The Upstream Team is founded and coordinated by a small group of mostly young researchers that are embedded within the Department of Epidemiology and Biostatistics at the VU Medical Center, part of the Amsterdam Public Health Institute. We closely collaborate with renowned experts in and across the domains of environment, lifestyle behaviours and chronic diseases.
Jeroen Lakerveld, PhD
"Our environment matters for our behaviour and health.
It is complex, but it matters."
'I would consider myself to be an ‘upstreamist’, as I truly believe that our environment shapes our behaviour and thus our health. For some more than others – and for very few in a simple, linear way.
In several projects we try to entangle what environmental characteristics (or clusters of characteristics) matters for whom, and how. Nationally, but also in international settings. As an epidemiologist I am interested in the individual and environmental determinants of lifestyle behaviours and risk of non-communicable chronic diseases. To do so I think it is of utmost importance to get the picture - or the 'exposome' - as complete as possible by mapping all types of exposures and lifestyle behaviours in a longitudinal way, and find measures and methods to make sense of these data.'
Joreintje D. Mackenbach, PhD
“An ounce of prevention is worth a pound of cure” – Benjamin Franklin
'Primary prevention is the main reason why I wanted to become a public health researcher. As much as I enjoy solving problems (‘How can we make sure that our society and health care system is fit for handling all these individuals with complications from overweight and obesity?’), there is just much more value in preventing problems (‘How can we make sure that our society and health care system does not have to deal with these complications?’). Overweight and obesity are so-called ‘welfare diseases’, and there is a huge potential for their prevention by modifying lifestyle behaviours such as eating, sitting and being physically active. My training at the Netherlands Institute for Health Sciences in Rotterdam and the EMGO Institute for Health and Care Research in Amsterdam, two of the most prominent Public Health institutes in the Netherlands, taught me to take a multidisciplinary perspective. I aim to integrate theories and knowledge from the social sciences, geography, public health and epidemiology to better understand how the context individuals live in affects their lifestyle behaviours and their weight status. I am especially interested in studying the role of social environmental factors (changing social norms, stimulating social support), physical environmental factors (provide opportunities to be physically active and eat healthily) and economic environmental factors (make sure that ‘healthy’ opportunities are affordable) for the prevention of adult overweight and obesity.'
Maria Gabriela M. de Pinho
"When “I” is replaced by “We” even Illness becomes Wellness" – Unknown Author
'People's behaviour and health status largely depend on the context in which they live – the upstream factors. Considering the challenges and opportunities of these upstream factors fascinates me. In the last decades we witnessed overweight and obesity become an epidemic. As a nutritionist interested in Public Health I decided to focus on how we can improve environments to enable people to behave healthier, and so reduce the health burden. Within this perspective I obtained my Bachelor and Master degree in Nutrition from Federal University of Santa Catarina, Brazil. Then, pursuing new challenges and opportunities to learn from and share knowledge with colleagues from different disciplines I started my PhD trajectory at the VUmc University Medical Center and the Amsterdam Public Health research institute in Amsterdam. My main research interests are in the individual and upstream determinants of dietary behaviours and obesity.'
Rosa de Groot
'I like to think that I am an autonomous person who makes rational decisions on my own on how to live my life. Unfortunately, scientific evidence indicates that our lifestyle is influenced by the environment we live in. I am interested to discover more about how the environment influences our chemical balances in our blood . During my internship of the Master Health Sciences at Sanquin Blood Supply I became aware that the human body is nothing without blood. With my PhD project at the Epidemiology and Biostatistics of the VU University Medical Center and Sanquin Blood Supply I hope to unravel more about how environmental characteristics and in turn lifestyle influence blood parameters such as triglyceride and cholesterol levels. Before we start to think about changes to improve our lives we need a deeper understanding of how the environment we live in impacts us. As epidemiologist in training I believe that a sound methodological framework is necessarily to learn more about such complex topics.'
Nicole R. den Braver
"Treatment without prevention is simply unsustainable.” - Bill Gates
'I am fascinated by unravelling the how’s and why’s of behaviour and health status. I like to study complex issues in epidemiology, find the right tools and methods to do so and attempting to peek inside the black box. This interest was ignited during my master at the Wageningen University with a specialization in Epidemiology and Public Health, where during my education I have been involved in different projects at different places. I have studied associations between nutritional intake and disease, as well as behavioral constructs and lifestyle behaviour change in preventing type 2 diabetes. Now I am wondering what shapes these patterns of behavior and health at a higher level, namely by looking at the environment that one lives in. The environment is immensely complex, containing built environment, perceptions of environment, social environment, and the interactions between these constructs. The ENDEAVOR project enables me to pursue my interests in a PhD project. I am eager to get a grasp on these concepts and apply advanced epidemiological and statistical methods to contribute to our understanding of these pathways.'
"A man's health can be judged by which he takes two at a time - pills or stairs.” - Joan Welsh
'I strongly believe that adjustments to the environment can promote healthy living, and in turn prevent chronic diseases. During my bachelor Health and Life Sciences at the VU University I became convinced that prevention is better than cure. My interest in prevention was further fuelled during my master Health Sciences (specialization Prevention and Public Health) and internship at the VU University Medical Centre, department of Epidemiology and Biostatistics. By tackling upstream factors such as social disadvantage and social inequities we can improve health and diminish health disparities. Therefore, my PhD project will help tackle social inequities stemming from socio-economic status by helping make the healthy choice a cheaper choice.'
"The idea is to die young, as late as possible" - Ashley Montagu”
'Growing old in optimal health – who does not want that? How to accomplice a high age, free from chronic diseases and disabilities, is a question that keeps on intriguing me. With a background in Nutrition and Dietetics and Health Sciences, I have experienced and learned about the impact of dietary choices and lifestyle behaviours on the prevention of several diseases, along with the major influence of social inequalities. Not all of us receive equal opportunities in life and not all dietary and lifestyle choices are a conscious choice of the individual.
I am convinced that environmental adjustments to promote healthy choices and behaviours, specifically targeting those who are at high risk of chronic diseases, can enhance equal chances of longevity in optimal health. During my PhD research for the SUPREME NUDGE project, I will focus on the implementation and evaluation of a large scale supermarket intervention trail, which aims to improve cardiometabolic health through nudging dietary behaviours and physical activity among low socioeconomic status adults. In addition, I am specifically interested in the development of an efficient and valid measurement method to detect changes in dietary intake.'
Geography has shaped our ancestors to what we are today and will no doubt keep telling us how to move and how to eat for the rest of our days. I know from my daily shopping routine how easy my ecological principles are outsmarted by compelling geographic factors like walk- or cycle distance. The common supermarket located between home and work wins often from the organic food shop which is slightly off route. So location does matter: change location –> change behavior.
Being a geographer myself I do not question if spatial variables matter for our health, but how they matter. Happily, within the Upstream Team I have plenty of space in the GECCO project to indulge myself with the collection and construction of relevant environmental variables and I may be able to support you to link these environmental-level data to your individual-level data. If you look for a specific spatial variables, need assistance in using GIS or have a good idea, I am happy to help you!