T H E U S E O F A P R E D I C T I O N M O D E L T O P R E V E N T A B N O R M A L W E I G H T I N C H I L D H O O D I N T H E Y O U T H H E A L T H C A R E P R A C T I C E vation than by information19. Parents have to be clearly explained how the growth of their child is evolving. Motivational interviewing by pediatricians and dietitians seems a promising office-‐based strategy to motivate parents to cooperate in the prevention of childhood overweight and obesity20. Also the development of underweight must not be neglected. Underweight is an underappreciated problem, because the main focus is on overweight and obesity, nowadays. However, a trend in underweight could be detected by comparing na-‐ tionwide Dutch growth studies from 1964-‐1966 and 1996-‐199721. In our study all the children in the control group, who were at risk to develop un-‐ derweight (PIm < PIe -‐ 2SD at the age of 1 year), had a normal weight at the age of 5 years. Though, it is important to monitor not only those children at risk of becom-‐ ing overweight, but also children at risk of becoming underweight: The health care physician must be aware of a possible development of certain co morbidities, like celiac disease. Unfortunately, we cannot prove that the prediction model can be used to predict the risk of becoming underweight. Conclusion By means of this prediction model, it is possible to predict the expected value of the PI at the age of 1 year by known PI at birth. If the measured value of PI at the age of 1 year exceeds the expected value, the child may be at risk to develop obesity at the age of 5 years. By using this prediction model, we are able to estimate the growth pattern of an infant. Our model seems better to predict overweight than the cur-‐ rently used methods using growth charts and PI formula only. If the actual growth pattern of the infant does not fit into the expected growth, intervention may be needed to prevent abnormal growth. Health care practitioners, who are trained in motivational interviewing techniques, can use this prediction model in preventing overweight in children. 101
Proefschrift binnenwerk Manon Ernst_DEF.indd
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