A thirty year trend in overweight and obesity in Dutch children

Introduction: National prevalence rates of overweight are an essential tool for monitoring trends and the potential impact of public health strategies. We assessed a thirty year trend in prevalence of overweight and obesity among a large population sample of Dutch children and children living in the major cities and the implications of the prevalence rates for growth monitoring. Methods: We used cross-sectional growth data of children aged 0-21 years from three Dutch nationwide surveys from 1980 (n=41,805), 1997 (n=14,500) and 2009 (n=10,129). Prevalence rates of overweight and obesity were based on the International Obesity Task Force (IOTF) cut-offs for body mass index (BMI) in kg/m2. Results: In 2009, 13% of the Dutch boys and 15% of the Dutch girls aged 2-21 years were overweight and 2% of the boys and girls were obese. Since 1980, this is a 2-3 fold increase in overweight and a 4-6 fold increase in obesity. This constitutes a 1.2-1.3 fold increase in overweight and a 1.4-2.0 fold increase in obesity since 1997. In the major cities, the overweight prevalence in children remained stable since 1997, at 14%. Discussion: We found a significant increasing trend in Dutch overweight and obesity rates overall, and a stabilization in the major cities. Due to this substantial rise in overweight and obesity, up-to-date growth references for BMI are no longer appropriate in the Netherlands as they may underestimate the problem. Instead, growth charts with the cut-offs proposed by the IOTF are currently in use.