Browsing by Author "Schlicht, Wolfgang"

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Open Access
Altern, Fitness, Wohlbefinden und körperliche Aktivität
(2007) Schlicht, Wolfgang
Während die meisten Menschen in den Industrienationen lange leben möchten, fürchten sie dennoch zugleich den biologisch bedingten und den mit dem Altern beschleunigten Abbau und Verlust an körperlicher wie geistiger Funktionstüchtigkeit. Die gerontologische und insbesondere die geronto-psychologische Forschung haben in den vergangenen Jahren überzeugende Belege gesammelt, dass das Altern – als ein epigenetisch moduliertes Phänomen – aber auch gelingen kann. Das subjektive Wohlbefinden ist ein Kriterium, das über das Gelingen oder das Misslingen entscheidet.Körperliche und geistige Aktivität sind Verhaltensweisen, die zum Gelingen beitragen.Welches Maß an körperlicher Aktivität ist ausreichend, wie lässt sich Aktivität reliabel,also zuverlässig erfassen, wie aktiv sind ältere Menschen? Das sind einige der Fragen,die der Beitrag beantwortet.
Open Access
Appraisal of triglyceride-related markers as early predictors of metabolic outcomes in the PREVIEW lifestyle intervention : a controlled post-hoc trial
(2021) Navas-Carretero, Santiago; San-Cristobal, Rodrigo; Siig Vestentoft, Pia; Brand-Miller, Jennie C.; Jalo, Elli; Westerterp-Plantenga, Margriet; Simpson, Elizabeth J.; Handjieva-Darlenska, Teodora; Stratton, Gareth; Huttunen-Lenz, Maija; Lam, Tony; Muirhead, Roslyn; Poppitt, Sally; Pietiläinen, Kirsi H.; Adam, Tanja; Taylor, Moira A.; Handjiev, Svetoslav; McNarry, Melitta A.; Hansen, Sylvia; Brodie, Shannon; Silvestre, Marta P.; Macdonald, Ian A.; Boyadjieva, Nadka; Mackintosh, Kelly A.; Schlicht, Wolfgang; Liu, Amy; Larsen, Thomas M.; Fogelholm, Mikael; Raben, Anne; Martinez, J. Alfredo
Individuals with pre-diabetes are commonly overweight and benefit from dietary and physical activity strategies aimed at decreasing body weight and hyperglycemia. Early insulin resistance can be estimated via the triglyceride glucose index {TyG = Ln [TG (mg/dl) × fasting plasma glucose (FPG) (mg/dl)/2]} and the hypertriglyceridemic-high waist phenotype (TyG-waist), based on TyG x waist circumference (WC) measurements. Both indices may be useful for implementing personalized metabolic management. In this secondary analysis of a randomized controlled trial (RCT), we aimed to determine whether the differences in baseline TyG values and TyG-waist phenotype predicted individual responses to type-2 diabetes (T2D) prevention programs. The present post-hoc analyses were conducted within the Prevention of Diabetes through Lifestyle intervention and population studies in Europe and around the world (PREVIEW) study completers (n = 899), a multi-center RCT conducted in eight countries (NCT01777893). The study aimed to reduce the incidence of T2D in a population with pre-diabetes during a 3-year randomized intervention with two sequential phases. The first phase was a 2-month weight loss intervention to achieve ≥8% weight loss. The second phase was a 34-month weight loss maintenance intervention with two diets providing different amounts of protein and different glycemic indices, and two physical activity programs with different exercise intensities in a 2 x 2 factorial design. On investigation days, we assessed anthropometrics, glucose/lipid metabolism markers, and diet and exercise questionnaires under standardized procedures. Diabetes-related markers improved during all four lifestyle interventions. Higher baseline TyG index (p < 0.001) was associated with greater reductions in body weight, fasting glucose, and triglyceride (TG), while a high TyG-waist phenotype predicted better TG responses, particularly in those randomized to physical activity (PA) of moderate intensity. Two novel indices of insulin resistance (TyG and TyG-waist) may allow for a more personalized approach to avoiding progression to T2D.
Open Access
Die „gesunde Kommune“ im Lichte „großer Wenden“ : ein sozialökologisch fundiertes Ziel kommunaler Gesundheitsförderung (KoGeFö)
(2021) Schlicht, Wolfgang; Bucksch, Jens; Kohlmann, Carl-Walter; Renner, Britta; Steinacker, Jürgen; Walling, Fabian
In Kommunen wird die Gesundheit der Bewohner*innen durch Lebensumstände geschützt, gefördert oder gefährdet. Kommunale Gesundheitsförderung (KoGeFö) findet in und mit der Kommune statt. In der Kommune konzentrieren sich Programme und Maßnahmen auf Endpunkte der Morbidität und Mortalität. Die Krankheitslast soll reduziert, sowie die individuelle Lebensqualität gestärkt werden. Mit der Kommune will Gesundheitsförderung die „gesunde Kommune“ entwickeln. Wann ist eine Kommune „gesund“? Welche Absichten werden in der Gesundheitsförderung mit der Kommune jenseits von Programmen verfolgt, die auf die Reduktion der Inzidenz und Prävalenz nicht-ansteckender Erkrankungen zielen, indem sie die Bewohner*innen motivieren und unterstützen, sich gesundheitsfördernd zu verhalten? Vor dem Hintergrund „großer gesellschaftlicher Herausforderungen“ und mit Rückgriff auf sozialökologische Ansätze wird erörtert, was eine „gesunde Kommune“ ausmacht, worauf die Gesundheitsförderung mit der Kommune zielt. Die „gesunde Kommune“ entwickelt sich in der intersektoralen Zusammenarbeit von Akteur*innen der Politik, von Verwaltungseinheiten, der Zivilgesellschaft und der Bewohner*innen. Die „gesunde Kommune“ ist als faire Umgebung gestaltet. Sie öffnet den Einzelnen Möglichkeitsräume für dessen Handeln und gewährt Verwirklichungschancen für persönlich wichtige Ziele. Die bevorzugte sozialökologische Perspektive schärft den Blick für die dynamische Interaktion von Umwelt- und Personenfaktoren. Mit Fairness, Möglichkeitsräumen und Verwirklichungschancen sind drei Kriterien benannt, die sich als Gradmesser für den Endpunkt „gesunde Kommune“ einer Gesundheitsförderung mit der Kommune eignen.
Open Access
A high-protein, low glycemic index diet suppresses hunger but not weight regain after weight loss : results from a large, 3-years randomized trial (PREVIEW)
(2021) Zhu, Ruixin; Fogelholm, Mikael; Larsen, Thomas M.; Poppitt, Sally D.; Silvestre, Marta P.; Vestentoft, Pia S.; Jalo, Elli; Navas-Carretero, Santiago; Huttunen-Lenz, Maija; Taylor, Moira A.; Stratton, Gareth; Swindell, Nils; Kaartinen, Niina E.; Lam, Tony; Handjieva-Darlenska, Teodora; Handjiev, Svetoslav; Schlicht, Wolfgang; Martinez, J. Alfredo; Seimon, Radhika V.; Sainsbury, Amanda; Macdonald, Ian A.; Westerterp-Plantenga, Margriet S.; Brand-Miller, Jennie; Raben, Anne
Previous studies have shown an increase in hunger during weight-loss maintenance (WLM) after diet-induced weight loss. Whether a combination of a higher protein, lower glycemic index (GI) diet and physical activity (PA) can counteract this change remains unclear. To compare the long-term effects of two diets [high protein (HP)-low GI vs. moderate protein (MP)-moderate GI] and two PA programs [high intensity (HI) vs. moderate intensity (MI)] on subjective appetite sensations during WLM after ≥8% weight loss (WL). Data derived from the 3-years PREVIEW randomized intervention study. An 8-weeks WL phase using a low-energy diet was followed by a 148-weeks randomized WLM phase. For the WLM phase, participants were assigned to one of the four groups: HP-MI, HP-HI, MP-MI, and MP-HI. Available data from 2,223 participants with overweight or obesity (68% women; BMI ≥ 25 kg/m2). Appetite sensations including satiety, hunger, desire to eat, and desire to eat something sweet during the two phases (at 0, 8 weeks and 26, 52, 104, and 156 weeks) were assessed based on the recall of feelings during the previous week using visual analogue scales. Differences in changes in appetite sensations from baseline between the groups were determined using linear mixed models with repeated measures. There was no significant diet × PA interaction. From 52 weeks onwards, decreases in hunger were significantly greater in HP-low GI than MP-moderate GI (Ptime × diet = 0.018, Pdietgroup = 0.021). Although there was no difference in weight regain between the diet groups (Ptime × diet = 0.630), hunger and satiety ratings correlated with changes in body weight at most timepoints. There were no significant differences in appetite sensations between the two PA groups. Decreases in hunger ratings were greater at 52 and 104 weeks in HP-HI vs. MP-HI, and greater at 104 and 156 weeks in HP-HI vs. MP-MI. This is the first long-term, large-scale randomized intervention to report that a HP-low GI diet was superior in preventing an increase in hunger, but not weight regain, during 3-years WLM compared with a MP-moderate GI diet. Similarly, HP-HI outperformed MP-HI in suppressing hunger. The role of exercise intensity requires further investigation. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT01777893.
Open Access
How to investigate within-subject associations between physical activity and momentary affective states in everyday life : a position statement based on a literature overview
(2013) Kanning, Martina; Ebner-Priemer, Ulrich W.; Schlicht, Wolfgang
Several meta-analyses have investigated the association between physical activity and affective states and have found evidence suggesting that exercise exerts a positive effect on affective state. However, in this field of research, most studies have conducted between-subject analyses. Nonetheless, there is more and more interest in the within-subject associations between physical activity and momentary affective states in everyday life. This position statement pertains to this up-and-coming field of research and provides methodological recommendations for further studies. The paper is divided into three parts: First, we summarise and evaluate three methodological requirements necessary for the proper evaluation of within-subject associations between physical activity and momentary affective states in everyday life. We propose that the following issues should be considered: a) to address the dynamic nature of such relationships, repeated assessments are necessary; b) as activities performed in everyday life are mostly spontaneous and unconscious, an objective assessment of physical activity is useful; c) given that recall of affective states is often affected by systematic distortions, real-time assessment is preferable. In sum, we suggest the use of ambulatory assessment techniques, and more specifically the combination of acceloremeter-assessment of physical activity with an electronic diary assessment of the momentary affective state and additional context information. Second, we summarise 22 empirical studies published between 1980 and 2012 using ambulatory assessment to investigate within-subject associations between momentary affective states and physical activity in everyday life. Generally, the literature overview detects a positive association, which appears stronger among those studies that were of high methodological quality. Third, we propose the use of ambulatory assessment intervention strategies to change people's behaviour (ambulatory assessment intervention) and to enable people to be active as often as possible during the day (e.g., reducing sitting time, taking more steps per day).
Open Access
Older people’s perceptions of friendliness and traffic safety : an experiment using computer-simulated walking environments
(2015) Kahlert, Daniela; Schlicht, Wolfgang
Open Access
PREVIEW behavior modification intervention toolbox (PREMIT): a study protocol for a psychological element of a multicenter project
(2016) Kahlert, Daniela; Unyi-Reicherz, Annelie; Stratton, Gareth; Meinert Larsen, Thomas; Fogelholm, Mikael; Raben, Anne; Schlicht, Wolfgang
Background: Losing excess body weight and preventing weight regain by changing lifestyle is a challenging but promising task to prevent the incidence of type-2 diabetes. To be successful, it is necessary to use evidence-based and theory-driven interventions, which also contribute to the science of behavior modification by providing a deeper understanding of successful intervention components. Objective: To develop a physical activity and dietary behavior modification intervention toolbox (PREMIT) that fulfills current requirements of being theory-driven and evidence-based, comprehensively described and feasible to evaluate. PREMIT is part of an intervention trial, which aims to prevent the onset of type-2 diabetes in pre-diabetics in eight clinical centers across the world by guiding them in changing their physical activity and dietary behavior through a group counseling approach. Methods: The program development took five progressive steps, in line with the Public Health Action Cycle: (1) Summing-up the intervention goal(s), target group and the setting, (2) uncovering the generative psychological mechanisms, (3) identifying behavior change techniques and tools, (4) preparing for evaluation and (5) implementing the intervention and assuring quality. Results: PREMIT is based on a trans-theoretical approach referring to valid behavior modification theories, models and approaches. A major “product” of PREMIT is a matrix, constructed for use by onsite-instructors. The matrix includes objectives, tasks and activities ordered by periods. PREMIT is constructed to help instructors guide participants' behavior change. To ensure high fidelity and adherence of program-implementation across the eight intervention centers standardized operational procedures were defined and “train-the-trainer” workshops were held. In summary PREMIT is a theory-driven, evidence-based program carefully developed to change physical activity and dietary behaviors in pre-diabetic people.
Open Access
Socio-economic factors, mood, primary care utilization, and quality of life as predictors of intervention cessation and chronic stress in a type 2 diabetes prevention intervention (PREVIEW Study)
(2023) Huttunen-Lenz, Maija; Raben, Anne; Adam, Tanja; Macdonald, Ian; Taylor, Moira A.; Stratton, Gareth; Mackintosh, Kelly; Martinez, J. Alfredo; Handjieva-Darlenska, Teodora; Bogdanov, Georgi Assenov; Poppitt, Sally D.; Silvestre, Marta P.; Fogelholm, Mikael; Jalo, Elli; Brand-Miller, Jennie; Muirhead, Roslyn; Schlicht, Wolfgang
Background. Sedentary lifestyle and unhealthy diet combined with overweight are risk factors for type 2 diabetes (T2D). Lifestyle interventions with weight-loss are effective in T2D-prevention, but unsuccessful completion and chronic stress may hinder efficacy. Determinants of chronic stress and premature cessation at the start of the 3-year PREVIEW study were examined. Methods. Baseline Quality of Life (QoL), social support, primary care utilization, and mood were examined as predictors of intervention cessation and chronic stress for participants aged 25 to 70 with prediabetes ( n= 2,220). Moderating effects of sex and socio-economic status (SES) and independence of predictor variables of BMI were tested. Results. Participants with children, women, and higher SES quitted intervention earlier than those without children, lower SES, and men. Lower QoL, lack of family support, and primary care utilization were associated with cessation. Lower QoL and higher mood disturbances were associated with chronic stress. Predictor variables were independent ( p ≤ .001) from BMI, but moderated by sex and SES. Conclusions. Policy-based strategy in public health should consider how preventive interventions may better accommodate different individual states and life situations, which could influence intervention completion. Intervention designs should enable in-built flexibility in delivery enabling response to individual needs.
Open Access
Using activity triggered e-diaries to reveal the associations between physical activity and affective states in older adult’s daily living
(2015) Kanning, Martina; Ebner-Priemer, Ulrich; Schlicht, Wolfgang
Background: Evidence suggests that elderly show positive affects after participating in an exercise program. However, it is less clear, how physical activities in daily living enhance affective states. This is surprising, as most of elderly’s physical activities are part of their daily living. We used activity-triggered e-diaries to investigate the within-subject effects of physical activity on three dimensions of affective states (valence, energetic arousal, calmness) in everyday life. Methods: Older adults (N = 74) between 50 and 70 years took part in the study during three consecutive days. Physical activity in daily living was objectively assessed with accelerometers. Affects were measured 10 minutes after a study participant surpassed a predefined threshold for activity or inactivity. The participants were prompted by an acoustic signal to assess their momentary affective states on an e-diary. Data were analyzed with hierarchical multilevel analyses. Results: When older individuals were more physically active, they felt more energized (energetic arousal) and agitated (calmness). However, they did not feel better (valence). Interestingly, body mass index (BMI) and valence were associated in a significant cross-level interaction, which demonstrates that BMI was a moderating variable. Lower BMI scores were associated with higher valence affect scores after being physically active. Conclusions: Activities in daily living only partially enhance the elderly’s affective states, because participants feel energized and agitated but not better. Accordingly to the moderating effect of BMI, older people with lower BMI feel better whereas older people with higher BMI did not feel better after being physically active in daily living.
Open Access
Walkability is only part of the story : walking for transportation in Stuttgart, Germany
(2014) Reyer, Maren; Fina, Stefan; Siedentop, Stefan; Schlicht, Wolfgang
In modern Western societies people often lead inactive and sedentary lifestyles, even though there is no doubt that physical activity and health are related. From an urban planning point of view it would be highly desirable to develop built environments in a way that supports people in leading more active and healthy lifestyles. Within this context there are several methods, predominantly used in the US, to measure the suitability of built environments for walking and cycling. Empirical studies show that people living in highly walkable areas are more physically active (for example, walk more or cycle more). The question is, however, whether these results are also valid for European cities given their different urban planning characteristics and infrastructure standards. To answer this question we used the Walkability-Index and the Walk Score to empirically investigate the associations between walkability and active transportation in the city of Stuttgart, Germany. In a sample of household survey data (n = 1.871) we found a noticeable relationship between walkability and active transportation—the more walkable an area was, the more active residents were. Although the statistical effect is small, the health impact might be of relevance. Being physically active is multi-determined and not only affected by the walkability of an area. We highlight these points with an excursion into research that the health and exercise sciences contribute to the topic. We propose to strengthen interdisciplinary research between the disciplines and to specifically collect data that captures the influence of the environment on physical activity in the future.