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OBJECTIVE: In many developed countries, overweight and obesity prevalence seems to stabilise. The aim of this study was to determine trends between 1999 and 2011 in overweight and obesity prevalence, and mean Body Mass Index (BMI) z-score in Dutch, Turkish, Moroccan and Surinamese South Asian children in the Netherlands. DESIGN: A cross-sectional population-based study with 136 080 measurements of height and weight of 73 290 children aged 3-16 years. BMI class and BMI z-score were determined with the latest International Obesity Taskforce (IOTF) criteria, with overweight defined as an adult BMI equivalent ≥ 25 and obesity ≥ 30. Time trends per year were analysed using logistic and linear regression analyses. RESULTS: The prevalence of overweight in Dutch children declined from 13% to 11% (OR 0.960; 95% CI 0.954 to 0.965), but increased in Turkish children from 25% to 32% (OR 1.028; 95% CI 1.020 to 1.036). In Moroccan and Surinamese South Asian children, overweight rates were stable, but obesity prevalence decreased (OR 0.973; 95% CI 0.957 to 0.989, OR 0.964; 95% CI 0.943 to 0.985, respectively) as well as the mean BMI z-score (B=-0.010; 95% CI -0.014 to -0.006, B=-0.010; 95% CI -0.016 to -0.004). In Turkish children, trends limited to the period 2007-2011 showed no statistically significant relationship for all outcome measures. CONCLUSIONS: The decrease in obesity prevalence in Dutch, Moroccan and Surinamese South Asian children suggests that overweight children became less adipose. The stabilising trend in overweight and obesity prevalence in Turkish children since 2007 may signify a levelling off for this ethnic group.

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OBJECTIVE: To determine trends in the prevalence of overweight and obesity in children in The Hague (the Netherlands) from 1999 through 2007. DESIGN: Population-based study of a series of cross-sectional assessments of height and weight from electronic health records. SETTING: Child Health Care (Municipal Health Service), The Hague. PARTICIPANTS: 50,961 children aged 3-16 years, with Dutch (59%), Turkish (17%), Moroccan (13%) or Surinamese South Asian (11%) ethnicity, representative of the four major ethnic groups in The Hague, with 85,234 weight and height measurements recorded in 1999-2007. MAIN OUTCOME MEASURES: (Trends in) the prevalence of overweight (excluding obesity) and obesity as defined by the International Obesity Taskforce cut-off points, using logistic regression with year as independent variable. RESULTS: From 1999 through 2007 there was a decrease in the prevalence of overweight in Dutch girls from 12.6% to 10.9% (OR 0.96; 95% CI 0.95 to 0.98) and an increase in Turkish boys from 14.6% to 21.4% (OR 1.08; 95% CI 1.04 to 1.11). Obesity prevalence rose significantly in Turkish boys from 7.9% to 13.1% (OR 1.04; 95% CI 1.01 to 1.06) and in Turkish girls from 8.0% to 10.7% (OR 1.04; 95% CI 1.01 to 1.08). Dutch boys, and Moroccan and Surinamese South Asian boys and girls showed no significant trends. CONCLUSIONS: The declining prevalence of overweight in Dutch girls may indicate reversal of previous trends in the Netherlands. However, in Turkish children overweight prevalence and obesity is high and increasing. Further public health action is necessary, especially for Turkish children.

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OBJECTIVES: To test whether early treatment with a high initial dose of levothyroxine can prevent suboptimal mental development in all neonates with congenital hypothyroidism (CH). STUDY DESIGN: Sixty-one patients, 27 with severe CH and 34 with mild CH, were treated either early (<13 days) or late (> or =13 days) with either a high initial dose of levothyroxine (> or =9.5 microg/kg/d) or a low initial dose (<9.5 microg/kg/d). With these criteria, 4 treatment groups were formed. The results of the Bayley test, performed at the age of 10 to 30 months and expressed as mental developmental index (MDI) and psychomotor developmental index (PDI), were related to socioeconomic status, treatment group, initial free thyroxine (FT(4)) concentration, and mean FT(4) concentration during the first 3 months of treatment (FT(4)-A) and the ensuing 9 months (FT(4)-B). RESULTS: Mean (+/- SD) MDI was 113 +/- 14, and mean PDI was 114 +/- 12. In the severe CH group, only the patients treated early with a high initial dose had normal MDI scores (124 +/- 16), whereas the scores of the other groups ranged from 97 to 103. In contrast, all patients in the mild CH group had normal scores (range, 122-125), except those in the group treated late with a low initial dose, whose score was 110 +/- 10. Forty-three percent of the variance in MDI and PDI scores was explained by treatment factors, such as the treatment group, initial FT(4) concentration, FT(4)-A, and FT(4)-B. CONCLUSIONS: Our data suggest that optimal treatment includes achievement of euthyroidism before the third week of life by initiation of therapy before 13 days with a levothyroxine dose above 9.5 microg/kg/d and maintenance of FT(4) concentrations in the upper normal range during the first year. Thus treated, patients with CH can achieve normal psychomotor development at 10 to 30 months, irrespective of the severity of the disease.

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Social class and ethnicity are important risk factors for small-for-gestational-age and preterm delivery in many countries. This study was performed to assess whether this is also the case in the Netherlands, a country with a high level of social security, relatively small income differences and easy access to medical care for all its inhabitants. Other risk factors that were taken into account were smoking, drinking, occupation, age and height. Information was collected by interview in the first 3 weeks of life of the mothers of 2027 (response 97%) live-born singletons born in the period from April 1988 to October 1989 in the study area. After adjustment for possible confounding factors very low social class, compared with high social class, was significantly associated with reduced birthweight (-4.0%; 95% CI, -7.4% to -0.7%), but not with preterm delivery (OR, 2.09; 95% CI, 0.67-6.48). The adjusted birthweight of Turkish infants (2.7%; 95% CI, -1.1% to 6.5%) and the adjusted birthweight of infants from Suriname or the Antilles (-1.6%; 95% CI, -5.5% to 2.1%) were not significantly different compared with infants of Dutch mothers. After adjustment, the frequency of preterm birth was lower in Turkish infants, but not significantly (OR, 0.22; 95% CI, 0.04-1.10), whereas the frequency of preterm birth in infants from Suriname or the Antilles was significantly higher (OR, 2.51; 95% CI, 1.04-6.08) compared with Dutch infants. Of the other factors the main risk factors were smoking (negatively related with birth-weight) and maternal age(ABSTRACT TRUNCATED AT 250 WORDS)

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