Combined lifestyle interventions (CLIs) can be effective in reducing weight and improving lifestyle-related behaviours but it is unclear how CLIs can best be implemented in practice in order to achieve sustained lifestyle changes. The Coaching on Lifestyle programme (CooL) is a CLI in the Netherlands, in which professional lifestyle coaches counsel adults and children (and/or their parents) who are obese or at high risk of obesity to achieve a sustained healthier lifestyle. The CooL intervention consists of group and individual sessions addressing the topics of physical activity, dietary behaviours, sleep and stress. Our longitudinal one-group pre-post study aimed to identify lifestyle changes among participants (adults, children and their parents) at 8 and 18 months after initiation. We assessed constructs ranging from motivation and behaviour-specific cognitions to behaviours and health outcomes. Positive and sustained changes among adults were found regarding perceived autonomy, motivation, perceived barriers, lifestyle behaviours, quality of life and weight. Among children and their parents, few improvements were found regarding behaviours and quality of life. CooL has been successful in coaching adult participants towards sustained behavioural change during the intervention period. Mixed results and smaller effect sizes were found for children and their parents.

(1) Background: The aim of this study is to investigate changes over time in participants of healthyLIFE, a Combined Lifestyle Intervention (CLI) based on the Coaching on Lifestyle (CooL) intervention. This study focuses on changes in behavior, physical fitness, motivation and Positive Health eight months after the start of the intervention. (2) Methods: In total, 602 Dutch adults, meeting the CLI inclusion criteria, were included from January 2018 until October 2020 in this descriptive case series study. We collected a broad set of data regarding weight/BMI, physical fitness, motivation, self-efficacy, social influence, personal barriers and needs towards food and physical activity and perceived personal health by means of the six dimensions of Positive Health. (3) Results: Eight months after baseline, positive effects of the intervention were found on most outcome measures. We found an increase in all measured aspects of physical fitness (stamina, flexibility, mobility, hand grip strength and BMI). Dietary changes were limited during the healthyLIFE intervention, except for fruit consumption (increase with an effect size of 0.42). The largest effect sizes were found for the dimensions of Positive Health ranging from 0.41 to 0.68. (4) Conclusion: The healthyLIFE intervention is successful in improving participants’ BMI, physical fitness, and perceived physical, mental and social health. A broad health perspective, beyond physical measurements, is recommended when studying effects of the CLI.

Background Sleep has a major impact on health, which makes it a relevant topic for research and health practitioners. Research on sleep determinants, i.e. factors that positively or negatively influence sleep, is fragmented. Objective The purpose of this umbrella review is to provide an overview of the current evidence on determinants of natural adult sleep. Methods A comprehensive literature search was performed on determinants of sleep. Reviews and meta-analyses on natural adult sleep were included. Six electronic databases (PubMed, WoS, Embase, CINAHL, PsycInfo and Cochrane) were used for the search, last accessed September 2021. The quality of the selected articles was assessed using the AMSTAR2 tool. Results were categorized in four main categories: biological, behavioral, environmental and personal/socio-economical determinants. Results In total 93 reviews and meta-analyses resulted in a total of 30 identified determinants. The impact of each determinant differs per individual and per situation. Each determinant was found to affect different sleep parameters and the relationship with sleep is influenced by both generic and specific moderators. Discussion A comprehensive overview on relevant sleep determinants provides a practical and scientifically based starting point to identify relevant intervention approaches to secure or improve individual sleep quality. The difference in aggregation level of the determinants and in measurement methods are the major limitations of this umbrella review. Extending existing generic sleep hygiene rules with an overview of all types of potential determinants will enhance the awareness of the complexity and can be used to improve the effect of sleep interventions in health promotion. Trial registration The umbrella review was registered with PROSPERO (registration ID CRD42020149648) https://www.google.com/search?client=firefox-b-d&q=CRD42020149648.

Background The main objective of this nationwide study was to investigate changes over time of participants after eight months of participation in the Combined Lifestyle Intervention CooL (Coaching on Lifestyle) regarding health perceptions, self-mastery, dietary intake, physical activity, alcohol use, smoking, sleep, stress management and anthropometry. Since the study took place when the COVID-19 pandemic emerged, we were able to address changes over time while participants were exposed to pandemic-related restrictions and uncertainties. Methods Data were collected from November 2018 until October 2021 at different locations across the Netherlands from 1824 participating adults, meeting the Combined Lifestyle Intervention inclusion criteria. We collected a broad set of data on anthropometrics, behaviours and health perceptions. Results The results indicate that the COVID-19 pandemic impacted negatively on changes in self-mastery, perceived fitness and stress, but not on anthropometric outcomes, diet, sleep or social support. Overall, the outcomes show improvements in health perceptions, behaviours and weight after eight months compared to baseline. The largest effect sizes were found on weight, waist circumference, perceived health and the awareness around diet (i.e. attentiveness for diet, amount of food and consuming food). Conclusion Participating in CooL appeared to protect against engaging in unhealthy behaviour during the pandemic, despite a decreased sense of self-mastery and increased stress. The results support the lifestyle coaching approach that small changes in multiple behaviours can synergistically contribute to better (perceived) health and health-related outcomes.

Background: Coaching on Lifestyle (CooL) is a two-year healthcare intervention for people with overweight or obesity, stimulating weight reduction by promoting sustained healthier behavior. The objective of this study is to investigate the effects of CooL on participants’ anthropometrics, personal factors and behavioral factors over the two-year timeframe of CooL.  Methods: A descriptive case series study, using a broad set of routinely collected data on anthropometrics, personal factors and behavioral factors of adults living across the Netherlands. The data were collected between November 2018 and December 2021 among participants of CooL (N=746) at three moments during the intervention: at baseline (T0), at 8 months (T1) after completion of phase 1 and at 24 months (T2) after ending CooL. Changes over time were analyzed using paired t-tests comparing baseline to T1 and baseline to T2. In addition, potential differences on outcomes in subgroups based on education level, weight status and group size were examined using paired t-tests and ANOVA-tests. Results: The results showed changes in the desired direction on all outcomes at 24 months compared to baseline. The largest effects were seen on perceived health, attentiveness towards meal size and meal composition (large effect size). Mean weight loss was 4.13 kilograms (SD 7.54), and mean waist circumference decreased with 4.37 centimeters (SD 8.59), indicating a medium to large effect size. Changes in outcomes were similar across all subgroups consisting of participants with different educational level, BMI at baseline and in different group sizes. Conclusion: The study showed sustained effects in weight-related outcomes of CooL over the timeframe of 24 months supporting the two-year set-up of CooL, The outcomes indicate that CooL is appropriate and effective for different group sizes and for a wide variety of participants irrespective of gender, age, BMI at baseline or level of education.