We investigate whether the increase in weight is related to a secular trend in height. Furthermore, it is discussed whether the increase in weight is part of the increase in height or goes beyond this. A second aim was to examine whether this secular trend in height and weight is already visible during intrauterine growth. For this purpose we explored and compared growth data of prenatal growth studies. We also examined the relation between height and weight by the Body Mass Index (BMI) during the postnatal secular trend by comparing growth data of different postnatal growth studies.
We explore whether short term changes in body composition, measured by total body water (TBW), as a result of rhGH therapy could be used to predict its growth effect after one year in children with GHD and SGA children. Because not all these children seem to benefit from this treatment it is important to predict whether a child will have an adequate or inadequate response to rhGH. This prediction is also important as a tool to predict a declining risk on the metabolic syndrome.
We analyze the metabolic growth pattern, expressed as BMI and weight for height values of SGA children, treated with rhGH. The objective of this study was to investigate whether short-term changes in BMI and weight for height, as a result of rhGH could be used to predict its growth effect after one year in GHD- and SGA children. If the outcome is the same as by the Deuterium measurement of TBW, the result can be utilized as a tool in the daily practice of the Youth Health Care.
We describe the construction of a prediction model for the development of obesity in children. This model is based on the longitudinal data of healthy infants, followed from birth until the age of 4 years. Most prevention pro-grams are applicable from the age of approximately two years. Thereby most children are presented to the pediatrician at the moment their weight is already out-side the normal range. Accordingly, we created a prediction model to detect the tendency of becoming overweight in childhood at a moment overweight has not been established. This model can be used in early childhood, in the first years of life. Such a model can provide the possibility to detect, whether the growth of an individual child still fits within the expected range of the growth velocity and thereby to detect if a child is at risk for an abnormal growth. Obesity prevention might then be possible already during the first years of life in the regular preventive health care program, coordinated by the Youth Health Care. Screening tools for deviated growth and body proportions are essential in a preventive program and can be used in the follow up of children.
We applied the prediction model to an overweight and non-overweight group to test our hypothesis. We compared our prediction model with 2 other methods to estimate (ab)normal growth of children: the often used weight for length growth chart and the BMI calculation. The prediction model can easily be used in the regular monitoring of children by the youth health care providers and thereby may reduce the incidence of obesity in childhood and thereby its comorbidities and health care costs. Especially in children overweight has to be prevented, because overweight and its co-morbidities will be one of the biggest health- and social care problems and costs in the future.
The full PhD thesis can be found here.