Social isolation is associated with type 2 diabetes (T2DM), but it is unclear which elements play a crucial role in this association. Therefore, we assessed the associations of a broad range of structural and functional social network characteristics with normal glucose metabolism, pre-diabetes, newly diagnosed T2DM and previously diagnosed T2DM. Participants originated from The Maastricht Study, a population-based cohort study (n = 2861, mean age 60.0 ± 8.2 years, 49% female, 28.8% T2DM (oversampled)). Social network characteristics were assessed through a name generator questionnaire. Diabetes status was determined by an oral glucose tolerance test. We used multinomial regression analyses to investigate the associations between social network characteristics and diabetes status, stratified by sex. More socially isolated individuals (smaller social network size) more frequently had newly diagnosed and previously diagnosed T2DM, while this association was not observed with pre-diabetes. In women, proximity and the type of relationship was associated with newly diagnosed and previously diagnosed T2DM. A lack of social participation was associated with pre-diabetes as well as with previously diagnosed T2DM in women, and with previously diagnosed T2DM in men. Living alone was associated with higher odds of previously diagnosed T2DM in men, but not in women. Less emotional support related to important decisions, less practical support related to jobs, and less practical support for sickness were associated with newly diagnosed and previously diagnosed T2DM in men and women, but not in pre-diabetes. This study shows that several aspects of structural and functional characteristics of the social network were associated with newly and previously diagnosed T2DM, partially different for men and women. These results may provide useful targets for T2DM prevention efforts.

Our aim was to assess the association between a priori defined dietary patterns and incident depressive symptoms. We used data from The Maastricht Study, a population-based cohort study (n = 2646, mean (SD) age 59.9 (8.0) years, 49.5% women; 15,188 person-years of follow-up). Level of adherence to the Dutch Healthy Diet (DHD), Mediterranean Diet, and Dietary Approaches To Stop Hypertension (DASH) were derived from a validated Food Frequency Questionnaire. Depressive symptoms were assessed at baseline and annually over seven-year-follow-up (using the 9-item Patient Health Questionnaire). We used Cox proportional hazards regression analyses to assess the association between dietary patterns and depressive symptoms. One standard deviation (SD) higher adherence in the DHD and DASH was associated with a lower hazard ratio (HR) of depressive symptoms with HRs (95%CI) of 0.78 (0.69–0.89) and 0.87 (0.77–0.98), respectively, after adjustment for sociodemographic and cardiovascular risk factors. After further adjustment for lifestyle factors, the HR per one SD higher DHD was 0.83 (0.73–0.96), whereas adherence to Mediterranean and DASH diets was not associated with incident depressive symptoms. Higher adherence to the DHD lowered risk of incident depressive symptoms. Adherence to healthy diet could be an effective non-pharmacological preventive measure to reduce the incidence of depression.

Background: Despite growing interest in sustainable employability (SE), studies on the effectiveness of interventions aimed at employees’ SE are scarce. In this review, SE is defined by four core components: health, productivity, valuable work, and long-term perspective. The aim of this review is to summarize the effectiveness of employer-initiated SE interventions and to analyze whether their content and outcome measures addressed these SE components. Methods: A systematic search was performed in six databases for the period January 1997 to June 2018. The methodological quality of each included study was assessed. A customized form was used to extract data and categorize interventions according to SE components. Results: The initial search identified 596 articles and 7 studies were included. Methodological quality ranged from moderate to weak. All interventions addressed the components ‘health’ and ‘valuable work’. Positive effects were found for ‘valuable work’ outcomes. Conclusions: The quality of evidence was moderate to weak. The ‘valuable work’ component appeared essential for the effectiveness of SE interventions. Higher-quality evaluation studies are needed, as are interventions that effectively integrate all SE core components in their content.

Unhealthy lifestyles in early childhood are a major global health challenge. These lifestyles often persist from generation to generation and contribute to a vicious cycle of health-related and social problems. This design article presents a study evaluating the effects of two novel healthy school interventions. The main outcome measure will be changes in children’s body mass index (BMI). In addition, lifestyle behaviours, academic achievement, child well-being, socio-economic differences, and societal costs will be examined. In close collaboration with various stakeholders, a quasi-experimental study was developed, for which children of four intervention schools (n = 1200) in the southern part of the Netherlands are compared with children of four control schools (n = 1200) in the same region. The interventions started in November 2015. In two of the four intervention schools, a whole-school approach named ‘The Healthy Primary School of the Future’, is implemented with the aim of improving physical activity and dietary behaviour. For this intervention, pupils are offered an extended curriculum, including a healthy lunch, more physical exercises, and social and educational activities, next to the regular school curriculum. In the two other intervention schools, a physical-activity school approach called ‘The Physical Activity School’, is implemented, which is essentially similar to the other intervention, except that no lunch is provided. The interventions proceed during a period of 4 years. Apart from the effectiveness of both interventions, the process, the cost-effectiveness, and the expected legal implications are studied. Data collection is conducted within the school system. The baseline measurements started in September 2015 and yearly follow-up measurements are taking place until 2019. A whole-school approach is a new concept in the Netherlands. Due to its innovative, multifaceted nature and sound scientific foundation, these integrated programmes have the potential to form a template for primary schools worldwide. The effects of this approach may extend further than the outcomes associated with well-being and academic achievement, potentially impacting legal and cultural aspects in our society. The study protocol was registered in the database ClinicalTrials.gov on 14-06-2016 with the reference number NCT02800616 .

In an effort to better quantify the impact of adulthood socioeconomic circumstances on prediabetes and type 2 diabetes (T2DM), we set out to examine the relative importance of four adulthood socioeconomic indicators. Using cross-sectional data from The Maastricht Study on 2011 middle-aged older men and women, our findings indicate that low educational level (OR = 1.81, 95% CI = 1.24–2.64), low occupational level (OR = 1.42, 95% CI = 0.98–2.05), and material deprivation (OR = 1.78, 95% CI = 1.33–2.38) were independently associated with T2DM. Low income (OR = 1.28, 95% CI = 0.88–1.87) was the strongest, albeit not significant, SEP (socioeconomic position) correlate of prediabetes. This association confirms SEP as a multifaceted concept and indicates the need to measure SEP accordingly. In order to tackle the social gradient in prediabetes and T2DM, one should, therefore, address multiple SEP indicators and their possible pathways.