S U M M A R Y / S A M E N V A T T I N G sion to the mean. A prediction model was developed to estimate the growth pattern of infants. Based on the individual growth patterns, we could estimate a PI or BMI after a certain period of growth by using formulas representing the “normal” growth of a child. If the actual growth pattern of an individual child does not fit into the expected growth pattern, intervention is needed to prevent obesity later on and thereby reduce the risk of the metabolic syndrome. Multiple local and national health programs are focused on reducing the incidence of obesity. Lots of these programs are focused on dietary and exercise advices. Apparently these programs are not effective enough. Moreover, most children are presented to the youth health care practitioner at the moment their weight is already outside the normal range. Once overweight or obesity is present in children, it is very difficult to solve the obesity problem. Therefore, we created this prediction model to detect the tenden-‐ cy of becoming overweight in childhood at a moment a child has still a healthy age. This model can be used, in the regular preventive health care program, coordinated by the Youth Health Care, in early childhood, to detect whether the growth of a child still fits within the expected range of growth and thereby to detect if a child is at risk to develop obesity. In the sixth chapter, we applied the prediction model to an overweight and non-‐ overweight group to test our hypothesis. Therefore, data were retrospectively col-‐ lected from child records of 120 children, born in 2002, who developed overweight at the age of 5 years. As a control group, data of 120 children born in 2002 in the same region were collected, who did not develop overweight or obesity at the age of 5 years. Based on longitudinal data, the expected value of the Ponderal Index (PIe) at a certain age until the age of 1 year, depending on the child’s starting posi-‐ tion at birth was calculated. According to our hypothesis, a child is at risk for over-‐ weight at the age of 5 years, if the measured PI value (PIm) > PIe + 2SD. We compared the prediction model with 2 other methods to estimate (ab)normal growth of children; The weight for length growth chart and the PI calculation. It appears that our prediction model is the best predictor for overweight at the age of 5 years. By using this prediction model, we are able to estimate the growth pattern of an infant. If the actual growth pattern of the infant does not fit into the expected growth, intervention may be needed to prevent abnormal growth. By implementing the prediction model in the electronic child record, health care practitioners could use this model in preventing overweight in children at an early age in an easy way. Especially in children overweight has to be prevented, because overweight and its co-‐morbidities will be one of the biggest health-‐ and social care problems and costs in the future. 121
Proefschrift binnenwerk Manon Ernst_DEF.indd
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