The public health impact of obesity

The prevalence of obesity (severe overweight) has been increasing in western societies during the last decades. Epidemiological studies to the public health impact of obesity are therefore warranted. This thesis aimed at describing the long-term and recent time trends of obesity in the Netherlands, and to explore the relations between obesity, mortality, morbidity, and disability.The prevalence of obesity, body mass index (BMI)≥30.0 kg/m 2, increased steadily in Dutch adults between 1974 and 1997. Between 1993 and 1997, the prevalence of obesity was estimated at 9% among men and at 10% among men aged 20-59 years, based on data from the Dutch MORGEN-project. Levels of waist circumference increased more over time and showed even greater seasonal variation than BMI.Obesity measured by BMI was related to increased all-cause mortality in men who never smoked, although relative risks seemed to decrease somewhat with ageing in European men from the Seven Countries Study. Levels of waist circumference identified more men over 55 years of age who never smoked with increased risk of mortality than levels of BMI in the Rotterdam Study.Obesity was related to hospitalisation for coronary heart disease and to medication for chronic conditions in Finnish men and women from the Social Insurance Institution's Mobile Clinic study. In the Mini-Finland Health Survey, obesity was associated with the presence of osteoarthritis, low back pain, shoulder joint impairment and neck pain. In addition, obesity was associated with work disability during a 15 years follow-up and to the presence of difficulties in daily life activities. Relative risks of obesity for morbidity and disability were highest in the youngest Finnish adults studied, and exceeded the relative risk for mortality.Prevention of weight gain (Although obesity was related to increased mortality, obese Finns had more unhealthy life years than Finns with normal weight. During a maximal follow-up period of 15 years until age 65 years, obese men had 0.5, 0.4 and 1.7 extra years of work disability, coronary heart disease and morbidity leading to chronic medication, respectively. Obese women suffered respectively 0.5, 0.4 and 1.3 extra years from these conditions.This thesis provides new evidence based on large epidemiological studies that weight gain prevention programs should get high priority on both the scientific and the political agenda.</font

Reported versus measured body weight and height of 4-year-old children and the prevalence of overweight

Background: In adults, body weight tends to be underestimated when based on self-reported data. Whether this discrepancy between measured and reported data exists in healthy young children is unclear. We studied whether parental reported body weight and height of 4-year-old children corresponded with measured body weight and height. In addition, we studied the determinants and the consequences of differences between reported and measured data. Methods: Data on body weight and height of 864 4-year-old Dutch children born in 1996/1997 enrolled in the Prevention and Incidence of Asthma and Mite Allergy (PIAMA) birth cohort study were collected via a questionnaire and a medical examination. Overweight was defined according to standard international age and gender specific definitions. Results: Mean differences between measured and reported body weight, height, and body mass index (BMI) were small. Parents of children with a low BMI tended to over report body weight while parents of children with a high BMI tended to underreport body weight. Whereas 9.5% of the children were overweight according to reported BMI, the prevalence of overweight was 13.4% based on measured BMI. Over 45% of the overweight children according to measured BMI were missed when reported BMI was used. Conclusion: These findings suggest that overweight prevalence rates in children are underestimated when based on reported weight and height

Voeding en Gezondheid : Obesitas

About 12% of the adult Dutch population is obese (Quetelet Index > or = 30 kg/m2). The prevalence has roughly doubled over the past 20 years. Obesity is strongly associated with a number of chronic diseases, such as type 2 diabetes mellitus, increased healthcare costs and a loss of productivity. Obesity is always the result of a mismatch between energy intake and energy expenditure. Foods with a high percentage of energy derived from fat are associated with weight gain, particularly when the rest of the energy is obtained from products containing little dietary fibre. Foods with a high content of refined added sugars or starch might be unfavourable with respect to the energy balance and the risk for type 2 diabetes mellitus and cardiovascular diseases. Slimming diets should aim for a gradual and sustained weight loss of about 10% of the initial weight over a period of six months, followed by weight maintenance over the next two years. Physical activity is an essential component of a weight loss strategy. Moderate sustained weight loss is associated with a strong reduction in the risk of type 2 diabetes mellitus in people with impaired glucose tolerance