O B E S I T Y I N C H I L D H O O D : S E C U L A R T R E N D O R E P I D E M I C D I S E A S E ? Introduction There is rising concern about the increasing incidence of overweight and obesity, not only in adults but also in children1. Obesity is one of the most serious present and possible future health problems, because of co-‐morbidities such as diabetes mellitus type II, cardiovascular diseases, joint problems and psychosocial problems. During the last 30 years, the prevalence of overweight and obesity in The Nether-‐ lands has increased2,3. The question arises as to whether this increase in weight may be attributed to or aligned with a secular trend in height? A secular trend describes the change in physical development from one generation to the next and can be interpreted as a ‘mirror of conditions in society’, as Tanner stated4. The improved physical and psy-‐ chological condition over the last 100 years in Western society, due to improved foods, living conditions and less diseases, led indeed to a tendency for children to become progressively larger and heavier at all ages. The aim of this study was to examine whether this secular trend in height and weight is already visible during intrauterine growth. Secondly, the rate between height and weight expressed by the Body Mass Index (BMI) as weight divided by squared height, during this secular trend was examined5. To compare growth data of children in the Netherlands con-‐ cerning the prenatal growth and postnatal growth, we analyzed two data sets. Es-‐ pecially a secular trend in prenatal growth with respect to population of the Neth-‐ erlands has not been investigated before. Methods Prenatal growth curves All the available nationwide data for prenatal growth in the Netherlands were used, these include two sets of growth data: The Kloosterman study from 19706 and the Perinatreg study from 20017 .The big time span between those studies can offer insight in a possible trend in growth. In the Kloosterman study, birth weight data of 80,000 infants were presented. All children were born at gestational age between 25 to 40 weeks in two Amsterdam clinics. The infants were subdivided by gender and those born from primiparae and multiparae6. The Perinatreg study consisted of a nationwide birth weight registration of 176,093 infants of the gestational age between 25 to 40 weeks, gathered in 2001. The total group is subdivided in infants born from primigravida and multiparous women7. To compare the two studies, the mean weight value for each gestational age in weeks of the Kloosterman registration was subtracted from the Perinatreg data. 27
Proefschrift binnenwerk Manon Ernst_DEF.indd
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