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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     Introduction   Obesity   in   childhood   is   one   of   the   most   challenging   diseases   to   tackle   these   days.   Nowadays  it  has  reached  epidemic  levels.  In  2010,  around  43  million  children  un-­‐ der   5   were   overweight   and   obese.   The   worldwide   prevalence   of   childhood   over-­‐ weight   and   obesity   increased   from   4.2%   in   1990   to   6.7%   in   2010.   This   trend   is   expected  to  reach  9.1%  in  20201.     Once  obesity  has  been  established,  it  becomes  very  difficult  to  solve  this  problem.   Therefore   it   is   of   great   importance   to   develop   an   instrument   to   detect   the   risk   of   becoming  overweight  at  an  early  age,  before  overweight  is  evident  in  a  child.  Espe-­‐ cially   in   children   overweight   has   to   be   prevented,   because   overweight   and   its   co-­‐ morbidities  will  be  one  of  the  biggest  health  care  problems  and  costs  in  the  future.   Overweight  and  obesity  are  the  fifth  leading  risk  for  global  deaths.  In  addition,  44%   of  the  diabetes  burden,  23%  of  the  ischemic  heart  disease  burden  and  between  7%   and  41%  of  certain  cancer  burdens  are  attributable  to  overweight  and  obesity1.     Overweight  and  obesity  in  childhood  and  adolescence  are  associated  with  increased   risk  of  both  premature  mortality  and  adult  morbidity,  particularly  cardio  metabolic   morbidity2.   There   are   not   only   severe   medical   consequences   of   overweight   in   childhood;   psychosocial   problems   are   probably   more   prevalent.   Childhood   over-­‐ weight  has  significant  impact  on  the  emotional  development  of  the  child  and  ado-­‐ lescent,   like   suffering   from   discrimination   and   stigmatization3.   Those   children   are   more   prone   to   be   bullied   too4.   Also   the   socioeconomic   consequences   of   obesity   should   not   be   neglected;   Persistent   obesity   in   adulthood   in   women   is   associated   with  poorer  employment  and  relationship5.     Nowadays,  lots  of  preventing  programs  for  overweight  are  developed.  Most  of  these   programs   are   focused   on   healthy   food   and   drinks,   stimulating   exercise   /   physical   activity   and   demoralize   inactive   living.   Most   prevention   programs   are   applicable   from  the  age  of  approximately  2  years.  Growth  charts  are  used,  internationally,  to   detect   abnormal   growth   of   children.   But   these   charts   appear   to   be   inadequate   in   preventing  overweight  in  children  at  an  early  age.  Therefore,  we  created  a  predic-­‐ tion   model   to   detect   the   tendency   of   becoming   overweight   in   childhood   at   a   mo-­‐ ment  overweight  has  not  been  established,  meant  for  use  in  early  childhood,  in  the   first  year  of  life.     Methods     Data  for  this  study  were  retrospectively  collected  at  the  youth  health  care  depart-­‐ ment  of  the  Regional  Public  Health  Service  South  Limburg,  Maastricht,  the  Nether-­‐   91  


Proefschrift binnenwerk Manon Ernst_DEF.indd
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