title: Comorbidities of obesity in school children: a cross-sectional study in the PIAMA birth cohort.
abstract: BACKGROUND
  There is ample evidence that childhood overweight is associated with increased risk of chronic disease in adulthood. The aim of this study was to investigate associations between childhood overweight and common childhood health problems.
  
  
  METHODS
  Data were used from a general population sample of 3960 8-year-old children, participating in the Dutch PIAMA birth cohort study. Weight and height, measured by the investigators, were used to define BMI status (thinness, normal weight, moderate overweight, obesity). BMI status was studied cross-sectionally in relation to the following parental reported outcomes: a general health index, GP visits, school absenteeism due to illness, health-related functional limitations, doctor diagnosed respiratory infections and use of antibiotics.
  
  
  RESULTS
  Obesity was significantly associated with a lower general health score, more GP visits, more school absenteeism and more health-related limitations, (adjusted odds ratios around 2.0 for most outcomes). Obesity was also significantly associated with bronchitis (adjusted odds ratio (aOR) and 95% confidence intervals (95%CI): 5.29 (2.58;10.85) and with the use of antibiotics (aOR (95%CI): 1.79 (1.09;2.93)). Associations with flu/serious cold, ear infection and throat infection were positive, but not statistically significant. Moderate overweight was not significantly associated with the health outcomes studied.
  
  
  CONCLUSIONS
  Childhood obesity is not merely a risk factor for disease in adulthood, but obese children may experience more illness and health related problems already in childhood. The high prevalence of the outcomes studied implies a high burden of disease in terms of absolute numbers of sick children.
authors.affiliation: Centre for Prevention and Health Services Research, National Institute for Public Health and the Environment, Bilthoven, The Netherlands. alet.wijga@rivm.nl
authors.forename: Alet H
authors.initials: AH
authors.lastname: Wijga
authors.forename: Salome
authors.initials: S
authors.lastname: Scholtens
authors.forename: Wanda J E
authors.initials: WJ
authors.lastname: Bemelmans
authors.forename: Johan C
authors.initials: JC
authors.lastname: de Jongste
authors.forename: Marjan
authors.initials: M
authors.lastname: Kerkhof
authors.forename: Maarten
authors.initials: M
authors.lastname: Schipper
authors.forename: Elisabeth A
authors.initials: EA
authors.lastname: Sanders
authors.forename: Jorrit
authors.initials: J
authors.lastname: Gerritsen
authors.forename: Bert
authors.initials: B
authors.lastname: Brunekreef
authors.forename: Henriette A
authors.initials: HA
authors.lastname: Smit
mesh_terms: D001724:Birth Weight; D002648:Child; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D008297:Male; D008430:Maternal-Child Health Centers / Q000706:statistics & numerical data; D009035:Mothers; D009426:Netherlands / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology*; D016017:Odds Ratio; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D012307:Risk Factors