Abstract
Since 1858, an increase of mean stature has been observed in the Netherlands, reflecting the improving nutritional, hygienic, and health status of the population. In this study, stature, weight, and pubertal development of Dutch youth, derived from four consecutive nationwide cross-sectional growth studies during the past 42 y, are compared to assess the size and rate of the secular growth change. Data on length, height, weight, head circumference, sexual maturation, and demographics of 14 500 boys and girls of Dutch origin in the age range 0–20 y were collected in 1996 and 1997. Growth references for height and weight were constructed with a method that summarizes the distribution by three smooth curves representing skewness (L curve), the median (M curve), and coefficient of variation (S curve). The relationship between height and demographic variables was assessed by multivariate analysis. Reference curves for menarche and secondary sex characteristics were estimated by a generalized additive model using a logit transformation. A positive secular growth change has been present in the past 42 y for children, adolescents, and young adults of Dutch origin, although at a slower rate in the last 17 y. Height differences according to region, educational level of child and parents, and family size have remained. In girls, median age at menarche has decreased by 6 mo during the past four decades to 13.15 y. Environmental conditions have been favorable for many decades in the Netherlands, and the positive secular change in height has not yet come to a halt, in contrast to Scandinavian countries. Main contributors to the increase in height may be improved nutrition, child health, and hygiene, and a reduction of family size.
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Abbreviations
- SDS:
-
standard deviation score
- LMS:
-
the data distribution is summarized by the L, M, and S curves
- QQ plot:
-
quantile–quantile plot
- G:
-
genital development
- PH:
-
pubic hair
- B:
-
breast development
- M:
-
menarche
- P10:
-
P50, P90, 10th, 50th, and 90th percentile
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Acknowledgements
This study was performed in co-operation with the Well Baby Clinics and Municipal Health Services. The authors thank the participating schools and universities, the Koninklijke Landmacht, and the Evangelische Omroep. We thank Prof. Dr. J.C. van Wieringen for reviewing the manuscript, Dr. R. Brand for his helpful statistical suggestions, and the advisers of the supervisory committee. We also thank E.M. Huijvenaar and A.M. Zondag for their work on the nonresponder data.
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This study was financially supported by The Ministry of Health, Welfare and Sports, Health Research and Development Counsel and Prevention, Nutricia, and Pharmacia & Upjohn.
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Fredriks, A., van Buuren, S., Burgmeijer, R. et al. Continuing Positive Secular Growth Change in the Netherlands 1955–1997. Pediatr Res 47, 316–323 (2000). https://doi.org/10.1203/00006450-200003000-00006
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DOI: https://doi.org/10.1203/00006450-200003000-00006
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