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      Increase in Prevalence of Overweight in Dutch Children and Adolescents: A Comparison of Nationwide Growth Studies in 1980, 1997 and 2009

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          Abstract

          Objective

          To assess the prevalence of overweight and obesity among Dutch children and adolescents, to examine the 30-years trend, and to create new body mass index reference charts.

          Design

          Nationwide cross-sectional data collection by trained health care professionals.

          Participants: 10,129 children of Dutch origin aged 0–21 years.

          Main Outcome Measures

          Overweight (including obesity) and obesity prevalences for Dutch children, defined by the cut-off values on body mass index references according to the International Obesity Task Force.

          Results

          In 2009, 12.8% of the Dutch boys and 14.8% of the Dutch girls aged 2–21 years were overweight and 1.8% of the boys and 2.2% of the girls were classified as obese. This is a two to three fold higher prevalence in overweight and four to six fold increase in obesity since 1980. Since 1997, a substantial rise took place, especially in obesity, which increased 1.4 times in girls and doubled in boys. There was no increase in mean BMI SDS in the major cities since 1997.

          Conclusions

          Overweight and obesity prevalences in 2009 were substantially higher than in 1980 and 1997. However, the overweight prevalence stabilized in the major cities. This might be an indication that the rising trend in overweight in the Netherlands is starting to turn.

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          Most cited references40

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          Worldwide trends in childhood overweight and obesity.

          Obesity has become a global epidemic but our understanding of the problem in children is limited due to lack of comparable representative data from different countries, and varying criteria for defining obesity. This paper summarises the available information on recent trends in child overweight and obesity prevalence. PubMed was searched for data relating to trends over time, in papers published between January 1980 and October 2005. Additional studies identified by citations in retrieved papers and by consultation with experts were included. Data for trends over time were found for school-age populations in 25 countries and for pre-school populations in 42 countries. Using these reports, and data collected for the World Health Organization's Burden of Disease Program, we estimated the global prevalence of overweight and obesity among school-age children for 2006 and likely prevalence levels for 2010. The prevalence of childhood overweight has increased in almost all countries for which data are available. Exceptions are found among school-age children in Russia and to some extent Poland during the 1990s. Exceptions are also found among infant and pre-school children in some lower-income countries. Obesity and overweight has increased more dramatically in economically developed countries and in urbanized populations. There is a growing global childhood obesity epidemic, with a large variation in secular trends across countries. Effective programs and policies are needed at global, regional and national levels to limit the problem among children.
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            Smoothing reference centile curves: the LMS method and penalized likelihood.

            Refence centile curves show the distribution of a measurement as it changes according to some covariate, often age. The LMS method summarizes the changing distribution by three curves representing the median, coefficient of variation and skewness, the latter expressed as a Box-Cox power. Using penalized likelihood the three curves can be fitted as cubic splines by non-linear regression, and the extent of smoothing required can be expressed in terms of smoothing parameters or equivalent degrees of freedom. The method is illustrated with data on triceps skinfold in Gambian girls and women, and body weight in U.S.A. girls.
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              The LMS method for constructing normalized growth standards.

              T. J. Cole (1990)
              It is now common practice to express child growth status in the form of SD scores. The LMS method provides a way of obtaining normalized growth centile standards which simplifies this assessment, and which deals quite generally with skewness which may be present in the distribution of the measurement (eg height, weight, circumferences or skinfolds). It assumes that the data can be normalized by using a power transformation, which stretches one tail of the distribution and shrinks the other, removing the skewness. The optimal power to obtain normality is calculated for each of a series of age groups and the trend summarized by a smooth (L) curve. Trends in the mean (M) and coefficient of variation (S) are similarly smoothed. The resulting L, M and S curves contain the information to draw any centile curve, and to convert measurements (even extreme values) into exact SD scores. A table giving approximate standard errors for the smoothed centiles is provided. The method, which is illustrated with US girls' weight data, should prove useful both for the construction and application of growth standards.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                1932-6203
                2011
                15 November 2011
                : 6
                : 11
                : e27608
                Affiliations
                [1 ]TNO Child Health, Leiden, The Netherlands
                [2 ]VU University Medical Center Amsterdam, EMGO Institute of Health Care Research, Amsterdam, The Netherlands
                [3 ]TNO Life Style, Leiden, The Netherlands
                [4 ]Leiden University Medical Center, Department of Pediatrics, Leiden, The Netherlands
                [5 ]University of Utrecht, Department of Methodology and Statistics, Utrecht, The Netherlands
                UCL Institute of Child Health, University College London, United Kingdom
                Author notes

                Conceived and designed the experiments: YS HT PvD BB SEB RAH SvB. Performed the experiments: YS HT PvD SvB. Analyzed the data: YS PvD SvB. Contributed reagents/materials/analysis tools: BB SEB RAH. Wrote the paper: YS HT PvD BB SEB RAH SvB.

                Article
                PONE-D-11-12669
                10.1371/journal.pone.0027608
                3216980
                22110687
                1ccd282c-da0c-4a31-951c-2442959fdb06
                Schönbeck et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
                History
                : 5 July 2011
                : 20 October 2011
                Page count
                Pages: 8
                Categories
                Research Article
                Medicine
                Epidemiology
                Pediatric Epidemiology
                Nutrition
                Obesity
                Pediatrics
                Child Development
                Public Health
                Child Health
                Health Screening
                Preventive Medicine

                Uncategorized
                Uncategorized

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