessing free-living activity is required. We examined the validity of a brief PA questionnaire (PAQ) used in the European Prospective Investigation into Cancer and Nutrition (EPIC). PA energy expenditure (PAEE) and time spent in moderate and vigo...

To examine whether the "Short QUestionnaire to ASsess Health-enhancing physical activity" (SQUASH) and the "Injuries and Physical Activity in the Netherlands" questionnaire ("Ongevallen en Bewegen in Nederland," OBiN) were valid in assessing adherence to physical activity (PA) guidelines. Participants (N=187) aged 20-69 years were categorized as "i...

Physical activity is inversely related to cardiovascular diseases. However, the type of activities that contribute most to these beneficial effects remain unclear. For this reason, we investigated self-reported leisure time physical activities in relation to fatal/nonfatal cardiovascular disease incidence. The Dutch Monitoring Project on Risk Facto...

During the past decade, quality of life (QoL) has become an accepted measure of disease impact, therapeutic outcome, and evaluation of interventions. So far, very little is known about the effects of community-based interventions on people's QoL. Therefore, the effect of an integrative cardiovascular diseases community-based intervention programme...

Leisure time physical activity in compliance with recommended levels is associated with improved health and lower mortality, but little is known on whether these physical activity habits are stable among adults and what characteristics predict physical activity changes. Our objective was to determine change in the levels of leisure time physical ac...

Outdoor play is a cheap and natural way for children to be physically active. This study aims to identify physical as well as social correlates of outdoor play in the home and neighborhood environment among children of different age groups. Cross-sectional data were derived from 6470 parents of children from 42 primary schools in four Dutch cities...

It is hypothesized that the intensity of physical activity habits, rather than the time spent on those activities, might mediate cognitive function. This study tested a possible association between changes in the time spent on or the average intensity of weekly physical activities and changes in cognitive function in healthy men and women. This lon...

Background: Physical activity is inversely related to cardiovascular diseases. However, the type of activities that contribute most to these beneficial effects remain unclear. For this reason, we investigated self-reported leisure time physical activities in relation to fatal/nonfatal cardiovascular disease incidence. Design: The Dutch Monitoring P...

This study describes the association between weight status and psychological health, suicidal thoughts and suicide attempts in adolescents from a population-based study of 21,730 adolescents who responded to a classroom-based internet questionnaire. It demonstrated clear associations between weight status in adolescents and poor psychological healt...

Community-based health promotion is a widely advocated strategy in public health to favorably alter lifestyle. The aim of this study was to investigate the net effect of a cardiovascular disease-prevention program (Hartslag Limburg) on lifestyle factors after 5 years of intervention (1998-2003). In a cohort study, 5-year mean changes in lifestyle f...

This review aimed to gain insight in the extent to which psychosocial effects of obesity prevention programmes have been studied, to give an overview of the methods used to measure the particular psychosocial aspects and - if possible - to quantify the effects found. Intervention studies (n = 267) covering the period 1990-October 2005 were derived...

*Objectives:* This study investigates the longitudinal association between 5-year weight change and quality of life (QoL) in Dutch men and women. *Design:* A prospective cohort study (1998, 2000, 2003) in a population based sample. Subjects: 2,414 men and women from the Maastricht region of the Netherlands. *Measurements:* QoL outcomes were measu...

Despite recognized benefits of regular physical activity on musculoskeletal fitness as well as general health, little is known about the physical activity behavior of patients after Total Hip Arthroplasty (THA). So far, no physical activity questionnaire has been validated in this category of patients. As the Short Questionnaire to Assess Health-en...

The aim of the present paper was to give insight into the practical consequences of using either single-level or multilevel regression analyses on data from research on environmental determinants of physical activity. For this purpose, results from single-level and multilevel regression analyses on comparable attributes of the environment were comp...

To gain insight in realistic policy targets for overweight at a population level and the accompanying costs. Therefore, the effect on overweight prevalence was estimated of large scale implementation of a community intervention (applied to 90% of general population) and an intensive lifestyle program (applied to 10% of overweight adults), and costs...

rss. Journal of Epidemiology and Community Health 2008;62:689-694; doi:10.1136/ . 2007.062869 Am J Prev Med 2002; 23: 36–43.[Medline]; R, Schmid T

Physical activity is thought to facilitate cognitive performance and to slow down the rate of age-related cognitive decline. This study aimed to investigate the association between the time spent on physical activity as well as the average intensity of these activities and cognitive function. Cross-sectional analysis. Our study population comprised...

Studies on effectiveness of phytosterol/-stanol-enriched margarines in the community have received low priority. For postlaunch monitoring purposes including risk-benefit analyses, it is needed to investigate both exposure and effectiveness of these margarines. To study the use and effectiveness of phytosterol/-stanol-enriched margarine. The study...

To investigate associations between neighbourhood-level psychosocial stressors (i.e. experience of crime, nuisance from neighbours, drug misuse, youngsters frequently hanging around, rubbish on the streets, feeling unsafe and dissatisfaction with the quality of green space) and self-rated health in Amsterdam, the Netherlands. A random sample of 291...

The objective of this systematic review of observational studies was to gain insight into potential determinants of various types and intensities of physical activity among adult men and women. Studies were retrieved from Medline, PsycInfo, Embase and Social scisearch. The ANGELO framework was used to classify environmental factors. In total, 47 pu...

In dit rapport wordt op basis van een expert meeting en aanvullende interviews/gesprekken met betrokken organisaties adviezen gegeven om te komen tot afstemming van vragenlijsten die tot doel hebben op landelijk (en eventueel regionaal) niveau informatie te verzamelen ten behoeve van het beleid voor de terreinen: • Sport • Bewegen Volwassenen • Bew...

There is increasing interest in the role the environment plays in shaping the dietary behavior of youth, particularly in the context of obesity prevention. An overview of environmental factors associated with obesity-related dietary behaviors among youth is needed to inform the development of interventions. A systematic review of observational stud...

Obesogenic environments are thought to underlie the increased obesity prevalence observed in youth during the past decades. Understanding the environmental factors that are associated with physical activity (PA) in youth is needed to better inform the development of effective intervention strategies attempting to halt the obesity epidemic. We condu...

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...

Evidence strongly suggests that the neighbourhood in which people live influences their health. Despite this, investigations of ethnic differences in cardiovascular risk factors have focused mainly on individual-level characteristics. The main purpose of this study was to investigate associations between neighbourhood-level environmental stressors...

The current ecological approach in health behaviour research recognises that health behaviour needs to be understood in a broad environmental context. This has led to an exponential increase in the number of studies on this topic. It is the aim of this systematic review to summarise the existing empirical evidence pertaining to environmental influe...

The current ecological approach in health behaviour research recognises that health behaviour needs to be understood in a broad environmental context. This has led to an exponential increase in the number of studies on this topic. It is the aim of this systematic review to summarise the existing empirical evidence pertaining to environmental influe...

A widely advocated strategy in public health is community-based health promotion. The aim of this study was to investigate the net effect of a cardiovascular disease prevention program (Hartslag Limburg) on cardiovascular risk factors after 5 years of intervention. Cohort study comparing 5-year mean change in risk factors between the intervention a...

Introduction Physical activity (PA) is a health enhancing behaviour: regular PA is associated with reduced risk for cardiovascular disease, obesity, diabetes, osteoporosis, some forms of cancer, and depression (1, 2). Also among the young current and future health benefits can be obtained through engaging in physically active lifestyles: it helps b...

Introduction The promotion of healthful eating in children and adolescents has become an increasingly important public health priority as the number of children and adolescents who are overweight or obese continues to escalate (1, 2). To effectively promote healthful eating, a detailed understanding of the factors influencing dietary behaviour is e...

Sporters voelen zich gezonder en leven gezonder dan niet-sporters. Dat uit zich in een grotere ervaren vitaliteit (bijna 10% vitaler dan niet-sporters), een gezonder gewicht (het aantal sporters dat last heeft van overgewicht licht 15% lager dan bij de niet sporters), minder gezondheidsklachten en minder chronische aandoeningen, waaronder diabetes....

Based on studies published so far, the protective effect of physical activity on stroke remains controversial. Specifically, there is a lack of insight into the sources of heterogeneity between studies. Meta-analysis of observational studies was used to quantify the relationship between physical activity and stroke and to explore sources of heterog...

Studies that relate change in physical activity to change in health-related quality of life in the general population are needed to confirm associations suggested by cross-sectional studies. In the present study, cross-sectional as well as longitudinal associations between leisure time physical activity and health-related quality of life were studi...

The purpose of this study was to identify factors of the physical environment that may influence time spent on walking and bicycling. Demographic factors and time spent on walking and bicycling (during leisure time and for commuting purposes) were assessed with a self-administered questionnaire. GIS databases were used to objectively measure the to...

In this thesis different public health aspects of physical activity in the Netherlands were addressed, taking into account its broad scope. Research was carried out on physical activity methodology, determinants of physical activity and the relationship between physical activity and different health outcomes. As to physical activity methodology, we...

The purpose of this study is to determine reproducibility and relative validity of the Short QUestionnaire to ASsess Health-enhancing physical activity (SQUASH). Participants (36 men and 14 women, aged 27-58) were asked to complete the SQUASH twice with an inbetween period of approximately 5 weeks. In addition, participants wore the Computer Scienc...

The relation between sports, physical activity and health is an important issue in the Dutch Public Health Policy, for example in the prevention of overweight and obesity. In this study this relation was examined on cross-sectional data of 5265 Dutch inhabitants of 12 years and older. These data were collected in the second Dutch National Study of...

Despite great expectations of the influence of the physical environment on nutrition and physical activity, relatively few studies have addressed this association, with the Netherlands clearly showing a backlog in comparison to the United States and Australia. More (Dutch) research is needed to be able to make well-grounded statements on: 1) the re...

An integrated policy, with broad implementation of interventions, will at least partially counteract the expected negative future trends in overweight and physical activity. Accompanying costs are high but outweighed by the health benefits. The costs per life year gained are approximately 6000 euros, accounting for the costs in life years gained, a...

Like in most other western countries, the physical and social environment in the Netherlands has developed in such a way that it has become easy to choose for an inactive lifestyle and excessive consumption of energy dense foods. Both lifestyle factors play an important role in the development of overweight in the Dutch population. Interventions th...

In this report, the contribution of lifestyle to weight gain in young adults is addressed. Aspects of lifestyle factors associated with weight gain differ between men and women. For example, among men consumption of savoury snacks seemed to be associated with weight gain, whereas among women consumption of sweet snacks seemed to be associated with...

According to a recent policy document (2003) the Dutch government promotes a healthy lifestyle. This includes efforts to increase physical activity levels in the Dutch population. In this context, the RIVM was asked to assess the health effects after introducing a quantitative policy target for physical activity. This target was to increase the num...

A health policy that aims at increasing physical activity and decreasing the intake of energy contributes to the prevention of overweight. In general, the long-term effects of interventions targeted at body weight, physical activity and/or energy intake are unknown. This report describes a literature study done by the RIVM under commission of the D...

Health gains can be achieved by actively combating and decreasing physical inactivity. One of the factors probably influencing physical activity is the living environment. The Policy Document on Housing ('Nota Wonen' in Dutch) presents policy measures influencing the human living environment. The policy measures evaluated in this health effect repo...