Overweight people from disadvantaged neighbourhoods can benefit from an intensive lifestyle programme in their own neighbourhood which offers weekly exercise classes, group sessions on nutrition and individual dietary advice. These findings come from doctoral research by Sandra Bukman.
Photo: Sandra Bukman
Diabetes and cardiovascular diseases are more common among people of lower socioeconomic status and from certain ethnic minorities. But these are precisely the groups who do not tend to join lifestyle programmes, or who soon drop out. So Bukman tried adapting the promising SLIM programme, with its weekly exercise classes and four hours per year of dietary advice, for this target group.
‘Participants are offered a tour of a supermarket, for instance, to look at how they could make healthy choices even on low budgets,’ explains Bukman. Participants from the Turkish or Moroccan communities were seen by dieticians and research assistant from the same communities. And there were separate exercise classes for men and women. To keep the threshold low, all the activities took place within their own neighbourhood.
A total of 117 people of Dutch, Turkish and Moroccan origins, living in disadvantaged neghbourhoods in Arnhem and Eindhoven, took this adapted programme last year (with a control group of 103 people). They were all overweight. In the course of the year the average girth size of the group went down by 3.3 centimetres and their cholesterol levels improved. So did their quality of life. Bukman received enthusiastic feedback such as: ‘I can walk upstairs again without getting tired’.
‘The classes really brought people together,’ adds dietician Anja Daniëls, who was involved in the intervention in the Arnhem neighbourhood of Geitenkamp. ‘It meant people could support each other, which made them keep on coming.’
The flip side of the positive results is the 31 percent dropout rate, which would seem a setback for a lifestyle programme. ‘It is,’ agrees Bukman, ‘but this proportion is comparable to other studies of this target group. And I wonder to what extent the dropout rate is because of the programme or whether it’s because of the study around it. Because some people didn’t want any more measurements taken.’ And some people drop out because of emigration or a period abroad.
Sandra Bukman graduates on 26 April. Her supervisor is Edith Feskens, professor of Nutrition and Health in the Life Cycle.