title: Trends in a life threatening condition: morbid obesity in dutch, Turkish and Moroccan children in The Netherlands.
abstract: BACKGROUND
  Morbid obesity can be a life threatening condition. The aim of our study is to assess the trend in morbid obesity in The Netherlands among children of Dutch origin since 1980, and among children of Turkish and Moroccan origin since 1997.
  
  
  RESULTS
  Cross-sectional height and weight data of children of Dutch, Turkish and Moroccan origin aged 2-18 years were selected from three national Dutch Growth Studies performed in 1980, 1997 and 2009 (n = 54,814). Extended international (IOTF) cut-offs in childhood were used to define morbid obesity (obesity class II and III combined). The morbidity index for overweight was calculated as the prevalence of morbid obesity divided by the prevalence of overweight. Our study showed that the prevalence of morbid obesity in children of Dutch origin was 0.59% in boys and 0.53% in girls in 2009. Significant upward trends occurred since 1980 and 1997. The prevalence was three to four fold higher in Turkish children compared to Dutch children. The Turkish children also had an upward trend since 1997, but this was only statistically significant in boys. The prevalence of morbid obesity in Moroccan children was two to three fold higher than in Dutch children, but it remained almost stable between 1997 and 2009. The Dutch and Turkish children showed an upward trend in morbidity index for overweight since respectively 1980 and 1997, while the Moroccan children showed a downward trend since 1997. In 2009, children of low educated parents had the highest prevalence rates of morbid obesity; 1.06% in Dutch, 2.11% in Turkish and 1.41% in Moroccan children.
  
  
  CONCLUSIONS
  An upward trend of morbid obesity in Dutch and Turkish children in The Netherlands occurred. Monitoring and reducing the prevalence of childhood morbid obesity is of high importance for these children, health care and the community.
authors.affiliation: Department of Life Style, TNO, Leiden, The Netherlands.
authors.forename: Paula
authors.initials: P
authors.lastname: van Dommelen
authors.affiliation: Department of Child Health, TNO, Leiden, The Netherlands.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Schönbeck
authors.affiliation: Department of Life Style, TNO, Leiden, The Netherlands; Department of Methodology and Statistics, University Utrecht, Utrecht, The Netherlands.
authors.forename: Stef
authors.initials: S
authors.lastname: van Buuren
authors.affiliation: EMGO Institute of Health Care Research, VU University Medical Centre Amsterdam, Amsterdam, The Netherlands.
authors.forename: Remy A
authors.initials: RA
authors.lastname: HiraSing
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D009018:Morocco / Q000208:ethnology; D009426:Netherlands / Q000453:epidemiology / Q000208:ethnology; D009767:Obesity, Morbid / Q000453:epidemiology* / Q000208:ethnology*; D015995:Prevalence; D014421:Turkey / Q000208:ethnology
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