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Background With urbanization and aging increasing in coming decades, societies face the challenge of keeping aging populations active. Land use mix (LUM) has been associated with cycling and walking, but whether changes in LUM relate to changes in cycling/walking is less known. Objectives Our objective was to study the effect of LUM on cycling/walking in two Dutch aging cohorts using data with 10 years of follow-up. Methods Data from 1183 respondents from the Health and Living Conditions of the Population of Eindhoven and Surroundings (GLOBE) study and 918 respondents from the Longitudinal Aging Study Amsterdam (LASA) were linked to LUM in 1000-m sausage network buffers at three time-points. Cycling/walking outcomes were harmonized to include average minutes spent cycling/walking per week. Data was pooled and limited to respondents that did not relocate between follow-up waves. Associations between LUM and cycling/walking were estimated using a Random Effects Within-Between (REWB) model that allows for the estimation of both within and between effects. Sensitivity analyses were performed on smaller (500-m) and larger (1600-m) buffers. Results We found evidence of between-individual associations of LUM in 1000-m buffers and walking (β: 11.10, 95% CI: 0.08; 21.12), but no evidence of within-associations in 1000-m buffers. Sensitivity analyses using 500-m buffers showed similar between-associations, but negative within-associations (β: -35.67, 95% CI: − 68.85; − 2.49). We did not find evidence of between-individual associations of LUM in any buffer size and cycling, but did find evidence of negative within-associations between LUM in 1600-m buffers and cycling (β: -7.49, 95% CI: − 14.31; − 0.66). Discussion Our study found evidence of positive associations between LUM and average walking time, but also some evidence of negative associations between a change in LUM and cycling/walking. LUM appears to be related to cycling/walking, but the effect of changes in LUM on cycling/walking is unclear.

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Background European Union (EU) Member states' food environments are shaped by both national and EU policies. To date however, studies assessing food environment policies developed and set by the EU are scarce. The aim of this study was to assess the strength of EU policies to improve food environments as well as to assess the extent these policies could lead to a decrease or widening of socio-economic inequalities in dietary intake. Methods We compiled evidence on the EU policies for each of the Food-EPI 47 indicators. A European panel of independent, non-government experts (N = 30) specialized in nutrition, obesity or chronic diseases, using the Food-EPI evidence, rated the strength of EU policies to improve food environments during an online survey in February-March 2020. The experts also rated to which extent policies could lead to a decrease or widening of socio-economic inequalities in dietary intake. In addition, experts formulated actions to improve EU food environment policies, which were prioritized during a follow-up online survey. Results The overview of EU-level policies resulted in a 79-pages document, describing policies (or the lack thereof) for each of the 47 Food-EPI indicators. This document has been verified for completeness and accuracy by EU governmental officials. The evidence document shows that the EU has mainly binding legislation on the food labelling whereas policies on the other Food-EPI domains are mostly voluntary. Results from the online survey and the formulated prioritized actions will be presented during the conference. The results will reflect the experts' ratings supported by documented evidence and will provide meaningful guidance to EU officials and public health advocates in their efforts to improve the food environment policies set by the EU.

Background Against the background of urbanization and aging and the aim to design age-friendly cities, it is crucially important to understand whether and why older adults’ health may benefit from being surrounded by older peers mainly, or by residents from all ages. We assessed the association between neighborhood age structure and mental health and the mediating role of social neighborhood perceptions. Methods Survey data were obtained from 1255 older adults aged 65 years and over, participating in the Dutch GLOBE study. The neighborhood age structure, measured in 2011, was defined as the Herfindahl-Hirschman index to assess homogeneity in the age composition (range from 0-100, a higher score indicating more homogeneity) and percentages of different age groups in a neighborhood. Mental health was measured in 2014 by the Mental Health Inventory-5 score, ranging from 0 to 100, where a higher score indicates better mental health. Perceptions of neighborhood social cohesion, feeling at home in a neighborhood, and social participation was assessed in 2011. Linear regression models were used to assess the association of neighborhood age composition with mental health. Causal mediation analysis was used to assess the potential mediating role of social neighborhood perceptions. Results A more homogeneous neighborhood age structure was associated with better mental health status. Feeling at home in a neighborhood partly mediated the association, whereas social cohesion and social participation did not mediate the association. While a higher percentage of children in the neighborhood was associated with better mental health, a higher percentage of elderly in the neighborhood was associated with lower mental health status. Conclusions The neighborhood age composition is a promising, but currently insufficiently understood, entry point for policies addressing the challenge of growing urban and aging European cities. Key messages The neighborhood age composition is a promising, but currently insufficiently understood, entry point for policies addressing the challenge of growing urban and aging European cities. Feeling at home in a neighborhood partly mediated the association between neighborhood age structure and mental health; social cohesion and social participation did not mediate the association.

BACKGROUND physical activity (PA) is an important factor to promote healthy ageing. However, older adults are not physically active enough. Socio-ecological models suggest that weather conditions are determinants of PA and may bias relations between other environmental factors and PA. This may especially be the case for the most vulnerable and inactive older persons. Understanding the role of weather conditions is based on daily or seasonal variation in weather, but it can be improved by using hour-to-hour measured weather conditions. PURPOSE to study the hour-to-hour relationships between weather factors and objectively measured walking and cycling in a sample of Dutch older adults. METHODS baseline data (2013) of a sub-sample of older adults (3,248 observations clustered in 43 adults) participating in The Neighborhood Walking in Rotterdam Older ADultS (NEW.ROADS) trial were used. Participants wore a GPS logger for 7 consecutive days. Hour-to-hour weather data (temperature, wind speed, rain and sun time) for the city of Rotterdam were retrieved from the Royal Netherlands Meteorological Institute. Multilevel linear regression models were fitted with minutes walked and minutes cycled as dependent variables and the weather variables as independent variables. RESULTS the time older adults walked increased with higher temperature, higher wind speed and the absence of rain. The time cycled increased with higher temperature. CONCLUSIONS this study improves the evidence of weather factors as a determinant for walking and cycling in older adults. Studies on the relation between environmental factors and PA should consider adjustment for weather factors.

BACKGROUND: Comorbidity and socioeconomic status (SES) may be related among cancer patients. METHOD: Population-based cancer registry study among 72 153 patients diagnosed during 1997-2006. RESULTS: Low SES patients had 50% higher risk of serious comorbidity than those with high SES. Prevalence was increased for each cancer site. Low SES cancer patients had significantly higher risk of also having cardiovascular disease, chronic obstructive pulmonary diseases, diabetes mellitus, cerebrovascular disease, tuberculosis, dementia, and gastrointestinal disease. One-year survival was significantly worse in lowest vs highest SES, partly explained by comorbidity. CONCLUSION: This illustrates the enormous heterogeneity of cancer patients and stresses the need for optimal treatment of cancer patients with a variety of concomitant chronic conditions. British Journal of Cancer (2010) 103, 1742-1748. doi:10.1038/sj.bjc.6605949 www.bjcancer.com Published online 26 October 2010 (C) 2010 Cancer Research UK

This study examined whether physical, social, cultural and economical environmental factors are associated with obesogenic dietary behaviours and overweight/obesity among adults. Literature searches of databases (i.e. PubMed, CSA Illumina, Web of Science, PsychInfo) identified studies examining environmental factors and the consumption of energy, fat, fibre, fruit, vegetables, sugar-sweetened drinks, meal patterns and weight status. Twenty-eight studies were in-scope, the majority (n= 16) were conducted in the USA. Weight status was consistently associated with the food environment; greater accessibility to supermarkets or less access to takeaway outlets were associated with a lower BMI or prevalence of overweight/obesity. However, obesogenic dietary behaviours did not mirror these associations; mixed associations were found between the environment and obesogenic dietary behaviours. Living in a socioeconomically-deprived area was the only environmental factor consistently associated with a number of obesogenic dietary behaviours. Associations between the environment and weight status are more consistent than that seen between the environment and dietary behaviours. The environment may play an important role in the development of overweight/obesity, however the dietary mechanisms that contribute to this remain unclear and the physical activity environment may also play an important role in weight gain, overweight and obesity.

The objective of this study was to analyse interventions for the prevention of overweight and obesity in children under 5 years of age. We carried out a systematic review focusing exclusively on randomized controlled trials (RCTs). Data sources include Medline, Cochrane Library, EMBASE, CINHAL, PsychInfo and Web of Science. Data were extracted from seventeen articles describing seven RCTs identified through electronic search, screening of references in systematic reviews, own files and contact with authors. RCTs were assessed with the Jadad scale. Four trials were carried out in preschool settings, one with an exclusive educational component, two with an exclusive physical activity component and one with both. Two trials were family-based, with education and counselling for parents and children. The remaining trial was carried out in maternity hospitals, with a training intervention on breastfeeding. None of the interventions had an effect in preventing overweight and obesity. The failure to show an effect may be due to the choice of outcomes, the quality of the RCTs, the suboptimal implementation of the interventions, the lack of focus on social and environmental determinants. More rigorous research is needed on interventions and on social and environmental factors that could impact on lifestyle.

Background: Fruit and vegetables are protective of a number of chronic diseases; however, their intakes have been shown to vary by socioeconomic position (SEP). Household and food shopping environmental factors are thought to contribute to these differences. To determine whether household and food shopping environmental factors are associated with fruit and vegetable (FV) intakes, and contribute to socioeconomic inequalities in FV consumption.Methods: Cross-sectional data were obtained by a postal questionnaire among 4333 adults (23-85 years) living in 168 neighbourhoods in the south-eastern Netherlands. Participants agreed/disagreed with a number of statements about the characteristics of their household and food shopping environments, including access, prices and quality. Education was used to characterise socioeconomic position (SEP). Main outcome measures were whether or not participants consumed fruit or vegetables on a daily basis. Multilevel logistic regression models examined between-area variance in FV consumption and associations between characteristics of the household and food shopping environments and FV consumption.Results: Only a few household and food shopping environmental factors were significantly associated with fruit and vegetable consumption, and their prevalence was low. Participants who perceived FV to be expensive were more likely to consume them. There were significant socioeconomic inequalities in fruit and vegetable consumption (ORs of not consuming fruit and vegetables were 4.26 and 5.47 among the lowest-educated groups for fruit and vegetables, respectively); however, these were not explained by any household or food shopping environmental factors.Conclusions: Improving access to FV in the household and food shopping environments will only make a small contribution to improving population consumption levels, and may only have a limited effect in reducing socioeconomic inequalities in their consumption.

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 conducted a systematic semi-quantitative review of 150 studies on environmental correlates of youth PA published in the past 25 years. The ANalysis Grid for Environments Linked to Obesity (ANGELO) framework was used to classify the environmental correlates studied. Most studies retrieved used cross-sectional designs and subjective measures of environmental factors and PA. Variables of the home and school environments were especially associated with children's PA. Most consistent positive correlates of PA were father's PA, time spent outdoors and school PA-related policies (in children), and support from significant others, mother's education level, family income, and non-vocational school attendance (in adolescents). Low crime incidence (in adolescents) was characteristic of the neighbourhood environment associated with higher PA. Convincing evidence of an important role for many other environmental factors was, however, not found. Further research should aim at longitudinal and intervention studies, and use more objective measures of PA and its potential (environmental) determinants.

To describe the longitudinal development of smoking behaviour from adolescence (age 13 years) into young adulthood (age 27 years) and to analyse the longitudinal relationship between smoking behaviour and biological risk factors for cardiovascular disease.Longitudinal.Amsterdam school children.This study was carried out as part of the Amsterdam Growth and Health Study, an observational longitudinal study. Six measurements were carried out over a period of 15 years in 84 males and 98 females, and included a questionnaire regarding smoking behaviour and blood analysis for cholesterol parameters. Tracking analysis and generalized estimating equations analysis were used.Both the percentage of smokers and the amount of tobacco smoked by smokers increased until the age of 21 years. After that smoking behaviour remained more or less stable in males and decreased slightly in females (period effect). Between 16 and 21 years half the number of persons tried to stop smoking but failed to succeed. The development of smoking behaviour appeared to be related to low systolic blood pressure and to development of a negative risk profile regarding hypercholesterolaemia (i.e. low high-density lipoprotein (HDL) cholesterol and high ratio of total cholesterol and HDL cholesterol). There was no relationship between smoking and the amount of subcutaneous fat.