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Proefschrift binnenwerk Manon Ernst_DEF.indd

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  


Proefschrift binnenwerk Manon Ernst_DEF.indd
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