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Chapter 1
General introduction
A big problem!
Overweight and obesity among children and adolescents in the Netherlands are increasing public health problems. The Fifth Dutch Growth Study (conducted 2008-2010), shows that 13% of Dutch children were overweight and 2-3% obese (see Figure 1) (1). The prevalence of overweight (including obesity) remains a large problem especially in certain ethnic subgroups. Only in children of Dutch origin the prevalence declined between 1999 and 2011 (2).
40
35
30
25
20
15
10
5 0
Boys
Dutch
Girls
Boys Girls
Turkish
1999
Boys Girls
Moroccan
2007 2011
Boys Girls
Surinamese South Asian
Figure 1: Prevalence of overweight (including obesity) in the Netherlands (1).
Causes of overweight and obesity in youth
Overweight and obesity (from now on obesity) is a multi-factorial disorder, a result of various interactions between personal, lifestyle, environmental and genetic factors (3,4). The epidemic of obesity is caused largely by an environment that promotes excessive and unhealthy food intake and sedentary behaviour and discourages physical activity (5). Unhealthy food intake includes sugar-containing beverages, increasing portion sizes for prepared foods and fast food service. In addition, the current environment plays a role in discouraging physical activity and promote sedentary behaviour. Nowadays there is an enormous increase in the number of hours children spend online, for example to play computer games or watching television. The rapid increase in obese adolescents suggests that environmental factors may play a greater role than genetic factors (6,7).
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