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 ? weight and BMI is obvious, but the increase in height stopped recently. If height increases, BMI also increases*. Taking into account the information that height does not increase anymore, the increase in BMI means a higher increase in weight. The BMI may be misleading in interpreting growth of children*. Another limitation of the anthropometric approach of overweight is that the BMI as well as weight for height does not distinct between fat mass (FM) and fat-‐free mass (FFM)12. In adipose children it is reasonable to ascribe the weight gain to an in-‐ crease in FM, but at the same time in relatively lean children a lower weight is largely due to a shift from FM to FFM12. Therefore Fredriks stated that waist cir-‐ cumference could be used as a better tool to screen for increased abdominal fat in children13. It is of great importance to detect and treat children who are already overweight at an early age. Prevention at an early age is necessary in reducing the problem of obesity or malnutrition and its co-‐morbidities, which will be a threat for the popu-‐ lation in the future. * It is true that the increase of BMI partly can be explained by the increase in height, taking the P3, P50 and P97 values into account, but only below the age of about 10 years. During that period the increase in weight is less pronounced than the in-‐ crease in height: on the curve weight for height the linear regression is y=0.283x -‐ 12.26. Beyond the age of ten years, the increase in weight compared to weight is more pronounced: y=0.753x-‐74.87. 37
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