COACH Childhood obesity; consequences, prevention and treatment
Division 1: Obesity, Diabetes & Cardiovascular Health Department of Pediatrics
Background
The childhood obesity epidemic is a critical public health challenge facing the 21st century, incurring a significant loss of quality of life, significant health risks that are likely to project into adulthood (chronic diseases, psychological disorders and premature death) and increased costs to society and healthcare systems worldwide. In the Netherlands, half a million children are overweight or obese.
Our studies have shown that more than 50% of children with overweight/obesity in our region have one or more weight related comorbidity. This underlines the urgency for effective multi-faceted interventions to achieve initial and long-term health benefits.
Dealing with the modifiable lifestyle factors of building a vital community and a healthier environment for children poses a major challenge to healthcare and other authorities.
Who is involved?
PI: Prof. dr. Anita Vreugdenhil and the Department of Pediatrics research team
Major breakthroughs
Expertise Centre for overweight adolescent and children’s healthcare.
Where research, clinic and society meet
The Centre for Overweight Adolescent and Children’s Healthcare (COACH) is a centre for evaluation, integral treatment and monitoring of children with overweight and obesity. This centre has evolved into the academic expertise centre that it is today, with a comprehensive multi-sectoral network of participating partners, multiple research lines with (inter) national collaborations and transfer of knowledge to all levels of society as an important assignment. The interdisciplinary, translational research team initiates basic studies, clinical studies, behavioral impact studies and social and economic impact studies of the interventions in real life practice. Research in COACH continuously seeks better detection of health risks, better coaching and monitoring strategies and better ways to create multilevel multi-stakeholder collaboration with a common aim; a healthy life for every child. The focus of research is lifestyle, overweight and obesity in the perspective of the developing child. Over the past years, a cohort of children with overweight, obesity and morbid obesity was built. The COACH research team searches for 1) new methods and markers to early recognize children with a specific high risk for metabolic derangement and liver pathology (NAFLD), 2) innovative interventions for the treatment of children with overweight and obesity, 3) characteristics of children and families prone for development of overweight and obesity.
Scientific impact/Research quality
With our research data, we generate knowledge and insights on new methods and markers to early recognize children with a specific high risk for metabolic derangement, diabetes mellitus, cardiovascular disturbances and liver pathology. In addition, insight is gained on the interrelationship of anthropometric measurements, comorbidities, metabolic derangements, cardiovascular measurements and liver parameters. Innovative interventions for the treatment of children with overweight and obesity have already been an important yield of our research work. More and more is known about the recognizing characteristics of children and families prone for development of overweight and obesity.
Users and collaborations
From the perspective of “Think globally, act locally” we collaborate with scientists and healthcare professionals within the MUMC+ and around the globe. The urgency to gain more knowledge about development, prevention and treatment of lifestyle related diseases in children is felt all over Europe, which has amongst others resulted in the European Paediatric Non-Alcoholic Fatty Liver Disease (EU-PNAFLD) network, in which physicians and researchers from all over Europe have united. With our research projects in Europe and India, we learn about possibilities to adjust lifestyle in different cultures and in Western and developing countries. Besides, we take action in our own communities, surrounding cities and the South of the Netherlands. This has grown into long-term and close contacts and cooperation with all kind of actors involved in the development of children at the micro-, meso- and macrolevel. In particular, we work together with parents, schools, companies, Youth and Healthcare Divisions, hospitals, municipalities and the Province of Limburg.
Societal impact
COACH developed an evidence-based approach for improving healthy living in overweight and obese children. The COACH approach is unique in that it connects the target individuals with other levels of society, stimulates mutual learning and initiates development of innovative nudging activities for the participating families. This approach has proven to be successful in health improvement; a healthier weight and less comorbidities. Our research work and results contribute to changes in policy, financial structures, collaboration between parties, awareness of lifestyle and obesity related consequences for children and next generations.
Future perspectives
We now expand the COACH approach and network to Your Coach Next Door by including more families, more societal partners, new regions and new methods for engaging all stakeholders in a sustainable financial model. Professionals in primary care provide the program close to home. The YCND program will be further developed, implemented, feasibility tested and the effectiveness and cost-effectiveness of YCND evaluated. This approach can be considered as a ‘natural experiment’ and a continual improvement process as the research will follow the natural course of the intervention development. Medical and online assessments and online data in YCND will gather an enormous amount of data resulting in a unique possibility to evaluate effects of interventions and, due to its large scale, enable prediction models for personalized successful interventions. From the beginning a nation-wide rollout of the concept was anticipated. Children’s voice is the starting point for all interventions.
The outdoor clinic is a playful and interactive world that nudges children and their parents in the direction of a healthy diet and reglar exercise. A motivating and stimulating environment that seems miles away from the world of doctors and hospitals.
