Pétur Benedikt Júlíusson

Overweight and obesity in Norwegian children: prevalence and socio-demographic risk factors

Aim:  The aim of this study was to estimate the prevalence of childhood overweight and obesity and to identify socio‐demographic risk factors in Norwegian children.

Growth of Belgian and Norwegian children compared to the WHO growth standards: prevalence below −2 and above +2 SD and the effect of breastfeeding

Background New national growth references have been published in Belgium and Norway. The WHO recommends universal use of their 2006 Child Growth Standards based on data from breastfed children. Objective To compare the growth of Belgian and Norwegian children with the WHO standards. Participants 6985 children 0–5 years of age from Belgium and Norway. Design Proportion of children below −2 SD and above +2 SD of the WHO standards was calculated for length/height, weight, body mass index and head circumference. Average SD scores of exclusively breastfed children of non-smoking mothers were compared with national reference data and with the WHO standards. Results Generally, the number of Belgian and Norwegian children below −2 SD lines of the WHO standards was lower and above +2 SD higher than expected. The largest differences were for head circumference (0.97% Belgian and 0.18% Norwegian children below −2 SD, 6.55% Belgian and 6.40% Norwegian children above +2 SD) and the smallest for length/height (1.25% Belgian and 1.43% Norwegian children below −2 SD, 3.47% Belgian and 2.81% Norwegian children above +2 SD). The growth pattern of breastfed children of non-smoking mothers was in both countries more alike the local national growth references than the WHO standards. Conclusions There are significant deviations in the proportion of children outside normal limits (±2 SD) of the WHO standards. This was true for all children, including those who were exclusively breastfed. Hence, adoption of the WHO growth charts could have consequences for clinical decision-making. These findings advocate the use of national references in Belgium and Norway, also for breastfed children.

Growth references for Norwegian children

BACKGROUND The growth charts currently used in Norway, are based on measurements from the 1970s and 80s. New data are available from the Bergen Growth Study collected in 2003 - 6. In 2006, WHO published international charts for 0-5 year-old children. MATERIAL AND METHODS New growth charts based on data from the Bergen Growth Study and the Medical Birth Registry of Norway are presented for children aged 0-19 years. These were compared with existing references and with the WHO curves. RESULTS Norwegian children aged 0-4 years have length, height and weight measurements that are only marginally different from those in the Norwegian growth charts in current use. In older children there has been an increase in the 50-percentile for height up to 3.4 cm in boys and 2.5 cm in girls. For children older than four years, weight for height has increased, especially for the upper percentiles. The percentile lines in the new Norwegian reference are generally positioned above the WHO standard for weight at birth, and for length/height, weight and head circumference in the age group 6 months to 5 years. INTERPRETATION The secular trends in growth mirror the need for new charts. The fact that Norwegian children differ from the WHO standards may reflect population differences relating to environment or growth potential between the populations.

Clinical Spectrum of SIX3-Associated Mutations in Holoprosencephaly: Correlation between Genotype, Phenotype, and Function.

Background: Holoprosencephaly (HPE) is the most common structural malformation of the human forebrain. There are several important HPE mutational target genes, including the transcription factor SIX3, which encodes an early regulator of Shh, Wnt, Bmp and Nodal signalling expressed in the developing forebrain and eyes of all vertebrates. Objective: To characterise genetic and clinical findings in patients with SIX3 mutations. Methods: Patients with HPE and their family members were tested for mutations in HPE-associated genes and the genetic and clinical findings, including those for additional cases found in the literature, were analysed. The results were correlated with a mutation-specific functional assay in zebrafish. Results: In a cohort of patients (n = 800) with HPE, SIX3 mutations were found in 4.7% of probands and additional cases were found through testing of relatives. In total, 138 cases of HPE were identified, 59 of whom had not previously been clinically presented. Mutations in SIX3 result in more severe HPE than in other cases of non-chromosomal, non-syndromic HPE. An over-representation of severe HPE was found in patients whose mutations confer greater loss of function, as measured by the functional zebrafish assay. The gender ratio in this combined set of patients was 1.5:1 (F:M) and maternal inheritance was almost twice as common as paternal. About 14% of SIX3 mutations in probands occur de novo. There is a wide intrafamilial clinical range of features and classical penetrance is estimated to be at least 62%. Conclusions: Our data suggest that SIX3 mutations result in relatively severe HPE and that there is a genotype–phenotype correlation, as shown by functional studies using animal models.

Overweight and obesity in Norwegian children: Secular trends in weight‐for‐height and skinfolds

Aim: The prevalence of overweight and obesity in paediatric populations has been rapidly increasing in many countries over the past decades. The aims of the present study were to provide new data on weight‐for‐height and skinfolds, and to compare these to growth references for children between 3 and 17 years, collected in the same city between 1971 and 1974.

Growth references for 0–19 year-old Norwegian children for length/height, weight, body mass index and head circumference

Background: Previous growth references for Norwegian children were based on measurements from the 1970s and 1980s. New reference data, collected through the Bergen Growth Study and the Medical Birth Registry of Norway, are presented as LMS values. Materials and methods: A cross-sectional sample of children aged 0–19 years in stratified randomized design measured in 2003–2006 as a part of the Bergen Growth Study (n = 7291) and birth data of children born in 1999–2003 from the Medical Birth Registry of Norway (n = 12 576) was used to estimate the new references by the means of the LMS method. Measurement reliability was assessed by test-rest studies. Results: New references were constructed for length/height, weight, body mass index (BMI) and head circumference. Length/height and weight for children aged 0–4 years were similar to previous Norwegian references, but mean height increased up to a maximum of 3.4 cm in boys and 2.5 cm in girls during the pubertal years. Mean height was similar to (or slightly higher) in comparison with other recent European references. Reliability of the measurements compared well with published estimates. Conclusion: Because of the observed secular trends in growth, it is advised to use the new references, which have been endorsed by the Norwegian Department of Health.

Feeding problems, growth and nutritional status in children with cerebral palsy.

Aim:  The aim was to estimate the prevalence of feeding and nutritional problems in children with cerebral palsy (CP) in Norway.

Waist circumference and waist‐to‐height ratio in Norwegian children 4–18 years of age: Reference values and cut‐off levels

Aim:  To establish reference values for waist circumference and waist‐to‐height ratio of Norwegian children.

The impact of continuous subcutaneous insulin infusion on health-related quality of life in children and adolescents with type 1 diabetes

Aim: To study the impact of continuous subcutaneous insulin infusion (CSII) therapy on health‐related quality of life in children and adolescents with type 1 diabetes. Methods: 31 children and adolescents with poorly regulated type 1 diabetes (mean HbA1c 10.4%, SD 1.8), mean age 14.4 (1.5) y (range 9.7–17.1) and mean diabetes duration of 6.8 (3.2) y (range 1.3–14.6) were consecutively assigned to CSII therapy. Data for generic (CHQ‐CF87) and diabetes‐specific quality of life (DQOL) were obtained before initiating pump therapy and twice during 15 mo of treatment. HbA1c, BMI and episodes of severe hypoglycaemia and ketoacidosis were recorded over 15 mo prior to and 15 mo during pump therapy. Results: Analysis showed improvements on the family activity scale (p=0.041) and change in health score (p=0.042) (CHQ‐CF87). Mean HbA1c decreased from 10.4% (1.8) to 9.0% (0.9) after 3 mo, increasing to 9.6% (1.2) after 15 mo. The number of overweight and obese children increased from 4 and 2 before CSII, to 6 and 3 after 15 mo (IOTF criteria). There was a reduction in severe hypoglycaemia episodes from 43.8 to 5.2 per 100 patient years, but no change in ketoacidosis episodes.

TV viewing and obesity among Norwegian children: the importance of parental education.

To analyse the effect of lifestyle factors on the prevalence of overweight and obesity in 6–15‐year‐old Norwegian children.