title: Obesity in asylum seekers' children in The Netherlands--the use of national reference charts.
abstract: BACKGROUND
  Growth assessment can be used to monitor health at individual and population level. For asylum seekers' children with different geographic backgrounds, growth reference values are frequently not available. We assessed nutritional condition and growth of asylum seekers' children upon arrival and follow-up in The Netherlands, using national growth charts, and related these parameters to geographic origin.
  
  
  METHODS
  Height and weight of 135 children originating from Africa (n=47), Central Asia (n=41), and Eastern Europe (n=47), were assessed longitudinally (median follow-up 3 years, range 1-8 years). Body-mass-index (BMI) was calculated, and overweight and obesity were defined according the international BMI cut-off values for age and gender.
  
  
  RESULTS
  Upon arrival at a median age of 4.5 years (range 0-11.5 years), 13% of the children were small for age (below -2 SD of the Dutch height for age reference), which decreased to 5% during follow-up (P<0.05). During follow-up, 90% of the height measurements in boys and 85% in girls were within the normal range (+/-2 SD) of the Dutch references. The proportion of children with overweight including obesity increased from 15% at arrival to 21% during follow-up (P<0.05). Irrespective of age, children originating from Africa were taller than children from Central Asia or Eastern Europe at follow up (P<0.05). Overweight and obesity was most prominent among children of Eastern Europe.
  
  
  CONCLUSIONS
  Dutch national reference values allow monitoring growth and the development of overweight or obesity in asylum seekers' children in The Netherlands. Prevention strategies to reduce the development of overweight and obesity among these children seem warranted.
authors.affiliation: Medical Organisation Asylum Seekers North Netherlands, P.O. Box 584; 9700 AN Groningen, The Netherlands.
authors.forename: Annette A M
authors.initials: AA
authors.lastname: Stellinga-Boelen
authors.forename: P Auke
authors.initials: PA
authors.lastname: Wiegersma
authors.forename: Charles M A
authors.initials: CM
authors.lastname: Bijleveld
authors.forename: Henkjan J
authors.initials: HJ
authors.lastname: Verkade
mesh_terms: D000349:Africa / Q000208:ethnology; D001208:Asia / Q000208:ethnology; D002648:Child; D002657:Child Development / Q000502:physiology*; D002675:Child, Preschool; D005061:Europe, Eastern / Q000208:ethnology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology / Q000503:physiopathology; D012016:Reference Values; D012036:Refugees