Overweight in 5-year-old Children: Assessment and Risk Factors (The Be Active, Eat Right Study)

Abstract

The World Health Organization defines overweight and obesity as “abnormal or excessive fat accumulation that may impair health”. Worldwide, about one in ten children at the age of 5 to 17 years have overweight (obesity included). In the last decades there has been a dramatic increase in the prevalence of childhood overweight and obesity in many countries. This increase over a relatively short period of time and within a relatively stable population indicates that genetic factors can not be the primary reason for the increase. The fundamental cause of overweight and obesity is an imbalance between energy intake and energy expenditure, and the increase in prevalence has been ascribed to changes in society that increase the energy intake and decrease the physical activity of the population. An environment with factors that facilitate the development of overweight and obesity is also referred to as an obesogenic environment. Children with overweight are at risk of developing obesity, and childhood obesity is associated with an increased risk of health problems already during childhood (e.g. cardiovascular risk factors, type 2 diabetes, asthma and psychosocial problems). However, the greatest health problems will be seen in next generations as overweight and obesity track from childhood into adulthood quite strong. Childhood overweight and obesity have been associated with higher morbidity and mortality later in life. Further, once childhood obesity is established, it is difficult to reverse. Childhood overweight and obesity are therefore a major burden on health care, and prevention of childhood overweight and obesity is an international public health priority. In the Netherlands, the prevention of overweight in children appeared as a priority on the political and public health agenda at the beginning of this century. As a result, the overweight prevention protocol for use in the setting of youth healthcare was developed in 2005. This thesis reports on a number of studies examining overweight assessment and risk factors for overweight in young children. These studies are embedded in the ‘Be active, eat right’ study. The ‘Be active, eat right’ study was initiated to implement the overweight prevention protocol in the youth healthcare setting, and to assess its effects on the prevalence of overweight and health behavior of children.