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Open Access Highly Accessed Research article

Comorbidities of obesity in school children: a cross-sectional study in the PIAMA birth cohort

Alet H Wijga1*, Salome Scholtens124, Wanda JE Bemelmans1, Johan C de Jongste3, Marjan Kerkhof4, Maarten Schipper5, Elisabeth A Sanders6, Jorrit Gerritsen7, Bert Brunekreef2 and Henriette A Smit18

Author Affiliations

1 Centre for Prevention and Health Services Research, National Institute for Public Health and the Environment, Bilthoven, The Netherlands

2 Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands

3 Department of Pediatrics, Division of Respiratory Medicine, Erasmus MC - Sophia, Rotterdam, The Netherlands

4 Department of Epidemiology and Bioinformatics, University of Groningen, Groningen, the Netherlands

5 Expertise Centre for Methodology and Information Services, National Institute for Public Health and the Environment, Bilthoven, The Netherlands

6 Department of Pediatric Immunology & Infectious Diseases, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands

7 Beatrix Children's Hospital, University Medical Centre, University of Groningen, Groningen, The Netherlands

8 Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands

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BMC Public Health 2010, 10:184  doi:10.1186/1471-2458-10-184

Published: 9 April 2010



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.


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.


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.


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.